The roots of Communities That Care reach back to the early 1980s and the University of Washington in Seattle. There, the Social Development Research Group, based in the School of Social Work, began under J. David Hawkins and Richard F. Catalano to draw together what decades of prevention research had established. CTC comes from social work itself: its authors describe it explicitly as a model of social-work practice in the tradition of .
Their aim was a prevention approach for adolescent problem behaviour, above all substance misuse, violence and offending, that rested on scientific evidence rather than good intentions. From the outset the central idea was not to address individual behaviours one at a time, but to identify the underlying in the settings where children grow up, family, school, peer group and community, and to influence them deliberately.
Building on the Social Development Model, the researchers reached a conclusion that still defines the approach: lasting change in young people's lives requires communities that can make evidence-based decisions about their own prevention work and carry them out. The point was to equip communities, with knowledge and with tools, to recognise local needs objectively and to act on them effectively.
Milestones
1980s
1980s
A vision from research
University of Washington
J. David Hawkins and Richard F. Catalano condense decades of prevention research into one systematic approach. The Social Development Model becomes the theoretical basis of CTC.
Sources
Hawkins, J.D., Catalano, R.F. and J.Y. Miller (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112(1), 64–105. doi.org/10.1037/0033-2909.112.1.64In the library →
1990s
1990s
Tested with communities
Hundreds of communities
CTC is tried out with hundreds of communities in the United States and refined continuously, along what are today the five phases.
The Joseph Rowntree Foundation funds the first CTC sites in the United Kingdom; a year later the Dutch government buys the CTC licence and DSP-groep adapts the youth survey. From 2000, neighbourhoods in Amsterdam, Arnhem, Rotterdam and Zwolle pilot the process and the Netherlands Institute for Care and Welfare compiles the first European inventory of promising programmes.
Sources
Crow, I., France, A., Hacking, S., & Hart, M. (2004). Does Communities that Care work? An evaluation of a community-based risk prevention programme in three neighbourhoods. Joseph Rowntree Foundation. core.ac.uk/download/288389332.pdfIn the library →
Jonkman, H., Junger-Tas, J., van Dijk, B. (2005). From Behind Dikes and Dunes: Communities that Care in the Netherlands. Children & Society, 19(2), 105–116. doi.org/10.1002/chi.865In the library →
Groeger-Roth, F., van den Hazel, B., & de Vries, R. (2016). Communities That Care in Europe 1998–2015. The implementation of a community based prevention strategy in Europe: Overview & experiences. Technical report on the CTC Implementation Guide. CTC European Network, with the financial support of the Prevention of and Fight against Crime Programme, European Commission. communities-that-care.eu/downloads/ctc-european-network-implementation-guide-2016.pdfIn the library →
France, A., & Crow, I. (2001). CTC – the story so far: An interim evaluation of Communities That Care. Joseph Rowntree Foundation. hdl.handle.net/2134/2507In the library →
2003
2003
Community Youth Development Study
24 communities
A randomised controlled trial follows 4,400 young people from grade 5 into adulthood. The effect of CTC is documented comprehensively for the first time.
Sources
Hawkins, J.D., Oesterle, S., Brown, E.C., Arthur, M.W., Abbott, R.D., Fagan, A.A., & Catalano, R.F. (2009). Results of a type 2 translational research trial to prevent adolescent drug use and delinquency: A test of Communities That Care. Archives of Pediatrics & Adolescent Medicine, 163(9), 789. doi.org/10.1001/archpediatrics.2009.141In the library →
Hawkins, J. D., Oesterle, S., Brown, E. C., Abbott, R. D., & Catalano, R. F. (2014). Youth Problem Behaviors 8 Years After Implementing the Communities That Care Prevention System. JAMA Pediatrics, 168(2), 122. doi.org/10.1001/jamapediatrics.2013.4009In the library →
2008–2011
2008–2011
Arrival in Germany
Lower Saxony
In the EU co-funded SPIN project the Crime Prevention Council of Lower Saxony brings CTC to Germany with Dutch partners, adapted structurally, culturally and linguistically, and starts the Grüne Liste Prävention.
The EU-funded project "Making CTC work at the European level" links Germany, the Netherlands, the United Kingdom, Austria, Sweden, Cyprus and Croatia, compares youth-survey data across countries and reviews Europe's effective programmes.
