j. david hawkins ph.d. social development research group university of washington sdrg

1

Using Advances in Using Advances in Prevention Science to Prevention Science to

Guide Youth Guide Youth Development and Development and

Prevention of Problems Prevention of Problems in Communities.in Communities.

J. David Hawkins Ph.D.Social Development Research Group

University of Washington

www.sdrg.org

http://www.sdrg.org/

2

Presentation Presentation ObjectivesObjectives

•A science-based public health approach to prevention of adolescent problem behaviours.

•How can local agencies collaborate to apply the advances of prevention science to promote positive youth development and prevent problem behaviours?

3

History of Delinquency History of Delinquency Prevention in the U.S. Prevention in the U.S.

•Before 1980, nine experimental tests of delinquency prevention programs were conducted in the U.S.

NONE found desired effects in preventing delinquency. (Berleman, 1980)

4

Early Drug Abuse Early Drug Abuse Prevention Research Prevention Research

FindingsFindings

• Tested approaches were largely ineffective (Elmquist, 1995; Hanson, 1992; Moskowitz, 1989).

• Drug information programs increased drug use in some studies (Tobler, 1986).

5

The Premise of The Premise of Prevention SciencePrevention Science

To prevent a problem before it happens, the factors that predict the problem must be changed.

6

Advances in PredictionAdvances in Prediction

• Longitudinal studies have identified predictors of substance abuse-

Risk factors.

• AND predictors of positive outcomes including avoidance of health risk behaviors-

Promotive and protective factors.

7

Risk Factors for Risk Factors for Adolescent Problem BehaviorsAdolescent Problem Behaviors

Constitutional Factors

Early Initiation of the Problem Behavior

Favorable Attitudes Toward the Problem Behavior

Friends Who Engage in the Problem Behavior

Rebelliousness

Early and Persistent Antisocial Behavior

Individual/Peer

Dep

ressio

n &

A

nxie

ty

Vio

len

ce

Sch

ool D

rop

-O

ut

Teen

P

reg

nan

cy

Delin

qu

en

cy

Su

bsta

nce

Ab

use

Risk Factors

8

Risk Factors for Risk Factors for Adolescent Problem Adolescent Problem

BehaviorsBehaviors

Favorable Parental Attitudes and Involvement in the Problem Behavior

Family Conflict

Family Management Problems

Family History of the Problem Behavior

Family

Dep

ressio

n &

A

nxie

ty

Vio

len

ce

Sch

ool D

rop

-O

ut

Teen

P

reg

nan

cy

Delin

qu

en

cy

Su

bsta

nce

Ab

use

Risk Factors

9

Risk Factors for Risk Factors for Adolescent Problem Adolescent Problem

BehaviorsBehaviors

Lack of Commitment to School

Academic Failure Beginning in Late Elementary School

School

Dep

ressio

n &

A

nxie

ty

Vio

len

ce

Sch

ool D

rop

-Ou

t

Teen

Pre

gn

an

cy

Delin

qu

en

cy

Su

bsta

nce A

bu

se

Risk Factors

10

Risk Factors forRisk Factors forAdolescent Problem Adolescent Problem

BehaviorsBehaviors

Extreme Economic Deprivation

Low Neighborhood Attachment and Community Disorganization

Transitions and Mobility

Media Portrayals of Violence

Community Laws and Norms Favorable Toward Drug Use, Firearms, and Crime

Availability of Firearms

Availability of Drugs

Community

Dep

ressio

n &

A

nxie

ty

Vio

len

ce

Sch

ool D

rop

-O

ut

Teen

P

reg

nan

cy

Delin

qu

en

cy

Su

bsta

nce

Ab

use

Risk Factors

11

Promotive and Promotive and Protective Factors:Protective Factors:

• Individual Characteristics• High Intelligence• Resilient Temperament• Competencies and Skills

• In each social domain (family, school, peer group and neighborhood)• Prosocial Opportunities• Reinforcement for Prosocial Involvement• Bonding or Connectedness• Clear and Healthy Standards for

Behavior

12

Prevalence of Illicit Drug UsePrevalence of Illicit Drug Use(Past 30 Days)(Past 30 Days)

By Exposure to Risk and Protective By Exposure to Risk and Protective FactorsFactors

Six State Student Survey of 6th - 12th Graders,Public School Students

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 to 1 2 to 3 4 to 5 6 to 8 9 or More

