title: Effects of the Communities That Care system on cross-sectional profiles of adolescent substance use and delinquency.
abstract: BACKGROUND
  Adolescent substance use and delinquency are major public health problems. Although community-based prevention strategies have been recommended to produce population-level reductions in rates of substance use and delinquency, few models show evidence of effectiveness.
  
  
  OBJECTIVE
  To test the efficacy of a community-based prevention system, Communities That Care (CTC), in reducing community rates of problem behaviors, particularly effects on specific profiles of adolescent substance use and delinquency in eighth- and tenth-graders.
  
  
  METHODS
  Twenty-four communities were randomized to CTC intervention or control groups. Data were collected from 14,099 8th- and 10th-grade students in these communities using anonymous cross-sectional surveys in 2004 and 2010 and analyzed in 2012. Outcomes were four different profiles of self-reported substance use and delinquency in 8th grade and five profiles in 10th grade.
  
  
  RESULTS
  In the cross-sectional 2010 data, there was no intervention effect on the probability of experimenting with substances or of substance use coupled with delinquent activities for either grade. However, tenth-graders in intervention communities were significantly less likely to be alcohol users than those in control communities (OR=0.69, CI=0.48, 1.00).
  
  
  CONCLUSIONS
  Cross-sectional population surveys showed evidence of CTC effects in reducing tenth-grade alcohol users but not experimenters. A community-wide reduction in adolescent alcohol use is important because alcohol is the most commonly used illicit substance during adolescence, and early initiation of alcohol use has been associated with alcohol-related disorders in adulthood. Failure to find hypothesized effects on experimenters qualifies these results.
authors.affiliation: Department of Psychology, University of South Carolina, Columbia, South Carolina. Electronic address: vanhorn@sc.edu.
authors.forename: M Lee
authors.initials: ML
authors.lastname: Van Horn
authors.affiliation: Department of Sociology, Criminology & Law, University of Florida, Gainesville, Florida.
authors.forename: Abigail A
authors.initials: AA
authors.lastname: Fagan
authors.affiliation: Social Development Research Group, University of Washington, Seattle, Washington.
authors.forename: J David
authors.initials: JD
authors.lastname: Hawkins
authors.affiliation: Social Development Research Group, University of Washington, Seattle, Washington.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Oesterle
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000517:prevention & control; D003153:Community Health Services / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency / Q000517:prevention & control / Q000706:statistics & numerical data*; D008297:Male; D017063:Outcome Assessment, Health Care; D011314:Preventive Health Services / Q000458:organization & administration; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control