using prevention science for community mobilization fileinternational standards for drug use...

International Standards for Drug Use PreventionInternational Standards for Drug Use Prevention

Vienna, AustriaVienna, Austria

January 24, 2012January 24, 2012

Using Prevention Science for Using Prevention Science for Community MobilizationCommunity Mobilization

Richard F. Catalano, Ph.D.Richard F. Catalano, Ph.D.

Bartley Dobb Professor for the Study and Prevention of ViolenceBartley Dobb Professor for the Study and Prevention of Violence

Director, Social Development Research GroupDirector, Social Development Research Group

School of Social WorkSchool of Social Work

University of WashingtonUniversity of Washington

www.sdrg.orgwww.sdrg.org

Universal

Selective

Indicated

Case

Identific

ation

Standard Treatment for

Known Disorders

Compliance with long-

term treatment (goal:

reduction in relapse and

recurrence)

After-car

e (including

rehabilita

tion)

Source: Institute of Medicine (2009). Preventing Mental, Emotional and

Behavioral Disorders Among Young People. O’Connell, Boat & Warner

(eds.) Washington DC: National Academy Press

Intervention Spectrum

Prevention

Prevention

Prevention

Prevention

TreatmentTreatmentTreatmentTreatmentMaintenance

Maintenance

Maintenance

Maintenance

Promotion

Define the Problem

Define the Problem

Identify Riskand Protective

Factors

Identify Riskand Protective

Factors

InterventionsInterventions

Program Implementation

and Evaluation

Program Implementation

and Evaluation

Public Health FrameworkPublic Health Framework

Problem Response

Risk Factors forRisk Factors for

Adolescent Problem BehaviorsAdolescent Problem Behaviors

��Extreme Economic Deprivation

��Low Neighborhood Attachment and

Community Disorganization

��Transitions and Mobility

��Media Portrayals

��Community Laws and Norms Favorable

Toward Drug Use, Firearms, and Crime

��Availability of Firearms

��Availability of Drugs

Community

Depression &

Anxiety

Violence

School Drop-Out

Teen Pregnancy

Delinquency

Substance Abuse

Risk Factors

��

Risk Factors for Risk Factors for


��Favorable Parental Attitudes and

Involvement in the Problem Behavior

��Family Conflict

��Family Management Problems

��Family History of the Problem Behavior

FamilyFamily

Depression &

Anxiety

Violence

School Drop-Out

Teen Pregnancy

Delinquency

Substance Abuse

Risk Factors



��Lack of Commitment to School

��Academic Failure Beginning in Late

Elementary School

SchoolSchool

Depression & Anxiety

Violence

School Drop-Out

Teen Pregnancy

Delinquency

Substance Abuse

Risk Factors



��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

Depression &

Anxiety

Violence

School Drop-Out

Teen Pregnancy

Delinquency

Substance Abuse

Risk Factors

Protective FactorsProtective 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

– Healthy Beliefs and Clear Standards

Communities Vary in Risk ExposureCommunities Vary in Risk Exposure

Pollard, Pollard, Pollard, Pollard, ndndndnd

No studentsNo studentsNo studentsNo students

in this areain this areain this areain this area.

Insufficient number of

students in thisthisthisthis area.

Neighborhood #2Neighborhood #2Neighborhood #2Neighborhood #2

Neighborhood #1Neighborhood #1Neighborhood #1Neighborhood #1 Neighborhood #3Neighborhood #3Neighborhood #3Neighborhood #3

What We Now Know AboutWhat We Now Know About

Risk and Protective FactorsRisk and Protective Factors

�� Both level of risk and level of protection Both level of risk and level of protection make a difference in predicting substance make a difference in predicting substance use and other problems use and other problems

�� Common risk and protective factors predict Common risk and protective factors predict substance use and other problemssubstance use and other problems

�� Risk and protective factors show much Risk and protective factors show much consistency in effects across diverse consistency in effects across diverse groups and cultures groups and cultures (Beyers et al., 2004; Glaser et al., (Beyers et al., 2004; Glaser et al., 2005; Hemphill et al., 2011; Solomon et al., 2011; Oesterle et a2005; Hemphill et al., 2011; Solomon et al., 2011; Oesterle et al., l., 2011) 2011)

�� Risk/protection vary by communityRisk/protection vary by community

What is an efficacious program?