Number of Risk Factors

Pre

vale

nce

0 to 1

2 to 3

4 to 5

6 to 8

Number of Protective Factors

13

Prevalence of “Attacked to Hurt”Prevalence of “Attacked to Hurt”By Risk and Protection LevelsBy Risk and Protection Levels

0%

10%

20%

30%

40%

50%

60%

Risk, Level0

Risk, Level1

Risk, Level2

Risk, Level3

Risk, Level4

Pre

vale

nce

Protection, Level 0

Protection, Level 1Protection, Level 2

Protection, Level 3Protection, Level 4

14

Prevalence of Academic SuccessPrevalence of Academic SuccessBy Number of Risk and Protective FactorsBy Number of Risk and Protective Factors

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 to 1 2 to 3 4 to 5 6 to 7 8 to 9 10+

Number of Risk Factors

Pre

vale

nce 0 to 1

2 to 34 to 56 to 78 to 9

Number of Protective

Factors

Six State Student Survey of 6th-12th Graders,Public School Students

15

What Is Known AboutWhat Is Known AboutRisk and ProtectionRisk and Protection

Risk & protective factors are found in communities, families, schools, peer groups and individuals.

The same risk & protective factors predict substance abuse, violence, and other health and behavior problems of youth.

Risk & protective factors show much consistency in effects across cultures, races and genders in samples from the US, Australia and the Netherlands.

The more risk factors present, the greater likelihood of substance abuse, violence, and other behavior problems and the less likelihood of positive outcomes.

Protective factors reduce effects of exposure to risk -- the greater the level of protection, the less likelihood of behavior problems.

16

Research Guiding PracticeResearch Guiding Practice

Malleable risk and protective factors identified through longitudinal studies should be targeted by preventive interventions.

17

Advances in PreventionAdvances in Prevention

Over the past 25 years, controlled trials have identified both ineffective and effective prevention policies and programs.

18

Ineffective StrategiesIneffective StrategiesNational Institute of JusticeNational Institute of Justice

o Didactic programs targeted on arousing fear (e.g. Scared Straight).

o D.A.R.E. o Peer counseling programs.o Segregating problem students into separate

groups.o After school activities with limited

supervision and absence of more potent programming.

o Summer jobs programs for at-risk youth.

National Institute of Justice, 1998

19

Effective Programs and Effective Programs and Policies Have Been Policies Have Been Identified in a Wide Identified in a Wide

Range of AreasRange of Areas1. Prenatal & Infancy

Programs

2. Early Childhood Education

3. Parent Training

4. After-school Recreation

5. Mentoring with Contingent Reinforcement

6. Youth Employment with Education

7. Organizational Change in Schools

8. Classroom Organization, Management, and Instructional Strategies

9. School Behavior Management Strategies

10. Classroom Curricula for Social Competence Promotion

11. Community & School Policies

12. Community Mobilization (Hawkins & Catalano, 2004)

20

Life Skills TrainingLife Skills Training

Description: Curriculum for social competence promotion and drug abuse prevention

Target: Students ages 11 to 14.

Contact: Gilbert Botvin, Ph.D., Director Institute for Prevention Research Cornell University Medical College411 East 69th Street, KB-201New York, NY, 10021 212-746-1270

21

Life Skills TrainingLife Skills TrainingMajor ComponentsMajor Components

• Drug Resistance Skills and Norms

• Self-Management Skills

• General Social Skills

Middle School Program

• 15 Class Periods (6th or 7th Grade)



23

Life Skills TrainingLife Skills Training

Evidence of Effect Evidence of Effect

• Reduces tobacco, alcohol, and marijuana use 50-75%.

• Effects maintained through grade 12.

• Cuts polydrug use up to 66%.

• Reduces pack-a-day smoking by 25%.

• Decreases use of inhalants, narcotics, and hallucinogens 25% to 55%.

24

Toward No Drug Abuse (TND)Toward No Drug Abuse (TND)

Description: Self-control/Social Competency Instruction, Drug Abuse Prevention

Target: All High School Youth (age 14-18) in Regular and Alternative High Schools

Contact: Steve Sussman, Ph.D. IPR-USC

1540 Alexander Street, CHP 209 Los Angeles, CA 90033

25

Program DeliveryProgram Delivery

• 12 classroom-based lessonsApproximately 40-50 minutes

each• Implemented over a 4-week

period (3-4 days per week)Option: twice a week for 6

weeks, if all lessons are taught.

