Prevention Service System Transformation Using Communities That Care.

Area of Science:

• Public Health
• Community Psychology
• Prevention Science

Background:

• Community-based prevention programs are crucial for addressing public health issues.
• Evaluating the long-term impact of comprehensive prevention strategies is essential.
• The Communities That Care (CTC) model aims to transform prevention systems through community engagement.

Purpose of the Study:

• To assess the sustainability of prevention system transformation in CTC communities.
• To examine differences in prevention approaches and resource allocation between CTC and control communities.
• To investigate the influence of community characteristics on prevention strategy adoption.

Main Methods:

• Community-randomized controlled trial design.
• Longitudinal survey data collection from community leaders at 4.5 years post-implementation.
• Comparative analysis of prevention activities, funding willingness, and community collaboration.

Main Results:

• Sustained higher adoption of science-based prevention in CTC communities compared to controls.
• Increased willingness among leaders in CTC communities to fund prevention initiatives.
• Community collaboration gains observed initially were not maintained over time.
• In high-poverty CTC communities, leaders reported stronger norms against drug use.

Conclusions:

• The Communities That Care model demonstrates sustained positive effects on science-based prevention adoption and resource commitment.
• Long-term maintenance of community collaboration requires ongoing attention.
• CTC's impact on community norms and specific strategies is evident, particularly in socioeconomically challenged areas.