Evaluation Quality

� At least one randomized

controlled trial OR a quasi-

experimental trial without design

flaws

Intervention Specificity

�Population of focus is clearly defined

�Risk and protective factors that

program seeks to change are

identifiable

Implementation Tools

� Training materials are available

� Information on the financial and

human resources required

Impact

� Impact on adolescent substance

use and other problems

� Absence of any negative effects

Wide Ranging Approaches Wide Ranging Approaches

Have Been Found To Be Have Been Found To Be

EfficaciousEfficacious1.1. Prenatal & Infancy ProgramsPrenatal & Infancy Programs

2.2. Early Childhood EducationEarly Childhood Education

3.3. Parent TrainingParent Training

4.4. AfterAfter--school Recreationschool Recreation

5.5. Mentoring with Contingent Mentoring with Contingent ReinforcementReinforcement

6.6. Youth Employment with Youth Employment with EducationEducation

7.7. Organizational Change in Organizational Change in SchoolsSchools

8.8. Classroom Classroom Organization, Organization, Management, and Management, and Instructional StrategiesInstructional Strategies

9.9. School Behavior School Behavior Management StrategiesManagement Strategies

10.10. Classroom Curricula for Classroom Curricula for Social Competence Social Competence PromotionPromotion

11.11. Community & School Community & School PoliciesPolicies

12.12. Community Community MobilizationMobilization

Summary of Benefits and Costs (2003Summary of Benefits and Costs (2003 DollarsDollars))Dollars Per Youth (PV lifecycle)Dollars Per Youth (PV lifecycle) BenefitsBenefits CostsCosts B B -- CC

Early Childhood Education $17,202 $7,301 $9,901

Nurse Family Partnership $26,298 $9,118 $17,180

Seattle Soc. Development Project $14,246 $4,590 $9,837

Life Skills Training $746 $29 $717

Guiding Good Choices $7,605 $687 $6.918

Strengthening Families Program 10-14 $6,656 $851 $5,805

Teen Outreach Program $801 $620 $181

Some Prevention Programs Have Some Prevention Programs Have

Demonstrated Benefit over CostDemonstrated Benefit over Cost

Steve Aos, Associate DirectorSteve Aos, Associate Director

Washington State Institute for Public PolicyWashington State Institute for Public Policy

[email protected]@wsipp.wa.gov www.wa.gov/wsippwww.wa.gov/wsipp

The ChallengeThe Challenge

�� How can we increase use of tested How can we increase use of tested

and effective prevention policies and and effective prevention policies and

programsprograms……

while recognizing that communities while recognizing that communities

are different from one another and are different from one another and

need to decide locally what policies need to decide locally what policies

and programs they use? and programs they use?

Why Community Mobilization Why Community Mobilization

to Prevent Substance Use?to Prevent Substance Use?

�� Risk/protective factors located in community, Risk/protective factors located in community,

family, school, peer and individualfamily, school, peer and individual

�� Risk/protection vary by neighborhoodRisk/protection vary by neighborhood

�� Community coalitions representing multiple Community coalitions representing multiple

sectors of influence can coordinate multiple sectors of influence can coordinate multiple

resources and actionsresources and actions

�� Community coalitions may be more likely to Community coalitions may be more likely to

reach all children and youth and may have reach all children and youth and may have

population wide effectpopulation wide effect

Ineffective Preventive Community Ineffective Preventive Community

Mobilization ApproachesMobilization Approaches

Providing resources to support community Providing resources to support community coalitions without a structure or processcoalitions without a structure or process

Sources of failure Sources of failure (Hallfors et al. 2002; (Hallfors et al. 2002; Klerman et al. 2005; Klerman et al. 2005; Merzel & D'Afflitti, 2003):Merzel & D'Afflitti, 2003):

–– Lack of clearly defined goals based in data, with highLack of clearly defined goals based in data, with high--quality data sources to monitor progress; quality data sources to monitor progress;

–– Lack of use of tested and effective programs, Lack of use of tested and effective programs,

–– Inattention to monitoring of implementation quality Inattention to monitoring of implementation quality and fidelity;and fidelity;

