The following studies were not included in rating CTC on the Scientific Rating Scale...

Hawkins, J. D., Brown, E. C., Oesterle, S., Arthur, M. W., Abbot, R. D., & Catalano, R. F. (2008). Early effects of Communities That Care on targeted risks and initiation of delinquent behavior and substance use. Journal of Adolescent Health, 43(1), 15–22. https://doi.org/10.1016/j.jadohealth.2008.01.022

The purpose of this randomized controlled trial was to assess the effects of Communities That Care (CTC) on reducing levels of targeted risk factors and reducing initiation of delinquent behavior and substance use in seventh grade, 1.67 years after implementing preventive interventions selected through the CTC process. Communities were selected from a larger pool of matched pairs of communities in seven states (Colorado, Illinois, Kansas, Maine, Oregon, Utah, and Washington) that participated in a naturalistic study of prevention. One community from within each matched pair was randomly assigned by coin toss to either intervention (CTC) or control condition. Measures utilized include the Youth Development Survey. Results indicate mean levels of targeted risks for students in seventh grade were significantly lower in CTC communities compared with controls. Significantly fewer students in CTC communities than in control communities initiated delinquent behavior between grades 5 and 7. No significant intervention effect on substance use initiation by spring of seventh grade was observed. Limitations include that the study relies on self-reports of young people regarding risk exposure and behavior, the study includes only small to moderate-sized towns in seven states and generalizability due to the present study not providing data on the efficacy of CTC in larger cities. Note: This study was not used for rating Communities that Care (CTC) in the Place-Based Initiatives (Child & Adolescent) topic area because it did not study outcomes related to children maltreatment as defined in the topic area definition.

Hawkins, J. D., Oesterle, S., Brown, E. C., Arthur, M. W., Abbot, R. D., Fagan, A. A., & Catalano, R. F. (2009). Results of a type 2 translational research trial to prevent adolescent drug use and delinquency: A test of Communities That Care. Archives of Pediatric Adolescent Medicine, 163(9), 789–798. https://doi.org/10.1001/archpediatrics.2009.141

This study uses the same population as Hawkins et al. (2008). The purpose of this randomized controlled trial was to test whether the Communities That Care (CTC) prevention system reduces adolescent alcohol, tobacco, and other drug use and delinquent behavior communitywide. Twenty-four small towns in 7 states, matched within state, were randomly assigned to control or CTC conditions. Measures utilized include the Youth Development Survey. Results indicate the incidences of alcohol, cigarette and smokeless tobacco initiation, and delinquent behavior were significantly lower in CTC than in control communities for students in grades 5 through 8. In grade 8, the prevalence of alcohol and smokeless tobacco use in the last 30 days, binge drinking in the last 2 weeks, and the number of different delinquent behaviors committed in the last year were significantly lower for students in CTC communities. Limitations include that the study relies on self-reports of young people regarding risk exposure and behavior, the study includes only small to moderate-sized towns in seven states, and generalizability due to the present study not providing data on the efficacy of CTC in larger cities. Note: This study was not used for rating Communities that Care (CTC) in the Place-based Initiatives (Child & Adolescent) topic area because it did not study outcomes related to children maltreatment as defined in the topic area definition.

Hawkins, J. D., Oesterle, S., Brown, E. C., Monahan, K. C., Abbott, R. D., Arthur, M. W., & Catalano, R. F. (2012). Sustained decreases in risk exposure and youth problem behaviors after installation of the Communities That Care prevention system in a randomized trial. Archives of Pediatrics & Adolescent Medicine, 166(2), 141–148. https://doi.org/10.1001/archpediatrics.2011.183

