BOX 11-1Models for Community Implementation of Evidence-Based Programs

Communities That Care

Communities That Care (CTC), a prevention system designed to reduce adolescent delinquency and substance use, was built as part of the Center for Substance Abuse Prevention approach to effective implementation (see It provides a process for communities, through a community prevention board, to identify their prevention priorities and develop a profile of community risk and protective factors. The CTC logic model involves community-level training and technical assistance for three steps: (1) community adoption of a science-based prevention framework, (2) creation of a plan for changing outcomes through a menu of evidence-based programs that target risk and protective factors identified by the community, and (3) implementation and evaluation of these programs using both process and outcome evaluations. Currently, there are 56 available programs that meet CTC’s required standard of evidence.

CTC’s theory of change hypothesizes that it takes two to five years to observe changes in prioritized risk factors and five or more years to observe effects on delinquency or substance use. CTC’s data driven process is being evaluated in multiple steps. The first step, a five-year nonexperimental study with 40 incorporated towns, assessed the degree to which they reported using tested and effective programs. In the next phase, 24 of these communities who had not reported already using such programs agreed to be part of a large randomized community-level trial to test the CTC model (Hawkins, 2006). Early findings from these communities indicate that CTC has positive effects on targeted risk factors and delinquent behavior (Hawkins, Brown, et al., 2008) as well as alcohol use and binge drinking (Hawkins, Oesterle, et al., in press). Longer term follow-up is under way.

PROmoting School-community-university Partnerships to Enhance Resilience Model

The PROmoting School-community-university Partnerships to Enhance Resilience (PROSPER) model (Spoth, Greenberg, et al., 2004; Greenberg, Feinberg, et al., 2007) has devised a system aimed at broad implementation of evidence-based programs designed to support positive youth development and reduce early substance use delivered to rural areas with supports at the local, regional, and state levels. Underlying this system is the building of an infrastructure that supports local ownership and capacity building as well as leadership and institutional support (Spoth, Greenberg, et al., 2004). Three groups are involved in the PROSPER partnership model: (1) faculty from land grant universities and affiliated cooperative extension staff, (2) the elementary and secondary school systems, and (3) community agency providers of services for children and families, along with other community stakeholders.

The partnership benefited from the existing training and technical assistance infrastructure provided by the Extension System and the U.S. Department of Education’s Safe and Drug-Free Schools (SDFS) Program. Because the prevention programs in PROSPER are delivered by local practitioners, it focuses on building strong support of the school–local community team, which chooses interventions and is responsible for their implementation. At the state level, researchers work with regional Extension Service prevention coordinators and coordinators from the SDFS Program. These regional coordinators then provide support to local teams of extension agents, elementary and secondary school faculties and staffs, and community interagency coalition members. The long-term goal is to provide infrastructure support as well as direct assistance to sustain effective, empirically based programs in communities.

This implementation model has national implications, as the Extension Service has more than 9,600 local agents working in 3,150 counties across the United States. The Department of Education has multiple technical assistance centers that support efforts to adopt empirically supported programs that can reduce substance abuse, violence, and other conduct problems in the schools. Furthermore, the SDFS Program currently has coordinators in many schools to facilitate the implementation of such research-based programs.

From: 11, Implementation and Dissemination of Prevention Programs

Cover of Preventing Mental, Emotional, and Behavioral Disorders Among Young People
Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities.
National Research Council (US) and Institute of Medicine (US) Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions; O'Connell ME, Boat T, Warner KE, editors.
Washington (DC): National Academies Press (US); 2009.
Copyright © 2009, National Academy of Sciences.

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