Effective Preventive Community Effective Preventive Community

Mobilization ApproachesMobilization Approaches

�� CMCACMCA--Communities Mobilizing for Change on Alcohol Communities Mobilizing for Change on Alcohol

((no effect under age 18no effect under age 18) (Wagenaar et al., 2000)) (Wagenaar et al., 2000)

�� CTICTI--Community Trials Intervention to reduce high risk Community Trials Intervention to reduce high risk

drinking (drinking (no effect under age 18no effect under age 18) (Holder et al., 2000)) (Holder et al., 2000)

�� Project NorthlandProject Northland (Perry et al., 2002)(Perry et al., 2002)

�� MPPMPP--Midwest Prevention Project Midwest Prevention Project –– (Pentz et al., 2006)(Pentz et al., 2006)

�� KIKI--Kentucky Incentives for prevention (Collins et al., Kentucky Incentives for prevention (Collins et al.,

2007)2007)

� PROSPER-Promoting school–community -university partnerships to enhance resilience (Spoth et al., 2007)

� CTC-Communities that Care (Hawkins et al., 2009; 2011; Feinberg et al., 2007)

Elements of Effective Elements of Effective

Community Mobilizization to Community Mobilizization to

Prevent Substance UsePrevent Substance UseCross-sector Community Mobilizing Program

Assess and Prioritize Risk and Protective Factors

Efficacious school prevention curriculum

Other efficacious preventive programs

Change norms and laws

CMCA Norms, laws, availability

CTI Norms, laws, availability

Project Northland

Norms, peers, family norms

MPP Norms, peers, family norms

KI Comprehensive

PROSPER No

CTC Comprehensive

Characteristics of Effective Characteristics of Effective

Coalitions with Impact on YouthCoalitions with Impact on Youth

�� Goals clearly defined, and manageableGoals clearly defined, and manageable

�� Planning time adequatePlanning time adequate

�� Prioritization based on local data about Prioritization based on local data about

community levels of risk, protectioncommunity levels of risk, protection

�� Prevention actions employed have Prevention actions employed have

evidence of efficacy from controlled trialsevidence of efficacy from controlled trials

�� Prevention actions monitored to ensure Prevention actions monitored to ensure

implementation quality implementation quality

An Example: CAn Example: Communities That Care ommunities That Care

Creating

Communities

That Care

Get Started

Get Organized

Develop a ProfileCreate a Plan

Implement andEvaluate

• Community readiness assessment.

• Identification of key

individuals, stakeholders,

and organizations.

The CThe Communities That Care ommunities That Care Operating SystemOperating System

Creating

Communities

That Care

Get Started

Get Organized



• Training key leaders

and board in CTC

• Building the

community coalition.


Creating

Communities

That Care

Get Started

Get Organized



• Collect risk/protective factor and outcome

data with CTC survey.

• Construct a

community profile from the data.


Creating

Communities

That Care

Get Started

Get Organized



• Define outcomes.

•Prioritize risk factors to be

targeted.

• Select tested, effective

interventions.• Create action plan.

• Develop evaluation plan.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Communityopportunities for

