The Community Youth Development Study Funded by: National Institute on Drug Abuse Center for...

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 Human Development

National Institute on Mental HealthNational Institute on Alcohol Abuse and

Alcoholism

2

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 Addictions and Mental Health

Division • Utah Division of Substance Use • Washington Division of Behavioral

Health and Recovery

3

CYDS Project AdvisorsCYDS Project Advisors

Cheryl Perry, Ph.D.Cheryl Perry, Ph.D. ProfessorProfessorUniversity of TexasUniversity of Texas

Steve Raudenbush, Ph.D.Steve Raudenbush, Ph.D.ProfessorProfessor University of ChicagoUniversity of ChicagoSchool of EducationSchool of Education

David Farrington, Ph.D., OBEDavid Farrington, Ph.D., OBEProfessorProfessorCambridge University Cambridge University Institute of CriminologyInstitute of CriminologyMary Ann Pentz, Ph.D.Mary Ann Pentz, Ph.D.ProfessorProfessorUniversity of Southern University of Southern CaliforniaCaliforniaInstitute for Prevention Institute for Prevention ResearchResearch

Mark Greenberg, Ph.D.Mark Greenberg, Ph.D.Professor and Bennett Chair of Professor and Bennett Chair of Prevention ResearchPrevention ResearchPenn State University Penn State University

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CYDS Research TeamCYDS Research TeamRobert D. Abbott Michael W. Arthur John S. Briney Blair Brooke-Weiss Eric C. Brown Richard F. Catalano Abigail Fagan John Graham Kevin HaggertyKoren Hanson

J. David Hawkins Margaret KuklinskiMatt Laughlin Kathryn Monahan David Murray Sabrina Oesterle Dana Prince Isaac Rhew Holly Santos Valerie ShapiroM. Lee Van Horn

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Community Youth Community Youth Development Development

StudyStudy• A community randomized trial of CTC

• 24 incorporated towns matched in pairs within state and randomly assigned to CTC or control condition.

• 4407 5th grade students- surveyed annually through 8th grade

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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

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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

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CTC Towns: CTC Towns: Coalition of StakeholdersCoalition of Stakeholders

•Received CTC Training 6 trainings over 12 months

•Collected Data on Local Levels of Risk and Protection CTC Youth Survey

•Prioritized Risk Factors to Address• Implemented Appropriate Tested

Prevention Programs from CTC menu on average 3 per community per year

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ResultsResults

•Using CTC System significantly reduced health risking behaviors among eighth grade students community wide.Compared with controls: 33% less likely to start smoking cigarettes. 32% less likely to start drinking alcohol. 25% less likely to start delinquent

behavior.

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ResultsResults•Using CTC System significantly

reduced health risking behaviors among eighth grade students community wide:

23% less likely to drink alcohol currently than controls.

37% less likely to “binge” (5 or more drinks in a row) than controls.

Committed 31% fewer different delinquent acts in past year than controls.

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Adoption of Science-based

Prevention

Community Collaboration for Prevention Appropriate Choice and

Implementation of Tested, Effective Prevention Programs

Positive Youth Outcomes

Decreased Risk and Enhanced Protection

CTC Training, Technical Assistance

Community Norms

Social Development Strategy

Community Supportfor Prevention

System Transformation Constructs System OutcomesSystem Catalyst

Communities That Care Communities That Care Logic ModelLogic Model

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Program SelectionProgram Selection

CTC Community Boards selected prevention programs from the CTC Prevention Strategies Guide, 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

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Programs Selected in 2004-Programs Selected in 2004-20082008

PROGRAM 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 7 Valued 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

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Exposure in the Exposure in the Community Community

Program Type 2004-05 2005-06 2006-07 2007-08

School Curricula

1432 3886 5165 5705

After-school 546 612 589 448

Parent Training

517 665 476 379

Note: Total eligible population of 6th, 7th, and 8th-grade students in 2005-06 was 10,031

Number of Program Participants/Families Receiving Programming

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Participant AttendanceParticipant Attendance

Program Type 2004-05 2005-06 2006-07 2007-08

School Curricula

96% 91% 95% 94%

After-school*

77% 81% 65% 70%

Parent Training

79% 78% 79% 75%

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

Percent attending >60% of the total number of sessions

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Balancing Research Balancing Research Goals and Community Goals and Community

PracticePractice

The Challenge: How could the UW:

Measure fidelity across a range of programs?

