Transcript Document

Melbourne Rotary
7 April 2010
Communities that Care Evaluation
Richard F. Catalano, Ph.D
Bartley Dobb Professor for the Study and Prevention of Violence
Director, Social Development Research Group
School of Social Work
University of Washington
www.sdrg.org
Communities That Care Ltd
a partnership between the Rotary Club of
Melbourne , the Royal Children’s Hospital
& the University of Washington
www.wch.org.au/ctc
[email protected]
Prevention Science
Framework
Program
Implementation
and
Evaluation
Interventions
Define the
Problem
Problem
Identify Risk
and Protective
Factors
Response
Prevention Science
Research Advances
Etiology/Epidemiology of Problem Behaviors

Identify risk and protective factors that
predict problem behaviors and describe
their distribution in populations.
Efficacy Trials

Design and test preventive interventions
to interrupt causal processes that lead to
youth problems.
Risk Factors for
Adolescent Problem Behaviors
Depression &
Anxiety
Violence
School Drop-Out
Teen Pregnancy
Delinquency
Substance Abuse
Risk Factors
Community
Availability of Drugs

Availability of Firearms
Community Laws and Norms Favorable
Toward Drug Use, Firearms, and Crime






Media Portrayals of Violence

Transitions and Mobility


Low Neighborhood Attachment and
Community Disorganization


Extreme Economic Deprivation








Family
School
Individual/Peer
Protective Factors
Individual Characteristics
– High Intelligence
– Resilient Temperament
– Competencies and Skills
In each social domain (family, school, peer
group and neighborhood)
– Positive Opportunities
– Reinforcement for Positive Involvement
– Bonding
– Healthy Beliefs and Clear Standards
Prevalence of 30 Day Alcohol Use
by Number of Risk and Protective Factors
Six State Student Survey of 6th-12th Graders, Public School
Students
100%
90%
Number of
Protective Factors
80%
Prevalence
70%
0 to 1
2 to 3
4 to 5
6 to 7
8 to 9
60%
50%
40%
30%
20%
10%
0%
0 to 1
2 to 3
4 to 5
6 to 7
Number of Risk Factors
8 to 9
10+
Prevalence of “Attacked to Hurt”
By Number of Risk and Protective Factors
60%
Prevalence
50%
40%
30%
20%
Protection, Level 0
Protection, Level 1
Protection, Level 2
Protection, Level 3
Protection, Level 4
10%
0%
Risk, Level Risk, Level Risk, Level Risk, Level Risk, Level
0
1
2
3
4
Prevalence of Other Problems
by Number of Risk Factors
50
40
depressive
symptomatology
30
deliberate self harm
%
homelessness
20
early sexual activity
10
0
0-1
2-3
4-6
Risk factors
7-9
>=10
Bond, Thomas, Toumbourou,
Patton, and Catalano, 2000
Number of School Building Level Risk
Factors and Probability of Meeting
Achievement Test Standard
Probability of Meeting Standard
(10th Grade Students)
1.0
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
0
1
2
3
4
5
6
7
8
9 10 11 12 13 14 15 16
Number of Risk Factors
Arthur et al., 2006
Math
Reading
Writing
Epidemiology

Different neighborhoods have
different profiles of risk,
protection, and outcomes.
Distribution of Risk in a City
Neighborhood #2
Insufficient number of
students in this area.
No students
in this area.
Neighborhood #1
Neighborhood #3
John A. Pollard, Ph.D. Developmental Research and Programs
Prevention Science
Research Advances
Etiology/Epidemiology of Problem Behaviors

Identify risk and protective factors that
predict problem behaviors and describe
their distribution in populations.
Efficacy Trials

