2019 · Study · English
Public Health Benefits 16 Years After a Statewide Policy Change: Communities That Care in Pennsylvania
Chilenski, S. M., Frank, J., Summers, N., & Lew, D.
Chilenski, S. M., Frank, J., Summers, N., & Lew, D. (2019). Public Health Benefits 16 Years After a Statewide Policy Change: Communities That Care in Pennsylvania. Prevention Science, 20(6), 947–958. doi.org/10.1007/s11121-019-01028-y
Summary
Evaluation in Prevention Science of what CTC achieves when spread by policy rather than by researchers: Pennsylvania has funded CTC coalitions since the 1990s, and the system has been installed in over 500 communities worldwide outside trial conditions. Using biennial anonymous surveys of students in grades 6, 8, 10 and 12 from 2001 to 2011, the authors analysed 470,798 observations from 388 school districts in a repeated cross-sectional design with propensity-score weighting at district level. Outcomes were lifetime and past-30-day use of alcohol, tobacco, marijuana and other drugs, delinquency and current depressive symptoms. Districts served by CTC coalitions showed significantly lower substance use, delinquency and depression; the effect was small to moderate depending on the outcome and became stronger once the use of evidence-based programmes was taken into account, pointing to variation in implementation quality. The first large-scale evidence that CTC effects appear outside a research context, with an effect size practitioners should quote as modest.