Encourage local ownership, high fidelity, and sustainability of prevention programs?

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CYDS Implementation CYDS Implementation Fidelity Monitoring Fidelity Monitoring

Tools Tools • Staff training• Fidelity assessment checklists • Observations of programs• Attendance documentation • Pre/post participant surveys

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Required Staff TrainingRequired Staff Training

• Training from program developers or certified trainers

~ Available for 11 of 16 programs*

• Training from SDRG/CTC staff~ CTC CPIT workshops emphasize

program fidelity, completion of fidelity instruments, and discussion of potential challenges

• All implementers received both trainings

*Exceptions: PALS, Tutoring, Parents Who Care, Family Matters, Parenting Wisely

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Fidelity Assessment Fidelity Assessment ChecklistsChecklists

• Provided similar information across programs to measure primarily adherence and dosage

• Checklists were completed by program staff, reviewed locally and analyzed at the UW

• 3,000-4,000 checklists were completed annually

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Adherence RatesAdherence Rates Averaged across all years Averaged across all years

0

10

20

30

40

50

60

70

80

90

100

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

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

21

Adherence Rates Adherence Rates School BasedSchool Based

0

10

20

30

40

50

60

70

80

90

100

LST All Stars SFA PDE Alert Olweus TNDA

2004-052005-062006-072007-08


22

Adherence Rates Adherence Rates AfterschoolAfterschool Programs Programs

0

10

20

30

40

50

60

70

80

90

100

SMART BBBS PALS Tutor Valued Youth

2004-052005-062006-072007-08


23

Adherence Rates Adherence Rates Parent TrainingParent Training

0

10

20

30

40

50

60

70

80

90

100

SFP 10-14 GGC PWC Family Matters Parenting Wisely

2004-052005-062006-072007-08


24

Delivery of LessonsDelivery of Lessons Averaged across all years Averaged across all years ((number, length, and frequency of required number, length, and frequency of required

sessions)sessions)

0

10

20

30

40

50

60

70

80

90

100

LST AS SFA Alert BPP TNDA SMART Tutor VY BBBS PALS SFP GGC PWC FM

Percentage of delivery requirements met

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Program ObservationsProgram Observations

• Community volunteers observed 10-15% of sessions for 10 programs

• Completed fidelity checklists to assess adherence

~ Rate of agreement w/ implementers was 92%-97%

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Quality of DeliveryQuality of Delivery• Observers rated the quality of delivery on

10 items (alpha = .87-.90) using a 5-point scale (higher scores indicate better quality)

• Example Items: ~ In general, how clear were the program implementer’s

explanations of activities?~ To what extent did the implementer keep on time

during the session and activities? ~ Rate the implementer on the following qualities:

• Level of enthusiasm

• Rapport and communication with participants

• Effectively addressed questions/concerns

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Quality of Delivery Quality of Delivery Averaged across all yearsAveraged across all years

1

1.5

2

2.5

3

3.5

4

4.5

5

LST All Stars Alert SFA BPP SMART PALS SFP GGC PWC

Average score on 10 items reported by program observersAverage score on 10 items reported by program observers

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Participant Participant ResponsivenessResponsiveness

•Observers rated participant responsiveness on two items, using a 1-5 scale (higher scores indicate better responsiveness):~ To what extent did the participants

appear to understand the material? ~ How actively did group members

participate in discussions and activities?