26

Drug Use and Violence-Related Effects across Drug Use and Violence-Related Effects across the first 3 TND Evaluation Studies: Compares the first 3 TND Evaluation Studies: Compares

Reduction of Program Group(s) Relative to Reduction of Program Group(s) Relative to Control Group(s)Control Group(s)

Study 1 (AHS)

Study 2 (RHS)

Study 3 (AHS)

Cigarettes NS NS 27%

Alcohol 7% 12% 9%

Marijuana NS NS 22%

Hard Drugs 25% 25% 26%

Victimization*

23% 17% 6%

Weapon Carrying*

21% 19% 25%

Notes: AHS=alternative high schools; RHS=regular high schools; NS=not statistically significant; drug use refers to last 30 days; violence indicators refer to last 12 months; * = among males only

27

Toward No Drug AbuseToward No Drug AbuseEvidence of EffectEvidence of Effect

• Consistent and significant reductions in alcohol use and in hard drug use across studies through 1 year follow up.

• Consistent significant reductions in victimization and weapons carrying across studies.

28

Guiding Good ChoicesGuiding Good Choices(Preparing for the Drug Free (Preparing for the Drug Free

Years)Years)Description: Series of Five Two Hour Workshops for Parents

Target: Parents of children ages 9 to 14

Contact: J. David Hawkins & Richard Catalano University of Washington

Available from:Channing Bete Company

www.channing-bete.com

29

Guiding Good ChoicesGuiding Good Choices

• Strengthens parents’ skills to:

build family bonding,

establish and reinforce clear and consistent guidelines for children’s behavior,

teach children skills to resist peer influence,

improve family management practices, and

reduce family conflict.

30

Guiding Good ChoicesGuiding Good ChoicesEvidence of EffectsEvidence of Effects

Significantly reduced drug use through age 18.

Significantly reduced growth in delinquency through age 16.

Significantly reduced growth in depression through age 18.

Significantly reduced alcohol abuse among young women at age 22.

31

Steve Aos, Associate Director

Washington State Institute for Public PolicyPhone: (360) 586-2768

E-mail: [email protected] Publications: www.wa.gov/wsipp

Benefits and Costs of Benefits and Costs of Prevention and Early Prevention and Early

Intervention Programs for Intervention Programs for YouthYouth

32

Summary of Benefits and Costs (2003 Dollars)

Dollars Per Youth (PV lifecycle)

Benefits

Costs B - C

Guiding Good Choices $ 7,605 $ 687 $6,918

Life Skills Training $ 746 $ 29 $ 717

ExamplesExamples

Intensive Juv. Supervision $0 $ 1,482 -$1,482

33

Benefit-to-Cost Ratios:Benefit-to-Cost Ratios:Selected Programs*Selected Programs*

Program Return on $1.00 investment

Life Skills Training $25.61

Guiding Good Choices $11.07

*Washington Institute for Public Policy (2004)

34

Lists of Rigorously Tested and Lists of Rigorously Tested and Effective Youth Violence and Effective Youth Violence and Substance Abuse Prevention Substance Abuse Prevention

ApproachesApproaches•Blueprints for Violence Prevention

www.colorado.edu/cspv/blueprints/

•Communities That Care Prevention Strategies Guidehttp://preventionplatform.samhsa.gov

35

But…But…

Prevention approaches that do not work or have not been evaluated have been more widely used than those shown to be effective.

(Gottfredson & Gottfredson, 2002, Hallfors et al 2001, Ringwalt et al., 2002.)

36

Empowering Communities Empowering Communities to Prevent Youth to Prevent Youth Substance MisuseSubstance Misuse

•Youths in different neighborhoods and communities are exposed to different levels of risk and protection.

37

Distribution of Risk in a Distribution of Risk in a CityCity

J ohn A. Pollard , P h.D. Developmental Research and Programs

No studentsin this area.

Insuffic ient number ofstudents in this area.

