Early effects of Communities That Care on targeted risks and initiation of delinquent behavior and substance use.

PURPOSE Communities That Care (CTC) is a prevention system designed to reduce levels of adolescent delinquency and substance use through the selection and use of effective preventive interventions tailored to a community's specific profile of risk and protection. This article describes early findings from the first group-randomized trial of CTC. METHODS A panel of 4407 fifth-grade students was surveyed annually through seventh grade. Analyses were conducted to assess the effects of 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. RESULTS 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. CONCLUSIONS CTC's theory of change hypothesizes that it takes from 2 to 5 years to observe community-level effects on risk factors and 5 or more years to observe effects on adolescent delinquency or substance use. The early findings indicating hypothesized effects of CTC on targeted risk factors and initiation of delinquent behavior are promising.