Design and test preventive interventions
to interrupt causal processes that lead
to youth problems.
Wide Ranging Approaches
Have Been Found To Be
Effective
1.
Prenatal & Infancy Programs
2.
Early Childhood Education
3.
Parent Training
4.
After-school Recreation
5.
Mentoring with Contingent
Reinforcement
6.
Youth Employment with
Education
7.
Organizational Change in
Schools
(Hawkins & Catalano, 2004)
8.
Classroom
Organization,
Management, and
Instructional Strategies
9.
School Behavior
Management Strategies
10. Classroom Curricula for
Social Competence
Promotion
11. Community & School
Policies
12. Community
Mobilization
Selected Benefit Cost Findings
Summary of Benefits and Costs (2003 Dollars)
Dollars Per Youth
Benefits
Costs
B-C
$17,202
$7,301
$9,901
Nurse Family Partnership
$26,298
Life Skills Training
$746
Seattle Soc. Dev. Project
$14,246
Guiding Good Choices
$7,605
Multi-D Treat. Foster Care
$26,748
Intensive Juv. Supervision
$0
Big Brothers/Sisters (all costs) $4,058
$9,118
$29
$4,590
$687
$2,459
$1,482
$4,010
$17,180
$717
$9,837
$6,918
$24,290
-$1,482
$48
(PV
lifecycle)
Early Childhood Education
(taxpayer costs only)
$4,058
$1,283
Steve Aos, Associate Director
Washington State Institute for Public Policy
[email protected] www.wa.gov/wsipp
$2,775
But…
 Prevention approaches that do not
work or have not been evaluated
have been more widely used than
those shown to be effective.
(Gottfredson et al 2000, Hallfors et al 2000, Hantman
et al 2000, Mendel et al 2000, Silvia et al 1997; Smith
et al 2002)
Communities that Care Model
for Achieving the Vision of
Science Informing Practice
Provides the education, skills and
tools to build community
capacity to change youth
outcomes through choosing
and implementing tested,
effective programs matched to
their needs
The Communities That Care
Operating System
• Community readiness
assessment.
• Identification of key
individuals, stakeholders,
and organizations.
Get Started
Implement and
Evaluate
Creating
Communities
That Care
Create a Plan
Get Organized
Develop a Profile
The Communities That Care
Operating System
• Training key leaders
and board in CTC
Get Started
Implement and
Evaluate
• Building the
community coalition.
Creating
Communities
That Care
Create a Plan
Get Organized
Develop a Profile
The Communities That Care
Tools for Decision Making
Get Started
Implement and
Evaluate
Creating
Communities
That Care
Create a Plan
• Collect
risk/protective factor
and outcome data.
Get Organized
• Construct a
community profile
from the data.
Develop a Profile
The CTC Youth Survey Tool
Helps Match Need to Tested,
Effective Programs



Identifies levels of 21 risk and 9
protective factors and academic and
behavioral outcomes
Guides planners to select tested, effective
actions
Monitors the effects of chosen actions
The Communities That Care
Tools for Decision Making
Get Started
Implement
and
• Define outcomes.
•Prioritize risk factors to be
Evaluate
targeted.
• Select tested, effective
interventions.
• Create action plan.
• Develop evaluation plan.
Creating
Communities
That Care
Create a Plan
Get Organized
Develop a Profile
Peer-Individual
Total Risk
Gang Involvement
Intention to Use Drugs
Depressive Symptoms
Rewards for ASB
Friends' Use of Drugs
Interaction with Antisocial Peers
Perceived Risk of Drug Use
School
Attitude Favorable to Drug Use
Attitude Favorable to ASB
Early Initiation of Drug Use
Early Initiation of ASB
Rebelliousness
Low Commitment to School
Family
Academic Failure
Parent Attitudes Favor Drug Use
Parent Attitudes Favorable to ASB
Community
amily History of Antisocial Behavior
Family Conflict
Poor Family Management
Perceived Availability of Handguns
Perceived Availability of Drugs
Laws & Norms Favor Drug Use
Community Disorganization
Low Neighborhood Attachment
Percentage of Youth at Risk
School A
2005 Risk Profile
100%
Total
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Schenectady High School
Protective Factors
Risk Factor Addressed
Individual/Peer Domain
Rebelliousness
Friends Who Engage in the
Problem Behavior
Favorable Attitudes
Toward the Problem
Behavior
Early Initiation of the
Problem Behavior
Constitutional Factors
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
Youth Employment with Education





15-18
Parent Training





6-14
Classroom Curricula for Social Competence
Promotion





6-14
Afterschool Recreation





6-14
Mentoring with Contingent Reinforcement


11-18
Classroom Curricula for Social Competence
Promotion





6-14
Parent Training





6-14
Classroom Organization Management and
Instructional Strategy





6-10
Classroom Curricula for Social Competence





6-14
Community/School Policies

Prenatal/Infancy Programs

Program Strategy






Community/School Policies
all

© 1998 Developmental Research and Programs



prenatal-2
Classroom Curricula for Social/
Emotional Competence Promotion
Tested, Effective Programs




The Life Skills Training Program (Botvin et
al., 1995)
Project Alert Drug Prevention Curriculum
(Ellickson et al., 1993; Ellickson and Bell,
1990)
Alcohol Misuse Prevention
(Maggs et al., 1998)
Towards No Drug Use
(Sussman et al. 2003; 2003)
Peer-Individual
Total Risk
Gang Involvement
Intention to Use Drugs
Depressive Symptoms
Rewards for ASB
Friends' Use of Drugs
Interaction with Antisocial Peers
Perceived Risk of Drug Use
School
Attitude Favorable to Drug Use
Attitude Favorable to ASB
Early Initiation of Drug Use
Early Initiation of ASB
Rebelliousness
Low Commitment to School
Family
Academic Failure
Parent Attitudes Favor Drug Use
Parent Attitudes Favorable to ASB
Community
Family History of Antisocial Behavior
Family Conflict
Poor Family Management
Perceived Availability of Handguns
Perceived Availability of Drugs
Laws & Norms Favor Drug Use
Community Disorganization
Low Neighborhood Attachment
Percentage of Youth at Risk
School A
2005 Risk Profile
100%
Total
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Schenectady High School
Protective Factors
Risk Factor Addressed
School Domain
Academic Failure
(continued)
Lack of Commitment
to School
Healthy
Beliefs
& Clear
Standards
Bonding
Opport.
Skills
Recog.
Classroom Organization, Management and
Instructional Strategies