Neighborhood #2

Neighborhood #1 Neighborhood #3

38

Madison Middle School Risk Profile 8th Grade

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pe

rce

nt

At

Ris

k

School 2002 District 2002

Community Family School

Survey Participation Rate 2002: 87.4%

2002

Estimated National Value

Peer-Individual

Madison Middle School Risk Profile 8th Grade 2002

39

Nova High School Risk Profile 10th Grade

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pe

rce

nt

At

Ris

k




2002

Peer-Individual


Peer-Individual

Nova High School Risk Profile 10th Grade 2002

40

The Goal for Community The Goal for Community

PreventionPrevention

To identify and address those risk factors that are most prevalent and those protective factors that are most suppressed with tested and effective policies and programs.

41

The The Communities That Communities That CareCare Prevention System Prevention System

• A coalition/board of diverse community stakeholders applies the advances of prevention science to guide youth development and prevention work.

• Measures community levels of protection and risk by surveying young people themselves.

• Matches the community’s profile of risk and protection with tested, effective programs and policies.

42

The The Communities That Communities That CareCare

Prevention SystemPrevention System• Ensures that new programs and

policies are implemented with fidelity

• Local control builds ownership to create sustainable change.

• Focuses on measured outcomes : Are fewer teens using drugs? Fewer smoking? Fewer committing violent acts?

43

The CThe Communities That Care ommunities That Care Operating SystemOperating System

Creating Communities

That Care

Get Started

Get Organized

Develop a ProfileCreate a Plan

Implement andEvaluate

44



That Care

Get Started

Get Organized



• Community readiness assessment.

• Identification of key individuals, stakeholders,

and organizations.

45



That Care

Get Started

Get Organized



• Training key leaders and board in CTC

• Building the community coalition.

46



That Care

Get Started

Get Organized



• Collect risk/protective factor and outcome data.

•Collect information on community resources

• Construct a community profile

from the data.

47

Madison Middle School Risk Profile 8th Grade

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Low Neig

hborh

ood A

ttachm

ent

Commun

ity Diso

rganiz

ation

Laws a

nd Norm

s Fav

orable

to Drug

Use

Perceiv

ed Ava

ilability

of Drug

s

Perceiv

ed Ava

ilability

of Han

dgun

s

Poor F

amily

Manag

emen

t

Family

Conflic

t

Family

History

of Anti

socia

l Beh

avior

Parenta

l Attit

udes

Favorab

le To

wards D

rug Use

Parenta

l Attit

udes

Favorab

le to

Antisoc

ial Beh

avior

Acade

mic Failu

re

Low Com

mitmen

t to Sch

ool

Rebelli

ousn

ess

Early P

roblem

Behav

ior

Early I

nitiati

on of

Drug Use

Favorab

le Attit

udes

Toward

Antisoc

ial Beh

avior

Favorab

le Attit

udes

Toward

Drug Use

Low Perc

eived

Risks o

f Drug

Use

Friend

s' Use

of Drug

s

Sensa

tion See

king

Reward

s for

Antiso

cial In

volve

ment

Overal

l Risk

Perc

en

t A

t R

isk




2002


Peer-Individual

48



That Care

Get Started

Get Organized



• Define outcomes.•Prioritize factors to be

targeted.• Select tested, effective

interventions.• Create action plan.

• Develop evaluation plan.

49

Addressing Barriers Addressing Barriers with Effective Actionwith Effective Action

3-5Early Childhood Education

prenatal-2Prenatal/Infancy Programs

6-14Family Therapy

prenatal-14Parent Training

Family Management Problems

Developmental PeriodProgram Strategy Factor Addressed

50

Effective Prevention for Effective Prevention for Parents of Young AdolescentsParents of Young Adolescents

• Creating Lasting Connections

• Family Matters

• Guiding Good Choices

• Parents Who Care

• Parenting Wisely

• Strengthening Families 10-14

51



That Care

Get Started

Get Organized



• Form task forces.• Identify and train

implementers.• Sustain collaborative

relationships.• Evaluate processes and

outcomes.• Adjust programming.

52

CTC TrainingsCTC Trainings

1.1. Key Leader OrientationKey Leader Orientation

2.2. Community Board TrainingCommunity Board Training

3.3. Community Assessment TrainingCommunity Assessment Training

4.4. Community Resource Assessment Community Resource Assessment TrainingTraining

5.5. Community Planning TrainingCommunity Planning Training

6.6. Community Program Implementation Community Program Implementation TrainingTraining

53

Assess risk,

protection and resources

Implement and evaluate

tested prevention strategies

Increase in priority

protective factors

Decrease in priority risk

factors

Increase in positive youth

development

Reduction in problem

behaviors

Vision for a healthy

community

ProcessMeasurable Outcomes

6-9 mos. 1 year 2-5 years 5-10 years

Communities that CareCommunities that CareProcess and TimelineProcess and Timeline

55

The Community Youth The Community Youth Development Study Development Study

(CYDS)(CYDS)

A 24 community randomized controlled trial to test the Communities That Care system started in 2003.

