Project

Community Youth Development Study (CYDS)

Project Description

The Community Youth Development Study began in 2003. It is a community-randomized trial of the effectiveness of the Communities That Care (CTC) prevention system. CTC is designed to help communities promote healthy youth development and reduce levels of youth drug use, violence, delinquency, teenage pregnancy, and school dropout. CTC is a science-based, operating system for planning and managing prevention activities at the community level. It empowers a community coalition of stakeholders to collect and use community-specific data on risk and protective factors to guide the selection of tested and effective prevention programs that address the community’s needs.

The study involves 12 pairs of matched communities across seven states randomly assigned to either receive training and technical assistance to implement CTC, or a control condition. Installation of CTC includes completion of five phases: 1) Get Started—assessing community readiness to undertake collaborative prevention efforts; 2) Get Organized—getting a commitment to the CTC process from community leaders and forming a diverse and representative prevention coalition; 3) Develop a Profile—using epidemiologic data to assess prevention needs and evaluating gaps in current services related to those needs; 4) Create a Plan—choosing tested and effective prevention policies, practices, and programs based on assessment data; and 5) Implement and Evaluate—implementing the new policies, programs, and practices with fidelity, in a manner congruent with the program’s theory, content, and methods of delivery, and evaluating progress over time.

During the first five years, the project demonstrated that the CTC intervention was implemented with fidelity; levels of adopting a science-based approach to prevention were significantly higher in CTC than control communities; and more tested and effective preventive programs were selected and well implemented in the CTC communities. Risk factors targeted by CTC communities decreased through 8th grade significantly more so in intervention than control communities. Furthermore, CTC reduced the incidence and prevalence of adolescent tobacco and alcohol use and prevented delinquent behavior community wide in CTC communities compared with those in control communities among a panel of youth followed from Grade 5 through Grade 8. Cost-benefit analysis found that by preventing the initiation of cigarette smoking and delinquency in adolescence, CTC returns $5.30 for every dollar invested.

In 2008, SDRG was awarded continuation funding to study the sustainability of the CTC coalitions and prevention programs implemented, to monitor prevention efforts in the control communities, and to assess the long-term effects of the CTC system on adolescent drug use, delinquency, and violence. The sustainability of CTC was examined six to nine years after CTC’s initial installation in the 24 study communities and 1 to 4 years after study-provided technical assistance and resources had ended. This phase of the study found that levels of adoption of a science-based approach to prevention remained significantly higher in CTC than control communities. One year after study-provided resources ended, targeted risk factors were still significantly lower when the panel of youth was in 10th grade. CTC also continued to reduce the incidence of delinquent behavior, alcohol use, and cigarette use and the prevalence of current cigarette use and past-year delinquent and violent behavior through 10th grade. At this point, 11 of the original 12 CTC coalitions were still active. Two years later, when communities had not received any support from the study for three years, 10 of the original 12 CTC coalitions were still active. CTC continued to prevent the initiation of delinquent and violent behavior, alcohol use, and cigarette use through 12th grade, but did not produce reductions in current levels of risk or current prevalence of problem behavior in Grade 12.