Frequently asked questions

Communities That Care is a system that helps a community plan prevention on the basis of its own data. It brings together the people who shape young people’s lives locally, from schools and youth services to police, health and local government. It takes them through five phases: assessing readiness, getting organised, building a profile of local risk and protective factors from a youth survey, choosing programmes with proven effect that match the priorities, and implementing them with an eye on results.

Its aim is to reduce problem behaviour among young people, above all substance use, violence and offending, and to promote healthy development. It does this by changing the conditions young people grow up in rather than by treating problems after they appear.

Yes, with honest caveats. The central evidence is the Community Youth Development Study, a randomised controlled trial in 24 US towns that followed more than 4,400 young people from age ten into adulthood. Young people in CTC towns started using alcohol and tobacco later, showed less delinquency and violence, and the differences persisted to age 21. Over twelve years the trial returned nearly thirteen dollars in avoided harm for every dollar invested.

A quasi-experimental comparison in Australia found a positive but smaller effect. European evidence so far shows CTC communities adopting more evidence-based programmes, has not yet shown the wider system change the US trial found, and is thinner still on behavioural outcomes. A 2025 review by the UK Youth Endowment Fund rated the effect on violence as statistically uncertain and advised against commissioning new CTC sites in the UK until the approach has been tested there again. None of the studies it pooled came from the UK, where Communities that Care UK ceased operations in 2009. The evidence page sets all of this out.

Through the concept of risk and protective factors. Research over several decades has identified conditions in family, school, peer group and neighbourhood that make problem behaviour more likely, and others that make it less likely. Many of them work across several outcomes at once: a weak bond to school raises the risk of both drug use and offending, and a strong family bond guards against both.

CTC measures these factors locally through the youth survey and asks the community to work on the two to five that matter most in its own data. Strengthening protection counts as much as reducing risk. The approach page explains the Social Development Model behind this.

In five phases, usually over twelve to eighteen months before the first programmes start. Phase one clarifies whether the community is ready: is there political backing, and is someone prepared to lead? Phase two builds the coalition and the working structure. Phase three runs the youth survey and turns the results into a community profile. Phase four selects programmes that match the prioritised factors and secures their funding. Phase five implements them and measures what changed.

The workload falls mainly on a local coordinator, typically a half to a full post, and on the coalition members, who meet regularly through phases two to four. Training for both is part of the process and is provided by the organisation that supports CTC in the country, a prevention council, a research institute or a non-profit, where one exists.

After three years, a functioning coalition, a first community profile, and the first evidence-based programmes running with fidelity. After five years, measurable change in the prioritised risk and protective factors in a second survey, and programmes anchored in the institutions that deliver them rather than in project funding. After ten years, change in the behaviour the community set out to prevent: the US trial saw its clearest behavioural effects five to eight years after the start.

Anyone promising behavioural change within two years is promising something CTC has never delivered. The approach is slow by design, because it works on causes.

Start where the coalition can actually work. In a town of thirty thousand that may be the whole town. In a city it is usually one or two districts with their own schools and services, where the people around the table know each other. A pilot area gives the coalition a real profile to act on and lets the city learn the process before scaling it.

What matters is that the survey area and the action area coincide. Surveying a whole city and then acting in one district produces a profile the district does not recognise.

In school-based administration with active school support, 60 to 80 % of eligible pupils is the normal range. Below 50 % the profile becomes unreliable, because the pupils who did not take part tend to differ systematically from those who did.

Low participation almost always has an organisational cause: consent letters sent too late, a school that treated the survey as optional, or a timetable clash. It is fixable, and it is worth fixing before the results are used for planning.

For the survey, yes: administering it, protecting the data and producing the profile is specialist work and is normally done by the organisation that supports CTC in the country or by a university partner. For the process itself, no. A trained local coordinator and a coalition that meets regularly are what CTC needs. External evaluation of outcomes is valuable and is what builds the evidence base, but it is a separate decision from running the process.

Two bodies, in most implementations. A small group of key leaders, the heads of the organisations whose money and staff the process depends on: the mayor or council leader, the directors of youth, education, health and social services, the senior police officer. They give the mandate and keep the doors open. And a community board of practitioners, the people who run schools, youth centres, family services and clubs, together with residents and, ideally, young people themselves. The board does the work: it reads the profile, sets the priorities and chooses the programmes.

The distinction matters. When the leaders try to do the board’s job, or the board lacks a mandate from the leaders, the process stalls.

A political sponsor who stays. A coordinator with time, not a task added to a full post. A coalition that includes the people who deliver services, not only those who manage them. Data that the community trusts because it collected it. And patience: the first behavioural results arrive years after the first meeting. Implementation research in the US and Germany points to the same handful of factors, and none of them is technical.

Three things, in order of frequency. The coordinator leaves and is not replaced. The coalition skips from the profile straight to the programme it already wanted, so the data changes nothing. Or the funding for phase four never materialises, and the coalition has a plan it cannot act on.

What helps is naming these risks at the start. Agree in phase one who replaces the coordinator, commit the coalition to choosing from a register rather than from habit, and secure at least indicative funding for programmes before the survey runs. A community that has answered these three questions rarely stalls.

Yes. No name, date of birth, address or any other identifier is collected. In the German online version, for example, each pupil receives a one-time access code that is not linked to any list of names. Responses are stored only with the school and year group, and results are reported only for groups large enough that no individual could be recognised, never for a class of fifteen. Neither the school, nor the parents, nor the community sees an individual questionnaire.

No. Participation is voluntary at two levels. Parents or guardians are informed in advance and can withhold consent; depending on the country, this is either an opt-in or an opt-out. And each pupil can decline on the day, skip any question, or stop at any point, without giving a reason and without any consequence. Teachers are asked to make this clear before the survey begins.

Because those are among the strongest predictors of the problems the community is trying to prevent, and a survey that left them out would produce a profile with the most important information missing. The questions are asked neutrally, alongside as many questions about strengths: whether pupils feel valued at home, have adults they can talk to, and opportunities to contribute at school. They are answered anonymously and analysed only in aggregate, so a single answer can never be traced to a child or a family.

They cannot, because there is nothing to use. The results exist only as group statistics: the share of pupils in a year group who report a given experience. They go to the community’s CTC coalition and, in aggregated form, to the participating schools, to inform what support is offered. That support is not aimed back at the year groups who answered: the profile describes the conditions all children in the community grow up in, and the measures that follow reach every age, from programmes for parents of small children to youth work. No authority receives individual data, because none exists. Where a country’s law requires it, the survey design is approved by the education authority and reviewed for data protection before it runs.

Parents can see it. Schools make the full questionnaire available for inspection before the survey, and many hold an information evening. It is not published on the internet because a measurement instrument whose items circulate freely stops measuring reliably: pupils who have discussed the questions beforehand answer differently, and results from different years and places stop being comparable. The original US instrument is public, but the national adaptations, such as the German version, are licensed, and their licence conditions require this.