Local program cuts youth drinking, violence: study

NEW YORK Thu Oct 6, 2011 6:05pm EDT

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NEW YORK (Reuters Health) - A program that helps communities identify and target health risks in young people led to fewer teens drinking, smoking and being delinquent, according to a new report.

Researchers said the "Communities That Care" approach is a way for towns to tailor specific, evidence-based strategies to the needs of their particular kids -- but for it to work, the community must dedicate significant time and resources to the cause.

"There are so many people who have good will who really care about the lives of young people," said J. David Hawkins of the University of Washington in Seattle, who worked on the study. "When they are armed with the tools and technology to guide their work, they can really make a difference."

The Substance Abuse and Mental Health Services Administration makes Communities That Care materials freely available to communities at bit.ly/n11Hr5.

In the version of the program Hawkins' team studied, local community leaders analyzed surveys completed by youth in their town, meant to identify specific things about families or communities that put those kids at risk for health and behavior problems.

Then, those leaders -- including parents, teachers and health workers -- chose from a "menu" of ways to address the most serious risks. The choices included tutoring programs, middle school curriculums targeting drug and alcohol abuse and educational sessions for parents of at-risk kids.

The researchers started out in 2003 by surveying some 4,400 fifth graders in seven states, who were then followed for five years.

At the end of that time, Hawkins and his colleagues compared youth drug and alcohol use and violence in 12 small towns where community leaders were trained and funded to use Communities That Care methods and another 12 that didn't get training. Towns in Colorado, Illinois, Kansas, Maine, Oregon, Utah and Washington participated.

By the time kids were in 10th grade, those in towns that participated in Communities That Care generally engaged in less risky behavior.

Two-thirds of them had started drinking alcohol, compared to three-quarters of kids in other towns. They were also almost half as likely to smoke cigarettes and 20 percent less likely to have engaged in delinquent behavior.

There was no difference, however, in the number of kids who said they had recently used illegal or prescription drugs, the researchers report in the Archives of Pediatrics and Adolescent Medicine.

Hawkins said some of those differences might have been bigger if communities started the program earlier, for example, targeting teenage moms and young kids with interventions proven to reduce future risks.

"The point is that we can use this approach across the developmental span of childhood and adolescence and find benefits, if you get the right programs in place," he told Reuters Health.

The program does come with costs, which the study did not specify.

Hawkins said that ideally, each community would have one person who worked full time at coordinating community leaders and specific interventions -- each of which also comes with a price tag.

Mark Feinberg, a researcher from Pennsylvania State University who has experience with Communities That Care programs there, said that some states, including his own, have started supporting the evidence-based interventions or providing incentives to towns that put them in place.

In the long run, he told Reuters Health, the interventions "actually save money, especially programs that reduce crime."

Less violence and drug and alcohol use means more people working and paying taxes and fewer crime victims, he said.

To be sure, Feinberg added, people in the community need to be motivated to look into local problems and organize change. But once it's in place, he concluded, Communities That Care "is an effective way of enabling communities to reduce adolescent problems (and) maximize and promote young people's success."

The National Institute on Drug Abuse and several other NIH institutes also supported the study. One of the study authors is on the board of Channing Bete Company, distributor of some of the materials used in the study.

Ralph Hingson said it's always challenging to apply findings from a research study in which the investigators are involved and invested, to the rest of the country.

"There are issues of how to take these research findings and help get the programs that seem to be effective disseminated on a broad basis," said Hingson, from the National Institute on Alcohol Abuse and Alcoholism, which contributed funding for the new study.

But, he told Reuters Health, "I think there is sufficient concern among the American people about underage drinking that there's motivation in communities to try and find things that will work."

SOURCE: bit.ly/nDfOuj Archives of Pediatrics and Adolescent Medicine, online October 3, 2011.

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