prosocialinvolvement

Communityrecognition for


FamilyAttachment

Familyopportunities for


Familyrecognition for


Schoolopportunities for


Schoolrecognition for


Social skills Belief in themoral order

OverallProtection

Pe

rce

nt P

rote

cte

dProtective Profile 10th Grade

School 2002 District 2002

Community Family School

Estimated National Value

Survey Participation Rate 2002: 79.7%

Peer-Individual Overall

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pe

rce

nt A

t R

isk

Risk Profile 10th Grade

School 2002 District 2002

Community Family School

Estimated National Value

Survey Participation Rate 2002: 79.7%

Peer-Individual

Protective Factors

Risk Factor Addressed Program Strategy

Healthy

Beliefs

& Clear

Standards

Bonding Opport. Skills Recog.Developmental

Period

Family Therapy � � � � � 6-14

Classroom Curricula for Social Competence

Promotion� � � � � 6-14

School Behavior Management Strategies � � � 6-14

Afterschool Recreation � � � � � 6-10

Mentoring with Contingent Reinforcement � � � 11-18

Rebelliousness

Youth Employment with Education � � � � � 15-18

Parent Training � � � � � 6-14


Promotion� � � � � 6-14

Afterschool Recreation � � � � � 6-14

Friends Who Engage in the

Problem Behavior

Mentoring with Contingent Reinforcement � � � 11-18


Promotion� � � � � 6-14Favorable Attitudes

Toward the Problem

Behavior Community/School Policies

Parent Training � � � � � 6-14

Classroom Organization Management and

Instructional Strategy� � � � � 6-10

Classroom Curricula for Social Competence � � � � � 6-14

Early Initiation of the

Problem Behavior

Community/School Policies � all

Ind

ivid

ual/

Pee

r D

om

ain

Constitutional Factors Prenatal/Infancy Programs � � � � � prenatal-2

© 1998 Developmental Research and Programs

CTC Prevention Strategies Guide to Efficacious CTC Prevention Strategies Guide to Efficacious

Programs and PoliciesPrograms and Policies

Efficacious Classroom Curricula for Efficacious Classroom Curricula for

Social and Emotional Competence Social and Emotional Competence

Promotion (Secondary School)Promotion (Secondary School)

�� The Life Skills Training Program (Botvin et The Life Skills Training Program (Botvin et

al., 1995)al., 1995)

�� Project Alert Drug Prevention Curriculum Project Alert Drug Prevention Curriculum

(Ellickson et al., 1993; Ellickson and Bell, (Ellickson et al., 1993; Ellickson and Bell,

1990)1990)

�� Alcohol Misuse Prevention Alcohol Misuse Prevention

(Maggs et al., 1998) (Maggs et al., 1998)

�� Towards No Drug Use Towards No Drug Use

(Sussman et al. 2003; 2003)(Sussman et al. 2003; 2003)


Creating

Communities

That Care

Get Started

Get Organized



• Form task forces.• Identify and train implementers.• Sustain collaborative relationships.• Evaluate processes and outcomes

for programs annually.•Evaluate community outcomes

every two years.• Adjust programming.

• Form task forces.• Identify and train implementers.• Sustain collaborative relationships.• Evaluate processes and outcomes

for programs annually.•Evaluate community outcomes

every two years.• Adjust programming.

• Assess readiness,

Mobilize the

community

• Assess risk,

• protection and

• resources,

• Develop strategic

plan

Implement

and

evaluate

tested,

effective

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

Process

Measurable Outcomes

6-9 mos. 1 year 2-5 yrs. 3-10 yrs. 10-15 yrs.

Evaluation

Process and TimelineProcess and Timeline

Evidence of Effectiveness of CTC fromEvidence of Effectiveness of CTC from

Community Youth Development Study Community Youth Development Study A 24 Community Randomized TrialA 24 Community Randomized Trial

PI: J. David Hawkins

Co-PI: Richard F. Catalano

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

National Institute on Alcohol Abuse and Alcoholism

Communities That CareCommunities That CareTheory of ChangeTheory of Change

Adoption of Science-based Prevention

Framework

Collaboration

Regarding Prevention Issues

Appropriate Choice and Implementation

of Tested, Effective Prevention Programs

Positive YouthOutcomes

Decreased Risk and

Enhanced Protection

CTC Training and Technical

Assistance

(Brown et al, 2007)

(Quinby et al, 2008; Fagan et al., 2008)

(Hawkins et al., 2008)

Effects of CTC on Onset of Effects of CTC on Onset of

Drug Use and Delinquency at Drug Use and Delinquency at

Grade 8 and 10*Grade 8 and 10*

Compared with controls:Compared with controls:

–– 33% less likely to start smoking cigarettes. 33% less likely to start smoking cigarettes.

–– 32% less likely to start drinking alcohol. 32% less likely to start drinking alcohol.

–– 25% less likely to start delinquent behavior.25% less likely to start delinquent behavior.

–– Results maintained through 10Results maintained through 10thth grade one grade one

year post interventionyear post intervention

**Among 5Among 5thth grade students who had not yet initiated. Significant at grade students who had not yet initiated. Significant at p<.05p<.05

Hawkins et al., 2009; 2011

Effects of CTC on Binge Drinking Effects of CTC on Binge Drinking

and Variety of Delinquency in the and Variety of Delinquency in the

Panel at Grade 8Panel at Grade 8

–– 37% less likely to 37% less likely to ““bingebinge”” (5 or more drinks (5 or more drinks

in a row) than controls.in a row) than controls.

