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Prevention Science

, Volume 20, Issue 6, pp 947–958 | Cite as

Public Health Benefits 16 Years After a Statewide Policy Change: Communities That Care in Pennsylvania

  • Sarah M. ChilenskiEmail author
  • Jennifer Frank
  • Nicole Summers
  • Daphne Lew
Article

Abstract

Communities That Care (CTC), an evidence-based prevention system, has been installed outside of a research context in over 500 communities worldwide. Yet, its effectiveness in a non-research context is unknown. Using a repeated cross-sectional design with propensity score weighting at the school district-level, the purpose of this study was to examine the effect of widespread diffusion of CTC across Pennsylvania on adolescent substance use, delinquency, and depression. Anonymous youth survey data were collected from 6th, 8th, 10th, and 12th grade students every other year from 2001 to 2011. Three-hundred eighty-eight school districts participated in one to six waves of data collection during that time, resulting in a total of 470,798 student-reported observations. The intervention school districts received programming provided by CTC coalitions. Outcome measures were lifetime and past 30-day alcohol, tobacco, marijuana, and other drug use. Lifetime and past year participation in delinquency and current depressive symptoms were also analyzed. Analyses revealed that CTC school districts had significantly lower levels of adolescent substance use, delinquency, and depression. This effect was small to moderate, depending on the particular outcome studied. Overall effects became stronger after accounting for use of evidence-based programs; there are likely differences in implementation quality and other factors that contribute to the observed overall small effect size. Future research needs to unpack these factors.

Keywords

Communities That Care (CTC) Effectiveness Policy change Evidence-based programs Dissemination Outcomes 

Notes

Acknowledgments

We thank Damon Jones, PhD, Mark Feinberg, PhD, and Wayne Osgood, PhD, for consulting regarding the statistical models. We thank Donald Miller at the Programming Core in the Social Science Research Institute at Pennsylvania State University for conducting the statistical analyses.

Funding

Work on this paper was supported by the National Institute on Drug Abuse, grant 1R03DA034664-01A1.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

For this type of study, formal consent is not required.

Supplementary material

11121_2019_1028_MOESM1_ESM.docx (21 kb)
ESM 1 (DOCX 20 kb)

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Copyright information

© Society for Prevention Research 2019

Authors and Affiliations

  1. 1.Edna Bennett Pearce Prevention Research CenterThe Pennsylvania State UniversityState CollegeUSA
  2. 2.The Clearinghouse for Military Family ReadinessThe Pennsylvania State UniversityState CollegeUSA
  3. 3.Educational Psychology, Counseling, and Special EducationThe Pennsylvania State UniversityState CollegeUSA
  4. 4.Department of Population Science and PolicySouthern Illinois University School of MedicineSt. LouisUSA
  5. 5.School of Public HealthSaint Louis UniversitySt. LouisUSA

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