Transforming Community Prevention Service Systems to Reduce Adolescent Drug Use and Delinquency

Background/Purpose: The theory of change underlying the Communities That Care (CTC) prevention system posits that changing certain aspects of a community's prevention service system, such as adopting a science-based approach to prevention and increasing collaboration among service providers, will encourage the choice of tested-effective prevention programs and policies, lower risk and enhance protection in the community, and ultimately foster positive youth development. This study examines the relationships between four characteristics of a community prevention system and adolescent drug use and delinquent behavior: (1) adoption a scientific evidence-based approach to prevention programming, (2) collaboration on prevention-specific activities, (3) community support for prevention, and (4) community norms against adolescent drug use in communities. Methods/Results: This study uses data from community key informant surveys collected in 2004 (N = 340) and from a cohort of 8th-grade students surveyed in 2007 (N = 4,407) as part of a community-randomized controlled trial of CTC in 24 communities across 7 states. Statistical analyses were conducted as random coefficient models with students nested within communities. The models accounted for differences in student and community characteristics. Student characteristics included students' age, gender, race/ethnicity, parental education level, religious attendance, and rebelliousness. Community characteristics included the total number of students in the community and the percentage of students who were eligible for free or reduced-price school lunch. All four prevention system constructs were significantly (p < .05) associated with adolescent alcohol, cigarette, and illicit drug use, and delinquent behavior. Adoption of a scientific evidence-based approach was the strongest system-level predictor of adolescent outcomes. Many of these relationships were maintained, even after controlling statistically for whether communities were assigned to experimental (i.e., implementing CTC) or control condition. Conclusions/Implications: Results from this study suggest that increasing the adoption a scientific evidence-based approach to prevention programming, increasing collaboration among service providers, increasing community support for prevention, and increasing community norms against adolescent drug use in communities can be an effective strategy for the prevention of adolescent drug use and delinquency.