1. Communities That Care

Communities That Care

Program Goals

Communities that Care (CTC) is a system for planning and marshalling community resources to address problematic behavior, such as aggression or drug use, in adolescents. It has five phases to help communities work toward their goals. The CTC system includes training events and guides for community leaders and organizations. The main goal is to create a “community prevention board” comprising public officials and community leaders to identify and reduce risk factors while promoting protective factors by selecting and implementing tested interventions throughout the community. Repeated assessments are incorporated into the CTC system to serve as an ongoing evaluation of the program and as a guidepost for communities dealing with adolescent health and behavioral problems.


Program Activities

CTC requires six training events, delivered between six months and one year to properly install it in communities. Certified CTC trainers lead community leaders and other local figures through the five phases of the program. Phase One, or “Getting Started,” is where communities organize and identify community issues. Phase Two, “Getting Organized,” has these early organizations reach out to key leaders and involve more of the community. Phase Three, or “Developing a Community Profile,” is where research comes in: in this phase, communities should collect data, analyze risk and protective factors, and assess available resources that can be used to address the issues at hand. Phase Four, known as “Creating a Comprehensive Community Action Plan,” is where organized communities merge the data gathered with the stated problems and create clear measurable outcomes that the community can work to resolve.


By marshalling resources, focusing on specific problems, and selecting evidence-based interventions, the CTC is expected to reduce communitywide risk factors that lead to reductions in adolescent delinquent behaviors. It should take two to five years for communities to notice a marked reduction in risk factors, and five to 10 years to observe substantial decreases in adolescent substance use and delinquency.


Eligibility/Targeted Sites

CTC is a community-level intervention that focuses on risk factors leading to teenage substance use and problem behavior. As such, any community that is dealing with or has problems with adolescent drug use and delinquency is eligible to use the CTC system.

Intervention ID

10 to 17


Study 1

Risk Factors

Hawkins and colleagues (2008) found that baseline measures of risk factors at grade Five between Communities that Care (CTC) communities and control communities were not significantly different. By grade Seven, those same risk factors were significantly higher for students in control communities. Grade Five levels of risk, students’ age, and parental education were all significantly associated with grade Seven levels of risk. No other demographic variables had such a relationship.


Drug Use

There was no significant intervention effect on substance use initiation. A student’s race, parental education, religious attendance, and rebelliousness were significantly associated with the onset of substance use. Community demographic variables were not significantly related to behavior outcomes. 



A significant intervention effect was found on the initiation of delinquent behavior. Adolescents from control communities were 27 percent more likely to initiate delinquent behavior during grades Six and Seven than youth from intervention communities. A student’s age, gender, race, parental education, and rebelliousness were significantly associated with onset of delinquent behavior. Community demographic variables were not significantly related to behavior outcomes.


Study 2

Drug Use

Hawkins and colleagues (2009) found a significant effect on the initiation of the use alcohol, cigarettes, and smokeless tobacco between seventh and eighth grades. Adolescents receiving the CTC system intervention were significantly less likely to start using any of the aforementioned substances. Students in control communities, on the other hand, were 60 percent more likely to use alcohol, 79 percent more likely to use cigarettes, and 134 percent more likely to use smokeless tobacco between seventh and eighth grade. Significant effects for the onset of marijuana and inhalant use were not observed by the spring of eighth grade, however.



A significant intervention effect was found on the incidence of delinquency that was proportional across time. Students in control communities were 41 percent more likely to initiate in delinquent behavior than those receiving the CTC intervention.

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