The Community Youth The Community Youth Development StudyDevelopment Study

Funded by:National Institute on Drug Abuse

Center for Substance Abuse Prevention National Cancer Institute

National Institute on Child Health and Development

National Institute on Mental Health

57

CYDS State CollaboratorsCYDS State Collaborators

• Colorado Alcohol & Drug Abuse Division • Illinois Division of Community Health &

Prevention • Kansas Alcohol and Drug Abuse

Services • Maine Office of Substance Abuse • Oregon Office of Alcohol & Drug Abuse

Programs • Utah Division of Substance Use • Washington Division of Alcohol &

Substance Abuse

58

CYDS Primary CYDS Primary AimAim

To test the effects of the Communities That Care system in

• reducing levels of risk

• increasing levels of protection

• reducing health and behavior problems among adolescents

using a true experimental design.

59

STUDY DESIGN

Randomized Controlled Trial

2003-2008

Randomize

5-Year Baseline

1997-2002

98 99 ‘00 ‘01 ‘02

CKICRD

2003 2004 2005 2006 2007 2008

Control

Intervention

CTCYS

CKICRD

CKICRD

CKICRD

CKICRD

YDS YDS YDS

CTCBoar

d

CTCBoar

d

CTCBoar

d

CTCBoar

d

CTCBoar

d

CTCYS: Cross-sectional student survey of 6th-, 8th-, 10th-, and 12th-grade students using the CTC Youth SurveyCKI: Community Key Informant InterviewCRD: Community Resource Documentation measuring effective prevention programs and policies in the community CTC Board: CTC Board Member InterviewYDS: Longitudinal Youth Development Survey of students in the class of 2011 starting in 5th grade in spring 2004

Planning Implement selected interventions

CTCYS CTCYS

CTCYS CTCYS CTCYS

CTCYS CTCYS CTCYS

CKICRD

YDSYDS

YDS YDSYDSYDSYDS

60

Demographics of 24 Demographics of 24 CYDS CommunitiesCYDS Communities

Mean Minimum Maximum

Total Population 14,616 1,578 40,787

Percent Caucasian 89.4% 64.0% 98.2%

Percent Hispanic Origin

Percent African-American

Percent Eligible for Free/Reduced Lunch

9.6%

2.6%

36.5%

0.5%

0.0%

20.6%

64.7%

21.4%

65.9%

61

Panel-Panel-Youth Development Youth Development

Survey (YDS)Survey (YDS)

• Annual survey of panel recruited from the Class of 2011 (5th grade in 2004)

• Active, written parental consent

62

Youth Development Youth Development SurveySurvey

• Participants recruited in grades 5 and 6.

• Final consent rate = 76.4%

Sixth Grade Eligible Population

Percent Consented

Percent Surveyed

Total Surveyed

Experimental

3170 76.2% 75.4% 2391

Control 2621 76.7% 76.3% 1999Total 5791 76.4% 75.8% 4390

63

2007 YDS2007 YDS

8th Grade Eligible Populatio

n

Percent Surveyed

Total Surveyed

Experimental 2406 95.6% 2300Control 2001 96.9% 1940Total 4407 96.2% 4240

• 96.2% Overall Student Participation• 11.9% (n=525) have moved out of

project schools

64

Communities That CareCommunities That CareLogic ModelLogic Model

Adoption of Science-based Prevention Framework

CollaborationRegarding Prevention Issues

Appropriate Choiceand Implementationof Tested, Effective

Prevention Programs & Adoption of Social Development Strategy as Community’s Way of

Bringing Up Children Positive Youth

Outcomes

Decreased Risk and Enhanced Protection

CTC Training and Technical Assistance

65

Adoption of Adoption of Science-Based PreventionScience-Based Prevention

Stage 0:Stage 0: No AwarenessNo Awareness

Stage 1:Stage 1: Awareness of Prevention Science Terms and ConceptsAwareness of Prevention Science Terms and Concepts

Stage 2:Stage 2: Using Risk and Protection Focused Prevention Using Risk and Protection Focused Prevention Approach as a Approach as a Planning Strategy.Planning Strategy.

