Communities That Care is modeled in Maricopa County, Arizona

Communities That Care (CTC) is a program of the Center for Substance Abuse Prevention (CSAP) in the office of the United States Government's Substance Abuse and Mental Health Services Administration (SAMHSA). CTC is a coalition-based prevention operating system that uses a public health approach to prevent youth problem behaviors such as violence, delinquency, school drop out and substance abuse.

Communities That Care (CTC) is a prevention system 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 is the product of years of prevention science research and collaboration with states and communities across the country. CTC helps communities use the system, choose tested and effective programs tailored to their needs, and track progress over time.

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, measurable, 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. 

Implementation of CTC is organized into five stages, each with its own series of "benchmarks" and "milestones" to help guide and monitor implementation progress. 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.

CTC provides information for how to receive guidance and resources necessary to implement the program through its website

To estimate the impact of a program or policy, we use systematic literature reviews to determine causal pathways and effect sizes. Well-researched interventions that have robust, high-quality evaluations allow us to model the impact of an intervention with greater certainty. However, sometimes interventions have limited evidence and not all of the outcomes that are likely to be associated with the intervention have been studied. In those cases, we can only model what is available in the evidence base. We urge future research to take the following gaps into consideration.

Cannabis and Illicit Drug Use - The studies we used did not find ample evidence to support modeling out an impact on drug use among high school students, suggesting a need for further study.

High School Graduation - The program likely also reduces morbidity among mothers and infants, however we did not find substantial evidence in the literature to directly model this outcome. Instead, we model changes in high school graduation based on reductions in number of arrests, which may underestimate the program's effectiveness in this domain.