Sources
Groeger-Roth, F., van den Hazel, B., & de Vries, R. (2016). Communities That Care in Europe 1998–2015. The implementation of a community based prevention strategy in Europe: Overview & experiences. Technical report on the CTC Implementation Guide. CTC European Network, with the financial support of the Prevention of and Fight against Crime Programme, European Commission. communities-that-care.eu/downloads/ctc-european-network-implementation-guide-2016.pdfIn the library →
Axford, N., Sonthalia, S., Wrigley, Z., Webb, L., Mokhtar, N., Brook, L., Wilkinson, T., Hunt, A., Timmons, L., Raja, A., Rawsthorn, M., Goodwin, A., Ohlson, C., Price, H., Whybra, L., Jamison, K., & Morpeth, L. (2016). What works in Europe? Developing a European Communities that Care database of effective prevention programmes. Dartington Social Research Unit, for the CTC European Network. communities-that-care.eu/downloads/ctc-european-network-what-works-in-europe-2016.pdfIn the library →
Farrington, D. P., Jonkman, H., & Groeger-Roth, F. (Eds.). (2021). Delinquency and Substance Use in Europe: Understanding Risk and Protective Factors. Springer. doi.org/10.1007/978-3-030-58442-9
2015
2015
Switzerland takes it up
Bischofszell, Köniz, Meilen
RADIX, a Swiss health foundation, pilots CTC in three municipalities and runs the first Swiss youth survey in autumn 2016. It has carried CTC for German-speaking Switzerland since, through two national funding phases to 2029.
Sources
RADIX Schweizerische Gesundheitsstiftung. (2026). Communities That Care: Was Gemeinden und Städte für die Gesundheit ihrer jungen Bewohnerinnen und Bewohner tun können [Broschüre]. radix.ch/media/e1kjhwgp/ctc_broschuere_2026.pdf
Siilbek, E., & Streimann, K. (2024). Adaptation of the Communities That Care Youth Survey for Use in Estonia: A Pilot Study. Journal of Prevention, 45(4), 483–500. doi.org/10.1007/s10935-024-00777-zIn the library →
ΕΚΤΕΠΝ [Greek Documentation and Monitoring Centre for Drugs] (2024). Κοινότητες που Νοιάζονται: Προσαρμογή στα ελληνικά, πιλοτική εφαρμογή και έλεγχος της αξιοπιστίας του ερωτηματολογίου. University Mental Health, Neurosciences and Precision Medicine Research Institute (UMHRI), Athens. ektepn.gr/ctc-2023In the library →
The South Western Regional Drug and Alcohol Task Force (SURF) launches Ireland's first CTC cycle in Newbridge, County Kildare, coordinated through Foróige's drug-prevention project, with Trinity College Dublin as survey partner.
Through the late 1980s and the 1990s, CTC was tested and refined in a participatory process with hundreds of American communities, at times more than 470. The system was adapted to communities of very different kinds. Two problems common in prevention practice were the explicit targets: the use of measures without adequate evidence, and the poor implementation of programmes that had been shown to work.
CTC was therefore built around local coalitions of key people from different sectors: local government, schools, youth services, police, health services and civil society. These coalitions learn to identify their community's specific risk and protective factors using the , a standardised questionnaire completed by school pupils, to set priorities, and to select and implement evidence-based programmes with attention to quality. The structured five-phase process, with clear milestones from readiness through to evaluation, became the hallmark of the approach.
The Community Youth Development Study
The scientific confirmation came with the . Launched in 2003, this in 24 rural towns across seven US states followed more than 4,400 young people from fifth grade into early adulthood. Its results confirmed the logic of the model at each step:
System change: CTC communities were measurably more likely to adopt a science-based approach to prevention and to improve cooperation across sectors.
Fewer risks, stronger protection: targeted interventions produced measurable improvement in the factors each community had prioritised.
Less problem behaviour: young people in CTC communities started using alcohol and tobacco later, and showed significantly lower rates of substance use, violence and offending.
Effects that lasted: at age 21 the differences persisted, and a twelve-year benefit-cost analysis found that every dollar invested had returned nearly thirteen.
The evidence page sets out these findings in detail, alongside the Australian replication and the more cautious verdicts from Europe.
Arriving in Europe
CTC crossed the Atlantic in the late 1990s. The United Kingdom was first: between 1998 and 2008 the charity Communities that Care UK worked with more than sixty sites in all four nations, around thirty of which ran the full process, with Wales and London most strongly represented. Its operations ceased in 2009. The Netherlands followed and, for some fifteen years, built the broadest European CTC practice: more than 25 municipalities and neighbourhoods, guided by the Netherlands Youth Institute with DSP-groep's youth survey and evaluated by the Verwey-Jonker Institute. No Dutch community is known to run the process today. Germany adopted the approach through the EU-funded SPIN project (2008–2011), led by the Crime Prevention Council of Lower Saxony, with the first pilot sites starting in 2009. Cyprus (from 2006), Croatia and Sweden each ran their own adaptations; Austria adapted and piloted the youth survey in a single Upper Austrian municipality, Sierning, in 2013.