This study uses the same population as Hawkins et al. (2008). The purpose of this randomized controlled trial was to test whether the Communities That Care (CTC) prevention system reduced levels of risk and adolescent problem behaviors community-wide 6 years after installation of CTC and 1 year after study-provided resources ended. Twenty-four small towns in 7 states, matched within state, were randomly assigned to control or CTC conditions. Measures utilized include the Youth Development Survey. Results indicate mean levels of targeted risks increased less rapidly between grades 5 and 10 in CTC than in control communities and were significantly lower in CTC than control communities in grade 10. The incidence of delinquent behavior, alcohol use, and cigarette use and the prevalence of current cigarette use and past-year delinquent and violent behavior were significantly lower in CTC than in control communities in grade 10. Limitations include that the study relies on self-reports of young people regarding risk exposure and behavior, the study includes only small to moderate-sized towns in seven states, and generalizability due to the present study not providing data on the efficacy of CTC in larger cities. Note: This study was not used for rating Communities that Care (CTC) in the Place-based Initiatives (Child & Adolescent) topic area because it did not study outcomes related to children maltreatment as defined in the topic area definition.

Brown, E. C., Hawkins, J. D., Rhew, I. C., Shapiro, V. B., Abbott, R. D., Oesterle, S., Arthur, M. W., Briney, J. S., & Catalano, R. F. (2014). Prevention system mediation of Communities That Care effects on youth outcomes. Prevention Science, 15, 623–632. https://doi.org/10.1007/s11121-013-0413-7

This study uses the same population as Hawkins et al. (2008). The purpose of this randomized controlled trial was to examine whether the significant intervention effects of the Communities That Care (CTC) prevention system on youth problem behaviors observed in a panel of eighth-grade students were mediated by community-level prevention system constructs posited in the CTC theory of change. Twenty-four small towns in 7 states, matched within state, were randomly assigned to control or CTC conditions. Measures utilized include the Youth Development Survey and the Community Key Informant Survey. Results indicate higher levels of community adoption of a science-based approach to prevention and support for prevention in 2004 predicted significantly lower levels of youth problem behaviors in 2007, and higher levels of community norms against adolescent drug use predicted lower levels of youth drug use in 2007. Effects of the CTC intervention on youth problem behaviors by the end of eighth grade were mediated fully by community adoption of a science-based approach to prevention. No other significant mediated effects were found. Limitations include that the communities did not represent a random selection of communities and the community leader respondents represented a select group of individuals in their communities, which may limit the generalizability of findings from this study; and the exclusive reliance on self-report survey data, both from key community leaders and from the panel of students. Note: This study was not used for rating Communities that Care (CTC) in the Place-based Initiatives (Child & Adolescent) topic area because it did not study outcomes related to children maltreatment as defined in the topic area definition.

Oesterle, S., Hawkins, J. D., Kuklinski, M. R., Fagan, A. A., Fleming, C., Rhew, I. C., Brown, E. C., Abbott, R. D., & Catalano, R. F. (2015). Effects of Communities That Care on males' and females' drug use and delinquency 9 years after baseline in a community-randomized trial. American journal of community psychology, 56(3-4), 217–228. https://doi.org/10.1007/s10464-015-9749-4

This study uses the same population as Hawkins et al. (2008). The purpose of this randomized controlled trial was to test sustained effects of the Communities That Care (CTC) prevention system on health-risking behaviors 9 years after baseline in a community-randomized trial involving 24 towns in seven states. Twenty-four small towns in 7 states, matched within state, were randomly assigned to control or CTC conditions. Measures utilized include the Youth Development Survey. Results indicate CTC had a significant overall effect across lifetime measures of the primary outcomes for males, but not for females or the full sample, although lifetime abstinence from delinquency in the full sample was significantly higher in CTC communities. Males in CTC communities also continued to show greater lifetime abstinence from cigarette smoking. CTC did not have a sustained effect on current substance use and delinquency, nor did it improve the secondary outcomes at age 19 for either gender. Limitations include findings may not generalize to suburban and urban cities and locations in other parts of the United States, such as the south; power to detect meaningful gender interactions may have been limited; and behavioral outcomes were measured by youth self-reports, which may be biased by social desirability or dishonesty. Note: This study was not used for rating Communities that Care (CTC) in the Place-based Initiatives (Child & Adolescent) topic area because it did not study outcomes related to children maltreatment as defined in the topic area definition.