Classroom Curricula for Social
Competence Promotion





School Behavior Management Strategies

Youth Employment with Education



Early Childhood Education


Organizational Changes in Schools

Classroom Organization, Management and
Instructional Strategies

School Behavior Management Strategies



6-14
Mentoring with Contingent Reinforcement



11-18
Youth Employment with Education


15-21
Program Strategy

Developmental
Period
6-18
6-14

6-14


15-21



3-5




6-18







6-18
Classroom Organization,
Management, and Instructional
Tested, Effective Strategies






The Good Behavior Game (Kellam and Rebok,
1992)
Seattle Social Development Project (Hawkins et al.,
1999; 2005; 2008)
Behavioral Intervention for Middle School Students
(Bry, 1982)
Cooperative Learning Programs (Slavin, 1983)
Tutoring Programs (Coie et al., 1984; Greenwood
et al., 1993)
Success for All (Slavin et al., 1990)
The Communities That Care
Tools for Accountability
• 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.
Implement and
Evaluate
Get Started
Creating
Communities
That Care
Create a Plan
Get Organized
Develop a Profile
Community Youth Development Study
A 24 Community Randomized Trial of CTC
PI: J. David Hawkins
Co-PI: Richard F. Catalano
Funded in 2003 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
Communities That Care
Theory of Change
CTC Training and
Technical Assistance
(Brown
et al,
2007)
Adoption of Science-based
Prevention Framework
Collaboration
Regarding Prevention Issues
(Quinby
et al,
2008;
Fagan et
al.,
2008,
Hawkins
et al.,
2008)
Appropriate Choice
and Implementation
of Tested, Effective
Prevention Programs &
Adoption of Social Development
Strategy as Community’s Way of
Bringing Up Children
Decreased Risk and
Enhanced Protection 2
years post initiation
Positive Youth
Outcomes 3+
years post
initiation
Effects of CTC on Onset of
Drug Use and Delinquency

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.
*=Significant at p<.05
Hawkins et al., 2009
Effects of CTC on Current Drug
Use and Delinquency in the Panel
•
•
•
•
Alcohol use*
Binge drinking*
Tobacco Use*
Delinquency*
*=significant at p<.05
Hawkins et al., 2009
Prevalence of Binge Drinking in Past
Two Weeks
In Panel
In Control and CTC Communities
25.00
Percentage
20.00
15.00
9.0
10.00
5.00
p < .05
5.7
1.3 ns 1.0
0.00
Grade 5
Controls
Grade 8
CTC
Note. Observed rates averaged across 40 imputations. ns = nonsignificant. N = 4407.
Hawkins et al., 2009
Mean Number of Different Delinquent
Behaviors
Committed by Panel in Past Year
In CTC and Control Communities
Number
3.00
2.00
1.13
1.00
p < .01
.78
.36 ns .31
0.00
Grade 5
Controls
Note. Observed means averaged across 40 imputations.
ns = nonsignificant. N = 4407
Grade 8
CTC
Hawkins et al., 2009
Summary and Implications
There is evidence that we can advance
public health in our communities by
using CTC to:
• Promote the collection of data on levels
of risk and protection to focus
community action on elevated risks.
• Engage in community efforts to
strengthen protection and reduce risks.
• Sponsor, endorse and use tested and
effective prevention programs.
• Deliver effective programs with fidelity
Communities That Care
has been pioneered in Australia
Bunbury
Ballarat
Mornington
Communities That Care LTD
Accomplishments
CTC Survey Victoria Wide (1999, 2009)
 Establishment of CTC Ltd (support from the

Rotary Club of Melbourne, the Baker Foundation,
Perpetual Trustees, VicHealth, the Brockhoff Foundation,
the Victorian Community Support Fund and others)
Selection of demonstration sites-2002
 Evaluation of demonstration sites in process
with promising findings

Communities That Care LTD
What Can You Do Now?





Continue Rotary Club link
Help identify new communities that need CTC
Support the CTC evaluation trial
Support implementation of tested, effective
programs
Encourage investment in prevention
Communities That Care Ltd
a partnership between the Rotary Club of
Melbourne , the Royal Children’s Hospital
& the University of Washington
www.wch.org.au/ctc
[email protected]
Communities That Care:
Quasi-Experimental Effectiveness
Trial in Pennsylvania
Investigators:
Mark Feinberg
Mark Greenberg
Louis Brown
Damon Jones
Collaborative Policy Innovators:
Mike Pennington
Clay Yeager
Summary of Findings
• Overall, CTC communities showed lower
levels of risk factors, substance abuse, and
delinquency (7x as many as chance)
• Even greater impact where evidence-based
prevention programs were used (11x)