Between 2013 and 2015 these efforts were connected for the first time. The EU-funded project Communities That Care European Network: Making CTC work at the European level brought together partners from seven countries to answer three questions. Does the CTC youth survey measure the same thing across borders? Which prevention programmes have actually been tested in Europe? And how should a new country go about introducing the approach? Its answers, a cross-national survey analysis, a European programme review that fed the EUDA's Xchange register, and an implementation guide, remain the foundation for CTC work on this continent.
This site continues that work. It is operated by FINDER e.V., a German non-profit that provides CTC training and survey infrastructure, and it exists to make the European adaptations visible to each other, and to the countries that do not yet have one.
Register
Blueprints for Healthy Youth Development
The US register of tested programmes for children and young people, run by the Institute of Behavioral Science at the University of Colorado Boulder. It certifies on three tiers. Promising asks for one randomised controlled trial or two quasi-experimental evaluations, with a consistent positive effect and no evidence of harm. Model adds a second high-quality trial and at least one follow-up twelve months or more after the intervention ends. Model Plus adds a replication carried out by researchers from outside the developer’s team. These are the standards of evidence the CTC European Network review applied when it assessed European programmes for Xchange.
An observational design: a group is followed over time and then distinguished by whether it received the programme or not; nobody is assigned. A prospective cohort starts observation in the present and runs into the future, a retrospective one works through a course of events that has already finished. Because the groups can differ from the outset, the risk of hidden confounders stays higher than in a randomised trial.
The working body of a CTC process: practitioners who run schools, youth centres, family services and clubs, together with residents and, ideally, young people themselves. The board reads the community profile, sets priorities and chooses the programmes. It is distinct from the key-leader group, which provides the mandate and the resources. Called Gebietsteam in Germany and community board in the US.
The social-work tradition of enabling residents and local institutions to identify and act on their own needs, rather than having services delivered to them. CTC’s authors place the approach explicitly in this tradition: the community collects its own data, sets its own priorities and owns its own plan. Known as Gemeinwesenarbeit in German-speaking countries.
The randomised controlled trial that established the evidence for CTC. Begun in 2003, it matched 24 small towns in seven US states in pairs and randomly assigned one of each pair to CTC, following more than 4,400 young people from age ten into adulthood. Young people in CTC towns started using substances later, showed less delinquency and violence, and the differences persisted to age 21.
How certain a statement about an effect is, not how large the effect turns out to be. GRADE describes this as the confidence in an estimate of an effect and grades it by how likely further research is to change that confidence. The Green List Prevention judges conclusiveness separately from the study design and makes it depend on group sizes, the number of studies and the presence of findings from the German language area.
The group that does not receive the programme and so shows how the participants would probably have developed without it. That yardstick can never be observed, only estimated; the effect is the difference between what happened and what would have happened without the measure. Without a comparison group it stays open whether a change is down to the programme or to maturation, prior experience and concurrent influences.
Four levels instead of the split between effective and ineffective: a programme is at first merely described, then theoretically grounded, then supported by first indications from practice, and finally by causal evidence. The lower the level, the more freely the evaluation design can be chosen; for a causal statement only designs that allow one come into question. The rating scheme of the Green List Prevention follows this model.
A measure of how large a difference is, independent of the size of the sample. The usual one in prevention is Cohen’s d: the difference between the means, divided by the spread. Unlike a p-value, an effect size says something about the extent of an effect and makes studies comparable with one another; the Green List Prevention therefore asks for it in studies with a control group.
A repeat measurement taken after a programme has ended. It shows whether an effect lasts or was only visible while the measure was running. The standards of the Society for Prevention Research ask for at least one long-term measurement at a reasonable distance from the end of the intervention and treat six months as the sensible minimum; the Green List Prevention uses the same interval and expects at least one positive effect to persist by then.
The online register of effectiveness-tested prevention programmes maintained by the Crime Prevention Council of Lower Saxony (Landespräventionsrat Niedersachsen), with the risk and protective factors each programme addresses. German CTC communities choose tested programmes from it in phase four. The register is in German only.
The people in a community who control budgets, shape policy and can commit their organisation: the mayor or head of the local authority, the police chief, the head of the school administration, and leaders from health, business, faith communities and the media. They give the CTC process its mandate and its resources, they recruit the community board and hold it and the coordinator to account, and they keep the work in place beyond a funding round. The division of labour is the point: the community board does the analysis, the priority setting and the planning, the key leaders make that work possible and act on what it recommends.
A programme is manualised when a written guideline for action settles what happens when and with whom; only that makes it repeatable elsewhere and testable at all. How closely the guideline is followed is part of what decides success: a review of almost 500 studies found effects at least two to three times as large where implementation was careful. The Green List Prevention therefore asks for available manuals, training and instruments of quality control.