Stage 3:Stage 3: Incorporation of Community Epidemiological Data on Incorporation of Community Epidemiological Data on Risk and Risk and Protection in Prevention System.Protection in Prevention System.

Stage 4:Stage 4: Selection and Use of Tested and Effective Preventive Selection and Use of Tested and Effective Preventive Interventions to Address Prioritized Interventions to Address Prioritized

Risk and Protective Risk and Protective Factors. Factors.

Stage 5:Stage 5: Collection and Feedback of Process and Outcome Collection and Feedback of Process and Outcome Data and Adjustment of Preventive Data and Adjustment of Preventive

Interventions Based on Data.Interventions Based on Data.Note. Community Key Informant Survey (CKI).

66Stage of Adoption

Pro

bab

ilit

yStages of Adoption Stages of Adoption

by Intervention Status (2001)by Intervention Status (2001)

Control Communities CTC Communities

67

Pro

bab

ilit




Stage of Adoption

Note. Change from 2001 to 2004, p < .05.

68

Pro

bab

ilit




Stage of Adoption

Note. Change from 2004 to 2007, nonsignificant (i.e., p > .10).

69

Communities That CareCommunities That CareTheory of ChangeTheory of Change






Outcomes



70

Program SelectionProgram Selection

CTC Community Board members selected prevention programs from a menu* of programs that:~ Showed significant effects on

risk/protective factors, and drug use, delinquency, or violence

~ In at least one high-quality research study

~ Targeted children or families in grades 5-9~ Provided materials and training

* Communities That Care Prevention Strategies Guide

71

Programs Selected in 2004-Programs Selected in 2004-20072007

PROGRAM 2004-05 2005-06 2006-07

All Stars Core 1 1 1

Life Skills Training 2 4* 5* Lion’s-Quest Skills for Adolescence 2 3 3 Project Alert - 1 1

Olweus Bullying Prevention Program - 2* 2* Program Development Evaluation Training 1 1 -

Participate and Learn Skills (PALS) 1 1 1 Big Brothers/Big Sisters 2 2 2 Stay SMART 3 3 1 Tutoring 4 6 6 Valued Youth Tutoring Program 1 1 1 Strengthening Families 10-14 2 3 3 Guiding Good Choices 6 7* 8*

Parents Who Care 1 1 - Family Matters 1 1 2

Parenting Wisely - 1 1

TOTAL 27 38 37

*Program funded through local resources in one or two communities

72

Exposure in the Exposure in the Community Community

Program Type 2004-05 2005-06 2006-07

School Curricula

1432 3886 5165

After-school*

546 612 589

Parent Training

517 665 476

*Includes PALS, BBBS, Stay SMART, and Tutoring programs

Note: Total eligible population of 6th, 7th, and 8th-grade students in2005-06 was 10,031.

73

Fidelity Assessment Fidelity Assessment ChecklistsChecklists

• Obtained from developers (9) or created by research staff (7)

• Provided similar information across all programs to measure 4 elements of fidelity

• Over 6,000 checklists were completed by program implementers and coordinators

~ Minimal missing data (8.2% in 2004-05 and 2.1% in 2005-06)

• Checklists were collected and reviewed by communities, then sent to SDRG

74

Adherence RatesAdherence Rates 2004-05 and 2005-062004-05 and 2005-06 school school

yearsyears

0

10

20

30

40

50

60

70

80

90

100

LST AS SFA Alert BPP PDE SS Tutor VY BBBS PALS SFP GGC PWC FM

Percentage of material taught or core components achievedPercentage of material taught or core components achieved

75







Outcomes



76

Prioritized Risk Factors in Prioritized Risk Factors in CTC CommunitiesCTC Communities

• Family management problems • Parental attitudes favorable to problem

behavior• Family conflict• Low commitment to school• Favorable attitudes toward problem behavior• Friends who engage in problem behavior• Academic failure• Rebelliousness• Laws and norms favorable toward drug and

alcohol use

77

Pre-post Change inPre-post Change inTargeted Risk FactorsTargeted Risk Factors

-0.20

-0.15

-0.10

-0.05

0.00

0.05

0.10

0.15

0.20

0.25


Ave

rage

Lev

el o

f R

isk

Note. Values are model-fitted levels of standardized average risk for students in the Youth Developmental Study panel sample, N = 4404. For Grade 7: γ010 = .111, SE = .043, df = 11, p < .026.