Oesterle, S., Kuklinski, M. R., Hawkins, J. D., Skinner, M. L., Guttmannova, K., & Rhew, I. C. (2018). Long-term effects of the communities that care trial on substance use, antisocial behavior, and violence through age 21 years. American Journal of Public Health, 108(5), 659–665. https://doi.org/10.2105/AJPH.2018.304320

This study uses the same population as Hawkins et al. (2008). The purpose of this randomized controlled trial was to evaluate whether the effects of the Communities That Care (CTC) prevention system, implemented in early adolescence to promote positive youth development and reduce health-risking behavior, endured through age 21 years. Twenty-four small towns in 7 states, matched within state, were randomly assigned to control or CTC conditions. Measures utilized include the Youth Development Survey. Results indicate the CTC system increased the likelihood of sustained abstinence from gateway drug use by 49% and antisocial behavior by 18%, and reduced lifetime incidence of violence by 11% through age 21 years. In male participants, the CTC system also increased the likelihood of sustained abstinence from tobacco use by 30% and marijuana use by 24%, and reduced lifetime incidence of inhalant use by 18%. No intervention effects were found on past-year prevalence of these behaviors. Limitations include that the findings may not generalize to suburban and urban cities and locations in other parts of the United States, such as the south; CTC system reduced lifetime incidence but not current substance use, antisocial behavior, and violence at age 21 years; and reliance on self-reported measure. Note: This study was not used for rating Communities That Care (CTC) in the Place-based Initiatives (Child & Adolescent) topic area because it did not study outcomes related to children maltreatment as defined in the topic area definition.

Kuklinski, M. R., Oesterle, S., Briney, J. S., & Hawkins, J. D. (2021). Long-term impacts and benefit–cost analysis of the Communities That Care prevention system at age 23, 12 years after baseline. Prevention Science, 22(4), 452–463. https://doi.org/10.1007/s11121-021-01218-7

This study uses the same population as Hawkins et al. (2008). The purpose of this randomized controlled trial was to estimate sustained impacts and long-term benefits and costs of the Communities That Care (CTC) prevention system which was implemented and evaluated in a longitudinal cluster-randomized trial involving 24 communities in seven states. Twenty-four small towns in 7 states, matched within state, were randomly assigned to control or CTC conditions. Measures utilized include the Youth Development Survey and the Patient Health Questionnaire (PHQ-9). Results indicate CTC had a statistically significant global effect on primary outcomes and on combined primary and secondary outcomes. Among primary outcomes, point estimates suggested absolute improvements in lifetime abstinence of 3.5 to 6.1% in the intervention arm and relative improvements of 13 to 55%; 95% confidence intervals revealed some uncertainty in estimates. Among secondary outcomes, 4-year college completion was 1.9% greater among young adults from intervention communities, a 20% relative improvement. Mental health outcomes were approximately the same across trial arms. Although CTC had small, sustained effects through age 23, benefit–cost analyses (BCA) indicated CTC was reliably cost beneficial, with a net present value of $7152 (95% credible interval: $1253 to $15,268) per participant from primary impacts and $17,919 ($306 to $39,186) when secondary impacts were also included. It remained cost beneficial even when impacts were adjusted downward due to the involvement of CTC’s developer in the trial. Limitations include that the findings may not generalize to urban cities and other states and regions not represented and BCA results are expected values from a complex simulation model developed primarily for use in Washington State policymaking, not actual benefit. Note: This study was not used for rating Communities That Care (CTC) in the Place-based Initiatives (Child & Adolescent) topic area because it did not study outcomes related to children maltreatment as defined in the topic area definition.