• By Dartington SRU
  • Posted on Friday 11th September, 2009

Coalition progress exceeds Washington's expectations

A community-based prevention system has reduced alcohol abuse, smoking and delinquent behavior among children between the ages of ten and 14 in over 20 US towns, says a new study by researchers from the University of Washington. Students in comparable towns where Communities that Care (CtC) was not implemented were 60% more likely to start using alcohol and 79% more likely to start smoking between ages 12 and 14. By the time children were 14 the incidence of drug abuse was also significantly higher in the control group areas. CtC also had an impact on levels of binge drinking. Published in the Archives of Pediatric and Adolescent Medicine, the study found that students in communities without the intervention were 41% more likely to become involved in delinquent behavior between the ages of ten and 14. They were also prone to find themselves in more kinds of trouble. Developed by David Hawkins and Richard Catalano from the Social Development Research Group at the University of Washington, Communities that Care is not in the traditional program mold. Instead, it provides a framework or “operating system” which communities use to select from a menu of evidence-based interventions. It also provides training and materials that are meant to mobilize and empower community coalitions to adopt science-based prevention programs.As such, it does not focus on a single outcome, but on addressing common risk factors that predict various later problems such as drug abuse and delinquency. The system has been implemented in the US, the UK, the Netherlands, Canada and Australia. Previous trials have shown promising signs, but have not used experimental methods. In the latest study, the research team were able to randomly assign communities to implement the CtC system, or to carry on as normal. They paired 24 from across Colorado, Illinois, Kansas, Maine, Oregon, Utah and Washington according to population size, ethnic diversity, prosperity and crime rates. The toss of a coin decided which would receive CtC and which would not. Evidence-based programs were implemented gradually over the course of the four-year study. On average, communities put three new programs into action annually. Menu choices included school-based curricula such as All Stars, Life Skills Training and Olweus Bullying Prevention; community programs such as Big Brothers Big Sisters and family-focused interventions such as Strengthening Families, Guiding Good Choices and Family Matters. The effect of CtC on alcohol and drug abuse, smoking and delinquency was judged using an annual panel survey of over 4,000 children in 88 schools between 2004 and 2007. To investigate the long-term effects of early intervention the research team hope to follow-up the panel’s progress a year after they would normally graduate from high school. The evaluation marks a tentative victory for prevention science. Programs have been shown to have impact on individuals when implementation has been supervised by researchers, but subsequent dissemination has had more limited success. The hypothesis that scaling up the effort would lead to community-wide effects has been largely untested until now. This new evidence on CtC suggests the theory holds water.Hence David Hawkins’s confident claim at yesterday’s Washington webcast: “We can have population effects in prevention. We now have the science to help us make wise choices.” [See: Maine people in normal hats rescue kids from drugs.]For a more guarded criminal justice perspective on the performance and limitations of CtC, see next week’s Prevention Action.See: Hawkins J D, Oesterle S, Brown E C, Arthur M W, Abbott R D, Fagan, A A and Catalano R F (2009), 'Results of a Type 2 Translational Research Trial to Prevent Adolescent Drug Use and Delinquency', Archives of Pediatrics and Adolescent Medicine, 163, 9, pp 790-798

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