Grade 5 Grade 7

78







Outcomes



79

Communities That Care: Communities That Care: Evidence of EffectsEvidence of Effects

• Adoption of science-based prevention is higher in CTC communities than in control communities.

• CTC communities and schools are adopting tested & effective programs.

• The new programs are being implemented with fidelity.

• Exposure to targeted risk factors is increasing less rapidly in the panel in CTC than in control communities.

• By the spring of grade 8,

significantly fewer panel students in CTC communities than controls have initiated smoking, smokeless tobacco use, alcohol use, and delinquent behavior.

Significantly fewer report drug use, specifically current alcohol use, binge drinking, and smokeless tobacco use.

Significantly lower rates of delinquent behavior.

80

The Communities That Care Prevention Operating System is available at:

http://preventionplatform.samhsa.gov/

82

The Future of Prevention in The Future of Prevention in CTC Communities:CTC Communities:

Community Leader Support for Community Leader Support for PreventionPrevention

• If you were deciding how to spend money for reducing substance abuse, what percentage would you allocate to each of the following If you were deciding how to spend money for reducing substance abuse, what percentage would you allocate to each of the following approaches?approaches?

Law EnforcementLaw Enforcement

TreatmentTreatment

PreventionPrevention

83

Funding Allocation Funding Allocation by Intervention Status (2001)by Intervention Status (2001)

ControlCommunities

CTCCommunities

LawEnforcement

Treatment

Prevention

Treatment LawEnforcement

Prevention

27.4%27.4%

31.9%31.9%

40.9%40.9%

28.0%28.0%

30.6%30.6%

41.5%41.5%

84

Percentage Funding for Prevention Percentage Funding for Prevention by Intervention Statusby Intervention Status

35.00

40.00

45.00

50.00

2001 2007

Perc

en

tag

e


2004

85


35.00

40.00

45.00

50.00

2001 2007

Perc

en

tag

e


2004

Note. Change from 2001 to 2004 nonsignificant, p > .10.

86


35.00

40.00

45.00

50.00

2001 2007

Perc

en

tag

e


2004

Note. Change from 2001 to 2007, p < .05.

87

Summary and Summary and ImplicationsImplications

Tested and effective policies and programs for preventing adolescent substance misuse are available.

They can be implemented and sustained widely in communities with strong prevention coalitions.

We should promote the use of tested and effective prevention approaches where appropriate.

We should support rigorous evaluation of untested prevention approaches.

88

Summary and Summary and ImplicationsImplications

We can advance public health in our communities:

• Sponsor, endorse and use tested and effective prevention programs.

• Promote the collection of data on levels of risk and protection to focus community action on elevated risks.

• Engage in community efforts to strengthen protection and reduce risks.

For measurable results and sustainability:• USE COMMUNITIES THAT CARE.

89

What is required to install What is required to install CTC? CTC?

• A coalition of community stakeholders.• A coordinator for the CTC process.• Manuals and curriculum materials.• Training from certified trainers.• Technical assistance when difficulties

are encountered.• A monitoring system to provide routine

feedback on progress and outcomes.

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Communities That Care Communities That Care in the UK and Irelandin the UK and Ireland

• CTC training, technical assistance, youth survey and materials are available from the Rainer Foundation in London.

• CTC UK Contact: Fran PollardRainer Foundation44 207 336 [email protected]

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My VisionMy Vision• Training and technical assistance are readily

available to communities seeking to use the CTC system.

• Systems for monitoring risk, protection and youth health are in place in communities.

• Systems for monitoring fidelity of prevention policies and programs are functioning in communities.

• Significant reductions in substance abuse and delinquency are achieved in communities.

• Significant increases in positive youth development are achieved across communities.

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Communities That CareCommunities That CareCYDS PublicationsCYDS Publications

Arthur, M.W., Briney, J.S., Hawkins, J.D., Abbott, R.D., Brooke-Weiss, B. &. Catalano, R.F. (2007). Measuring community risk and protection using the Communities That Care Youth Survey. Evaluation and Program Planning, 30, 197-211.

