Implementing the Communities That Care Prevention System: Challenges, Solutions, and Opportunities in an Urban Setting.

INTRODUCTION: Communities That Care, refined and tested for more than 25years, offers a step-by-step coalition-based approach to promote well-being and prevent risk behaviors among youth. Communities That Care guides coalitions to identify and prioritize underlying risk and protective factors; set specific, measurable community goals; adopt tested, effective prevention programs to target selected factors; and implement chosen programs with fidelity. Communities That Care has been implemented in a variety of communities, but has only recently begun to be systematically evaluated in diverse, urban communities. METHODS: This paper presents a process evaluation of Communities That Care implementation within a Midwestern ethnically diverse, urban community. In-depth surveys of 25 black male youth aged 8-14years and their caregivers were conducted to determine the degree to which coalition-selected priorities aligned with the experience of black families. Implementation and survey data were collected in 2014-2017 and analyzed in 2017-2018. RESULTS: Roughly 30% of youth reported ever being bullied or bullying someone else on school property; this aligned with the coalition's decision to focus on positive social skills and bullying prevention. Additional data aligned with the coalition's intent to expand its community action plan to encompass other priorities, including family transitions and mobility. For example, roughly one third of caregivers went on welfare and one third of families moved to a new home or apartment in the past year. CONCLUSIONS: In communities whose residents have experienced historical and current inequities, an effective community prevention plan may need to address structural as well as social determinants of well-being among youth and their families. SUPPLEMENT INFORMATION: This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

If At First You Don't Succeed Keep Trying: Strategies to Enhance Coalition/School Partnerships to Implement School-Based Prevention Programming.

Community-based coalitions have been advocated as a promising mechanism to reduce youth involvement in violence, delinquency, and substance use, but coalitions have not always been successful in ensuring widespread adoption of evidence-based prevention strategies. This paper describes the strategies used by 12 community coalitions to collaborate with schools to select and implement school-based prevention programs, including the barriers to establishing coalition/school partnerships and methods for overcoming these challenges.In this five-year research project, all communities adopted school-based prevention programs. Coalitions helped achieve this outcome by building relationships with school personnel, fostering champions within the school, creating win/win situations in which schools' needs were addressed, and initiating school-based prevention programs as pilot efforts that were later expanded. While success was achieved in all cases, persistent messaging about the importance of youth problem behaviours was needed to overcome schools' concerns about using academic time to teach prevention messages and replacing current practices with unfamiliar programs.Findings from this study can be used by coalitions and prevention scientists that want to partner with schools to reach a large population of students with effective prevention programming. The results are also of value to researchers and practitioners interested in fostering widespread dissemination of other types of evidence-based programs.

Measuring risk and protection in communities using the Communities That Care Youth Survey.

The Communities That Care Youth Survey measures risk and protective factors shown in prior studies to predict adolescent problem behaviors such as drug use, delinquency, and violence. This paper describes the development and validation of cut points for the risk and protective factor scales in the Communities That Care Youth Survey that distinguish youths at higher risk for involvement in problem behaviors from those at lower risk. Using these cut points, populations surveyed with this instrument can be described in terms of the proportions of youths experiencing risk and the proportions experiencing protection on each predictor. This facilitates communities' prioritization of specific factors for attention. This paper compares different cut points, and evaluates the discriminant validity of selected cut points. Results indicate that cut points with sufficient sensitivity and selectivity can be established for each of the scales, and that risk and protective factors can be profiled as prevalence rates. Implications of these findings for prevention planning are discussed.