The statistical combination of the results of several studies of the same question into one pooled estimate; Gene Glass introduced the term in 1976 for the analysis of a large collection of results from individual studies. Each study is weighted, as a rule by how precisely it measured, and the result is reported with a confidence interval and with a measure of how far the studies disagree with one another. A meta-analysis cannot repair the studies it pools: where the primary evidence is thin, one-sided or drawn from a different setting, the pooled figure inherits all of that.
The geographical unit a CTC process works in. Not an administrative boundary but the area whose residents share schools, services and daily life, and whose practitioners know each other. Choosing it well matters: the youth survey area and the action area must coincide, or the coalition ends up acting on a profile the area does not recognise. Called Sozialraum in German.
An approach that treats adolescence as a period of growth to be supported rather than a set of problems to be prevented, and that works on competence, confidence, connection, character and contribution. It shares its theoretical roots with CTC in the Social Development Model, and CTC’s emphasis on protective factors is where the two meet.
The share of a population that shows a characteristic at one point in time or within a given period, for instance the proportion of fifteen-year-olds who drank alcohol in the past thirty days. Prevalence counts the cases that exist, so it depends both on how many new cases arise and on how long each one lasts; incidence counts only the new cases in a period. A measure that shortens an episode lowers prevalence without changing incidence, which is why prevention studies report the two separately.
A classification by target group, not by timing. Universal offers address a whole population without any individual risk having been established; selective ones address subgroups whose risk is markedly above average; indicated ones address individual young people showing first signs that do not yet warrant a diagnosis. CTC works universally and selectively.
A classification by the point at which one intervenes. Primary prevention starts before a disorder appears and lowers the number of new cases; secondary prevention shortens courses that have already begun, through early detection and treatment; tertiary prevention reduces the impairment a disorder leaves behind. Only primary and secondary prevention programmes enter the Green List Prevention, because that matches the direction of CTC.
Conditions that lower the likelihood of problem behaviour and promote healthy development: strong bonds to family, school and community, clear standards, opportunities to contribute, the skills to use them, and recognition for doing so. In the Social Development Model they are what bonding is made of. Strengthening protection counts as much in CTC as reducing risk.
A design with a comparison group but without random assignment: who receives the programme follows from practice. In the field this is often the only workable option, but it calls for extra precautions such as several points of measurement, statistical control or a stepped roll-out, because the programme and comparison groups can differ systematically.
A study in which participants are assigned to the programme or to the comparison condition at random. Because chance makes the groups comparable on average, a difference at the end is more readily attributed to the programme than to pre-existing differences. The standards of the Society for Prevention Research ask, for a statement of efficacy, for at least two methodologically rigorous studies with consistently positive findings and at least one significant long-term measurement.
Conditions in a young person’s family, school, peer group or neighbourhood that raise the likelihood of problem behaviour such as substance use, violence, offending or leaving school early. Many act on several outcomes at once. CTC measures them locally through the youth survey and asks the community to prioritise the ones that are most elevated.
Aaron Antonovsky’s question of what keeps people healthy, as opposed to what makes them ill. Its central idea, a sense of coherence built from comprehensibility, manageability and meaningfulness, corresponds closely to the protective factors CTC works with. The term is widely used in European health promotion and less so in the US prevention literature.
The developmental theory behind CTC, formulated by Richard F. Catalano and J. David Hawkins. It holds that young people bond to the social units, prosocial or antisocial, that give them opportunities, the skills to use them and recognition for doing so, and that they then adopt those units’ norms. Prevention therefore means creating those three conditions in family, school and community. The Social Development Strategy is its practical form.
A finding is called significant when the data would be sufficiently unlikely on the assumption that there is no difference; the usual threshold is five per cent. The American Statistical Association notes that a p-value measures neither the size of an effect nor the importance of a result, and that scientific or policy conclusions should not depend on whether it falls below a threshold.
A written-out assumption about how a programme works: which steps lead from the measure through intermediate outcomes to the intended goal, and which conditions have to hold along the way. It is developed before implementation together with those involved, and it settles what will later be measured. In the Green List Prevention a theory of change study counts as an evaluation level of one star: it tests the assumed chain of effects, not the effect against a control group.
The question whether a programme developed elsewhere also works here. There is a tension between fidelity and fit: a rigid adoption misses the target group, a free adaptation can remove the very ingredients that worked, and the balance can only be struck deliberately and on the record. The Green List Prevention grades transferability by the number of studies from the German language area, in four steps from given to unclear.
The standardised, anonymous questionnaire that a CTC community puts to school pupils, as a rule between the ages of eleven and seventeen, to measure the risk and protective factors in its own neighbourhoods. Answers are reported for an area or a year group, never for an individual or a class, and the profile they produce is what phase three turns into a short list of priorities. National adaptations translate the scales, drop items that do not apply and re-test them: the German version was confirmed as largely one-dimensional and valid against reported violence, delinquency, substance use and depressive symptoms.