Brooke-Weiss, B., Haggerty, K. P., Fagan, A. A., Hawkins, J. D., & Cady, R. (2008). Creating community change to improve youth development: The Communities That Care (CTC) system. The Prevention Researcher 15(2), 21-24.

Brown, E.C., Hawkins, J.D., Arthur, M.W., Briney, J.S., & Abbott, R.D. (2007). Effects of Communities That Care on prevention services systems: Findings from the Community Youth Development Study at 1.5 years. Prevention Science. 8, 180-191.

Fagan, A. A., Hawkins, J. D., & Catalano, R. F. (2008). Using community epidemiologic data to improve social settings: The Communities That Care prevention system. In M. Shinn & H. Yoshikawa (Eds.), Toward positive youth development: Transforming schools and community programs. New York: Oxford University Press.

Fagan, A.A., Van Horn, M.L., Hawkins, J.D., & Arthur, M.W. (2007). Using community and family risk and protective factors for community-based prevention planning. Journal of Community Psychology, 35(4), 535-555.

Hawkins, J.D. (2006). Science, social work, prevention: Finding the intersections. Social Work Research, 30(3), 137-152.

Hawkins, J.D., Brown, E.C., Oesterle, S., Arthur, M.W., Abbott, R.D., & Catalano, R.F. (2008). Early effects of Communities That Care on targeted risks and initiation of delinquent behavior and substance use. Journal of Adolescent Health.

Murray, D.M., Van Horn, M.L., Hawkins, J.D., & Arthur, M.W. (2006). Analysis strategies for a community trial to reduce adolescent ATOD use: A comparison of random coefficient and ANOVA/ANCOVA models. Contemporary Clinical Trials. 27, 188-206.

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Communities That CareCommunities That Care CYDS In Press CYDS In Press

Brown, E.C., Hawkins, J.D., Arthur, M.W., Van Horn, M.L., & Abbott, R.D. (in press). Multilevel analysis of a measure of prevention collaboration. American Journal of Community Psychology.

Fagan, A.A., Hanson, K., Hawkins, J.D., & Arthur, M.W. (in press). Bridging science to practice: Achieving prevention program implementation fidelity in the Community Youth Development Study. American Journal of Community Psychology.

Fagan, A.A., Hanson, K., Hawkins, J.D., & Arthur, M.W. (in press). Implementing effective community-based prevention programs in the Community Youth Development Study. Youth Violence and Juvenile Justice.

Hawkins, J. D., Catalano, R. F., Arthur, M. W., Egan, E., Brown, E. C., Abbott, R. D., et al. (in press). Testing Communities That Care: The rationale, design and behavioral baseline equivalence of the Community Youth Development Study. Prevention Science.

Jonkman, H. B., Haggerty, K. P., Steketee, M., Fagan, A. A., Hanson, K., & Hawkins, J. D. (in press). Communities That Care, core elements and context: Research of implementation in two countries. Social Development Issues.

Quinby, R.K., Fagan, A.A., Hanson, K., Brooke-Weiss, B., Arthur, M.W., & Hawkins, J.D. (in press). Installing the Communities That Care prevention system: Implementation progress and fidelity in a randomized controlled trial. Journal of Community Psychology.

Van Horn, M.L., Fagan, A.A., Jaki, T., Brown, E.C., Hawkins, J.D., Arthur, M.W., Abbott, R.D., & Catalano, R.F. (in press). The use of mixture models to evaluate differential intervention effects in group randomized trials. Multivariate Behavioral Research.

94

Using Advances in Using Advances in Prevention Science to Guide Prevention Science to Guide

Youth Development and Youth Development and Prevention of Adolescent Prevention of Adolescent Problem Behaviours in Problem Behaviours in

Communities.Communities.

Social Development Research GroupSocial Development Research Group

University of WashingtonUniversity of Washingtonwww.sdrg.org

J. David Hawkins Ph.D.J. David Hawkins Ph.D.

[email protected]

Office of the Minister for Children and Youth Office of the Minister for Children and Youth AffairsAffairs

30 June 200830 June 2008

http://www.sdrg.org/

mailto:[email protected]

j. david hawkins ph.d. social development research group university of washington sdrg

Documents

prevention of problems

advances of prevention

prevention needs assessment

positive youth development

drug information programs

protective factorschart30

peer group

public health approach