–– Committed 31% fewer different delinquent Committed 31% fewer different delinquent

acts in past year than controls acts in past year than controls

significant at p<.05significant at p<.05

Hawkins et al., 2009

Investment in CTC Pays OffInvestment in CTC Pays Off

$0.00

$1.00

$2.00

$3.00

$4.00

$5.00

$6.00Reduced

• Initiation of

Delinquency

• Initiation of

Smoking

$5.30

InvestmentToday ($2008)

Future Savings ($2008)

$1.00

3434

(Kuklinski et al., 2011)

Communities That Care on Communities That Care on

the Webthe Web

All CTC materials are available at:All CTC materials are available at:

httphttp://www.c://www.communitiesthatcare.netommunitiesthatcare.net

Communities That Care on FacebookCommunities That Care on Facebook

httphttp://://www.facebook.com/pages/Communitieswww.facebook.com/pages/Communities--

thatthat--Care/169417303103839Care/169417303103839

Communities That Care on WikipediaCommunities That Care on Wikipedia

http://en.wikipedia.org/wiki/Communities_That_Care

Government Actions to Support Government Actions to Support

Effective Community Effective Community

Mobilization for PreventionMobilization for Prevention� Develop database of tested, efficacious prevention programs and policies

� Educate policy makers, practitioners, scientists, and citizens about efficacious prevention

� Develop database of surveys to assess local risk, protection, substance use, and related problems

� Shift 2-5% of funds spent on children to efficacious prevention

Government Actions to Support Government Actions to Support

Effective Community Mobilization Effective Community Mobilization

for Preventionfor Prevention

Build capacity of community prevention staff to:

�Build coalitions

�Assess and prioritize risk, protection, substance use and related problems

�Match priorities to efficacious preventive interventions

�Support/sustain quality implementation of efficacious preventive interventions

International Standards for Drug Use PreventionInternational Standards for Drug Use Prevention

Vienna, AustriaVienna, Austria

January 24, 2012January 24, 2012

Using Prevention Science for Using Prevention Science for Community MobilizationCommunity Mobilization

Richard F. Catalano, Ph.D.Richard F. Catalano, Ph.D.

Bartley Dobb Professor for the Study and Prevention of ViolenceBartley Dobb Professor for the Study and Prevention of Violence

Director, Social Development Research GroupDirector, Social Development Research Group

School of Social WorkSchool of Social Work

University of WashingtonUniversity of Washington

www.sdrg.orgwww.sdrg.org

Tested, Effective Programs Tested, Effective Programs

Selected in 2004Selected in 2004--20082008PROGRAM 2004-05 2005-06 2006-07 2007-08

All Stars Core 1 1 1 1

Life Skills Training (LST) 2 4* 5* 5*

Lion’s-Quest Skills for Adolescence 2 3 3 3

Project Alert - 1 1 1

Olweus Bullying Prevention Program - 2* 2* 2*

Program Development Evaluation (PDE) 1 1 - -

Project Towards No Drug Abuse (TNDA) - - - 2

Project Northland Class Action - - - 1*

Participate and Learn Skills (PALS) 1 1 1 2

Big Brothers/Big Sisters (BBBS) 2 2 2 1

Stay SMART 3 3 1 1

Tutoring 4 6 6 7Valued Youth Tutoring Program 1 1 1 0

Strengthening Families Program (SFP) 10-14 2 3 3 2

Guiding Good Choices (GGC) 6 7* 8* 7

Parents Who Care (PWC) 1 1 - -

Family Matters 1 1 2 2

Parenting Wisely - 1 1 2

TOTAL 27 38 37 37

*Program funded through local resources in one or two communities

Prevalence of 30 Day Alcohol Use Prevalence of 30 Day Alcohol Use

by Number of Risk and Protective Factorsby Number of Risk and Protective Factors

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 7 8 to 9 10+

Number of Risk Factors

Pre

va

len

ce

0 to 1

2 to 3

4 to 5

6 to 7

8 to 9

Number of

Protective Factors

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

By Number of Risk and Protective FactorsBy Number of Risk and Protective Factors

Six State Student Survey of 6th - 12th Graders,Six State Student Survey of 6th - 12th Graders,Six State Student Survey of 6th - 12th Graders,Six State Student Survey of 6th - 12th Graders,

