Activating community coalitions for effective prevention planning: the Communities That Care approach

Community coalitions have been suggested as mechanisms to build capacity to mount effective prevention initiatives in communities. Despite support for the development of coalitions to guide community prevention efforts, several studies have found coalitions to be ineffective in reducing the prevalence of adolescent health and behavior problems in communities. The Communities That Care (CTC) prevention operating system was developed to improve coalition outcomes by providing structure, processes, and tools designed to enable coalitions to use prevention science as a basis for community prevention services. CTC is designed to reduce levels of adolescent delinquency and substance use through the selection and use of effective preventive interventions tailored to a community’s specific profile of risk and protection. CTC provides a structure for engaging community stakeholders, a process for establishing a shared community vision, tools for assessing levels of risk and protection in communities, and processes for prioritizing risk and protective factors and setting specific, measureable community goals. CTC guides the coalition to create a strategic community prevention plan designed to address the community’s profile of risk and protection with tested, effective programs and to implement the chosen programs with fidelity. CTC instructs the coalition to monitor program implementation and to periodically reevaluate community levels of risk and protection and outcomes, and to make adjustments in prevention programming if indicated by the data. CTC is installed in communities through a series of six training events delivered over the course of 6 to 12 months by certified CTC trainers. All CTC training materials are available on the internet at http://preventionplatform.samhsa.gov. CTC has been shown in a controlled randomized trial to delay the initiation of adolescent substance use and delinquency and reduce the prevalence of substance use and the variety of delinquent behavior among 8th grade students.