Community Interventions for Preventing Adolescent and Young Adult Substance Abuse

Background/Purpose: Community-based efforts offer broad potential for achieving population-level reductions in substance use and abuse among youth and young adults. This presentation reviews findings from controlled trials and quasi-experimental studies to identify key components of effective community level preventive interventions. Recent findings from the trial of the Communities That Care (CTC) prevention system are used to illustrate key components of effective community level preventive interventions identified through the review. Implications of findings for community level social work practice are discussed.

Methods:  A systematic review of 15 community level interventions designed to prevent adolescent and young adult substance abuse was conducted. Elements and processes of those interventions found to be effective in preventing adolescent and/or young adult substance use community-wide were identified. These key elements and processes are described as they operate in the implementation of the CTC prevention system, found to be effective in reducing the initiation of substance use, delinquency, and violence in a panel of 4407 students followed from grade 5 through grade 12 in a randomized trial of CTC involving 24 community in 7 states. The effects of CTC on cumulative initiation rates by grade 12 were assessed using the Generalized Linear Mixed Model. Multi-level discrete-time survival analyses were used to examine the effect of CTC on the hazard of initiating drug use, delinquency, and violence between grades 6 and 12.

Results: Two key findings emerged. First, a common feature of successful community focused prevention strategies is reliance on local coalitions to select and implement preventive interventions that have been tested and proven effective in changing factors that place youths at risk for engaging in substance use. Second, all community preventive interventions found effective in reducing substance use by youth younger than 18 years of age included a universal, school-based prevention curriculum in the larger community effort, even when these curricula were not required in the specifications for the original community level preventive intervention. Skills and competencies required to successfully implement an effective community prevention initiative were identified.

Conclusions/Implications: Key elements and processes of effective community level interventions for preventing adolescent and young adult substance abuse have been identified. These require important competencies and skills of local community prevention practitioners. If social workers are to be effectively involved in community level prevention work, schools of social work will need to include these key competencies and skills in their MSW curricula.