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Participant Participant ResponsivenessResponsiveness

Averaged across all yearsAveraged across all years

1

1.5

2

2.5

3

3.5

4

4.5

5

LST All Stars SFA Alert BPP SMART PALS SFP GGC PWC


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Pre-Post Survey Pre-Post Survey ResultsResultsParent Survey Results (n=261) from SFP 10-14 in Community Q

PARENTING SKILLPre-survey Mean Score

Post-survey Mean Score

COMMUNICATION STYLE EG: I let my youth know the reason for the rules we have

2.82 3.26*

SCHOOL INVOLVEMENT EG: I attend parent-teacher conferences at school

3.13 3.39*

NURTURE AND SUPPORT EG: We take time to do something fun together as a family

3.04 3.37*

CONTINGENT PARENTING EG: I follow through with consequences each time he or she breaks a rule

2.86 3.28*

*Statistically significant change (p<.05) from pre-survey to post-survey based on t-tests All items rated on a 1-4 scale (from “a little bit of the time” to “most of the time”)

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Implementation Implementation SummarySummary

• We successfully “bridged” science and practice in the study, as researchers assisted local CTC community coalitions to ensure high implementation fidelity

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Adoption of Science-based

Prevention

Community Collaboration for Prevention Appropriate Choice and

Implementation of Tested, Effective Prevention Programs

Positive Youth Outcomes

Decreased Risk and Enhanced Protection

CTC Training, Technical Assistance

Community Norms

Social Development Strategy

Community Supportfor Prevention

System Transformation Constructs System OutcomesSystem Catalyst

Communities That Care Communities That Care Logic ModelLogic Model

33

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

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-0.30

-0.20

-0.10

0.00

0.10

0.20

0.30

0.40

Controls CTC

Grade 5 Grade 7

Results: Change in prioritized risk factors

Ave

rage

Lev

el o

f R

isk

Grade 6 Grade 8

Note. Results from a linear growth model with community matched pairs using data from YDS Grades 5 through 8 averaged across 40 imputed data sets; β101 = 0.026, SE = 0.010, t (df = 9, N = 4407) = 2.54, p = 0.032 for linear slopes; β001 = -0.064, SE = 0.031, t (df = 9, N = 4407) = -2.10, p = 0.064 for mean difference at Grade 8.

35

Effects of CTC on Effects of CTC on Initiation (Incidence) of Initiation (Incidence) of

Drug Use and Drug Use and DelinquencyDelinquency Onset of substance use and delinquency

between grade 6 and 8: Alcohol use * Cigarette smoking* Smokeless tobacco use* Marijuana use Other illicit drug use Delinquent behavior*

Among 5th grade students who had not yet initiated.

36

Onset of Alcohol UseOnset of Alcohol Use

36

Adjusted Hazard

Alcohol

0.170.13 0.13

0.25

0.110.13

0.00

0.05

0.10

0.15

0.20

0.25

Grade 6 Grade 7 Grade 8

Control

CTC

p < .05OR = 0.63

37

Onset of Cigarette Onset of Cigarette SmokingSmoking

0.08

0.12

0.030.05

0.040.05

0.00

0.05

0.10

0.15


Control CTC

37

Adjusted Hazard

p < .05

OR = 0.55

38

Onset of Delinquent Onset of Delinquent BehaviorBehavior

0.16

0.21

0.18

0.11

0.13

0.08

0.00

0.05

0.10

0.15

0.20

0.25


Control CTC

38

Adjusted Hazard

p < .05

OR = 0.71

p < .05

OR = 0.71

39

0.00

5.00

10.00

15.00

20.00

25.00

Grade 5 Grade 8

Controls CTC

Prevalence of Current Alcohol Use In Panel

In Control and CTC CommunitiesP

erce

ntag

e

Note. Observed rates averaged across 40 imputations. ns = nonsignificant. N = 4407.

