Sustained Decreases in Risk Exposure and Youth Problem Behaviors After Installation of the Communities That Care Prevention System in a Randomized Trial
Sustained Decreases in Risk Exposure and Youth Problem Behaviors After Installation of the Communities That Care Prevention System in a Randomized Trial
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DOI：
10.1001/archpediatrics.2011.183
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发表时间：
2012-02-01
影响因子：
--
通讯作者：
Catalano, Richard F.
中科院分区：
文献类型：
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作者：
Hawkins, J. David;Oesterle, Sabrina;Catalano, Richard F.
目的：为了测试社区关怀（CTC）预防系统是否在CTC安装后6年和研究提供的资源结束后1年降低了整个社区的风险和青少年问题行为水平。设计：社区随机试验。设置：2003年7个州的24个小城镇，在州内匹配，随机分配到对照或干预条件。参与者：从2004年到2009年，每年对4407名五年级学生进行调查，直到10年级。一个社区利益攸关方联盟接受了安装CTC的培训和技术援助，使用流行病学数据来确定社区中升高的风险因素和降低的保护因素，并实施了一系列针对10至14岁青少年、他们的家庭和学校的经过测试和有效的方案，以解决他们社区的高风险。按10年级列出的吸烟、酗酒和其他药物使用的风险水平、发病率和患病率;青少年犯罪;暴力行为。在CTC中，目标风险的平均水平在5级和10级之间的增长速度低于对照社区，十级。在10年级，CTC的犯罪行为、饮酒和吸烟的发生率以及当前吸烟和过去一年犯罪和暴力行为的患病率均显著低于对照社区。使用CTC系统可以在社区范围内持续减少青少年的风险因素和问题行为，可能有助于长期的公共卫生利益。
Objective: To test whether the Communities That Care (CTC) prevention system reduced levels of risk and adolescent problem behaviors community-wide 6 years after installation of CTC and 1 year after study-provided resources ended.Design: A community randomized trial.Setting: Twenty-four small towns in 7 states, matched within state, randomly assigned to control or intervention condition in 2003.Participants: A panel of 4407 fifth-grade students was surveyed annually through 10th grade from 2004 to 2009.Intervention: A coalition of community stakeholders received training and technical assistance to install CTC, used epidemiologic data to identify elevated risk factors and depressed protective factors in the community, and implemented programs to address their community's elevated risks from a menu of tested and effective programs for youths aged 10 to 14 years, their families, and schools.Outcome Measures: Levels of risk and incidence and prevalence of tobacco, alcohol, and other drug use; delinquency; and violent behavior by grade 10.Results: Mean levels of targeted risks increased less rapidly between grades 5 and 10 in CTC than in control communities and were significantly lower in CTC than control communities in grade 10. The incidence of delinquent behavior, alcohol use, and cigarette use and the prevalence of current cigarette use and past-year delinquent and violent behavior were significantly lower in CTC than in control communities in grade 10.Conclusions: Using the CTC system can produce enduring reductions in community-wide levels of risk factors and problem behaviors among adolescents beyond the years of supported implementation, potentially contributing to long-term public health benefits.