Public School StudentsPublic School StudentsPublic School StudentsPublic School Students

0%0%0%0%

10%10%10%10%

20%20%20%20%

30%30%30%30%

40%40%40%40%

50%50%50%50%

60%60%60%60%

70%70%70%70%

80%80%80%80%

90%90%90%90%

100%100%100%100%

0 to 10 to 10 to 10 to 1 2 to 32 to 32 to 32 to 3 4 to 54 to 54 to 54 to 5 6 to 86 to 86 to 86 to 8 9 or More9 or More9 or More9 or More

Number of Risk FactorsNumber of Risk FactorsNumber of Risk FactorsNumber of Risk Factors

Prevalence

Prevalence

Prevalence

Prevalence

0 to 10 to 10 to 10 to 1

2 to 32 to 32 to 32 to 3

4 to 54 to 54 to 54 to 5

6 to 86 to 86 to 86 to 8

Number of Number of Number of Number of

ProtectiveProtectiveProtectiveProtective

Factors Factors Factors Factors

Prevalence of Other ProblemsPrevalence of Other Problems

by Number of Risk Factorsby Number of Risk Factors

0

10

20

30

40

50

0-1 2-3 4-6 7-9 >=10

Risk factors

%

depressive

symptomatology

deliberate self harm

homelessness

early sexual activity

Bond, Thomas, Toumbourou, Patton, and Catalano, 2000

Number of School Building Risk Number of School Building Risk

Factors and Probability of Meeting Factors and Probability of Meeting

WASL Standard (10WASL Standard (10thth Grade Students)Grade Students)

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Number of Risk Factors

Probability of Meeting Standard

Math Reading WritingArthur et al., 2006

Number of School Building Protective Number of School Building Protective

Factors and Probability of Meeting Factors and Probability of Meeting

WASL Standard (10WASL Standard (10thth grade students) grade students)

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0 1 2 3 4 5 6 7

Number of Protective Factors

Probability of Meeting Standard

Math Reading WritingArthur et al., 2006

CTC Youth SurveyCTC Youth Survey

�� Identifies levels of 21 risk and 9 Identifies levels of 21 risk and 9

protective factors and academic and protective factors and academic and

behavioral outcomesbehavioral outcomes

�� Guides planners to select tested, effective Guides planners to select tested, effective

actions actions

�� Monitors the effects of chosen actions Monitors the effects of chosen actions

Effects of CTC on Cigarette Use Effects of CTC on Cigarette Use

Initiation Maintained Through Initiation Maintained Through

Grade 10Grade 10

4646

AOR = .55 , p=.003(in 8th grade)

AOR = .54 , p=.006(in 10th grade)

Note: AOR = adjusted odds ratio from multilevel discrete time survival analysis controlling for student and community characteristics. (Hawkins et al., 2011)

Effects of CTC on Alcohol Use Effects of CTC on Alcohol Use

Initiation Maintained Through Initiation Maintained Through

Grade 10Grade 10

4747

AOR = .62 , p=.028(in 10th grade)

Note: AOR = adjusted odds ratio from multilevel discrete time survival analysis controlling for student and

community characteristics. (Hawkins et al., 2011)

Effects of CTC on Delinquent Behavior Effects of CTC on Delinquent Behavior

Initiation Maintained Through Grade Initiation Maintained Through Grade

1010

4848

AOR = .79 , p=.033(across grades 5-10)

Note: AOR = adjusted odds ratio from multilevel discrete time survival analysis controlling for student and community

characteristics. (Hawkins et al., 2011)

Effects of CTC on Current Drug Effects of CTC on Current Drug

Use and Delinquency in the Panel Use and Delinquency in the Panel

at Grade 8at Grade 8

–– 23% less likely to drink alcohol currently 23% less likely to drink alcohol currently

than controls. than controls.

–– 37% less likely to 37% less likely to ““bingebinge”” (5 or more drinks (5 or more drinks

in a row) than controls.in a row) than controls.

–– Committed 31% fewer different delinquent Committed 31% fewer different delinquent

acts in past year than controls acts in past year than controls

significant at p<.05significant at p<.05

Hawkins et al., 2009

using prevention science for community mobilization fileinternational standards for drug use...

Documents