21.4 p < .05

16.4

3.3 ns 3.1

40

0.00

5.00

10.00

15.00

20.00

25.00

Grade 5 Grade 8

Controls CTC

Prevalence of Binge Drinking in Past Two Weeks

In Panel In Control and CTC Communities

Per

cent

age


9.0 p < .05

5.7

1.3 ns 1.0

0.00

5.00

10.00

15.00

20.00

25.00

Grade 5 Grade 8

Controls CTC

Prevalence of Current Smokeless Prevalence of Current Smokeless Tobacco Use Tobacco Use

In PanelIn PanelIn CTC and Control CommunitiesIn CTC and Control Communities

Per

cent

age


0.7 ns 0.4

4.3 p < .052.2

0.00

1.00

2.00

3.00

Grade 5 Grade 8

Controls CTC

Mean Number of Different Delinquent Mean Number of Different Delinquent BehaviorsBehaviors

Committed by Panel in Past YearCommitted by Panel in Past YearIn CTC and Control CommunitiesIn CTC and Control Communities

Num

ber

Note. Observed means averaged across 40 imputations. ns = nonsignificant. N = 4407

.36 ns .31

1.13 p < .01.78

43

Why Does CTC Work?Why Does CTC Work?

• Complete set of manualized trainings.• Process for assessing community

readiness.• Milestones and Benchmarks that guide

communities through the CTC process.• Standardized assessment process for

community needs assessment.• Menu of tested and effective preventive

interventions.• Training and tools for monitoring

implementation fidelity and quality and outcomes.

• Paid community coordinator.

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Communities That Care is owned by the federal government and is available at:

http://preventionplatform.samhsa.gov/

NIDA Virtual Town Hall: http://www.visualwebcaster.com/drugabuse-TownHall/

/

CSAP Contact:Patricia Getty, Ph.D.Acting Director, Division of Systems DevelopmentCenter for Substance Abuse [email protected]

http://www.visualwebcaster.com/drugabuse-TownHall/

45

Communities That Care:Communities That Care:Challenge and Challenge and OpportunityOpportunity

•Training and technical assistance are needed to install the CTC system with fidelity.

•CSAP Contact: Dr. Patricia Getty 240 276 2577

[email protected]

46

Using Prevention Science to Using Prevention Science to Reduce Behavioral Problems Reduce Behavioral Problems

Among Young People Among Young People Community-wideCommunity-wide

J. David Hawkins, Ph.D.

Professor of Prevention

Social Development Research Group

School of Social Work

University of Washington

[email protected]

www.sdrg.org

mailto:[email protected]

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Delivery – School Based Delivery – School Based

((number, length, and frequency of required number, length, and frequency of required sessions)sessions)

0

10

20

30

40

50

60

70

80

90

100

LST All Stars SFA Alert Olweus TNDA

2004-052005-062006-072007-08

Percentage of delivery requirements met

48

Delivery - AfterschoolDelivery - Afterschool((number, length, and frequency of required number, length, and frequency of required

sessions)sessions)

0

10

20

30

40

50

60

70

80

90

100

SMART BBBS PALS Tutor Valued Youth

2004-052005-062006-072007-08

Percentage of delivery requirements metPercentage of delivery requirements met

49

Delivery - Parent Delivery - Parent Training Training (n(number, length, and umber, length, and

frequency of required sessions)frequency of required sessions)

0

10

20

30

40

50

60

70

80

90

100

SFP 10-14 GGC PWC Family Matters

2004-052005-062006-072007-08

Percentage of delivery requirements met Percentage of delivery requirements met

50

Quality of Delivery Quality of Delivery School BasedSchool Based

1

1.5

2

2.5

3

3.5

4

4.5

5

LST All Stars SFA Alert Olweus

2004-052005-062006-072007-08


51

Quality of Delivery Quality of Delivery Afterschool & Parent Afterschool & Parent

TrainingTraining

1

1.5

2

2.5

3

3.5

4

4.5

5

SMART PALS SFP 10-14 GGC PWC

2004-052005-062006-072007-08


52

Participant Responsiveness Participant Responsiveness

School BasedSchool Based

1

1.5

2

2.5

3

3.5

4

4.5

5

LST All Stars SFA Alert Olweus

2004-052005-062006-072007-08


53

Participant Participant Responsiveness Responsiveness

Afterschool & Parent Afterschool & Parent TrainingTraining

1

1.5

2

2.5

3

3.5

4

4.5

5

SMART PALS SFP 10-14 GGC PWC

2004-052005-062006-072007-08


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