%0 Journal Article %J Prev Sci %D 2013 %T The application of meta-analysis within a matched-pair randomized control trial: An illustration testing the effects of Communities That Care on delinquent behavior. %A Monahan, Kathryn C %A Hawkins, J D %A Abbott, Robert D %K Adolescent %K Age of Onset %K Attention Deficit and Disruptive Behavior Disorders %K Child %K Cohort Studies %K Consumer Participation %K Cross-Sectional Studies %K Female %K Humans %K Juvenile Delinquency %K Longitudinal Studies %K Male %K Matched-Pair Analysis %K Meta-Analysis as Topic %K Risk Factors %K Socioeconomic Factors %K Substance-Related Disorders %X

Use of meta-analytic strategies to test intervention effects is an important complement to traditional design-based analyses of intervention effects in randomized control trials. In the present paper, we suggest that meta-analyses within the context of matched-pair designs can provide useful insight into intervention effects. We illustrate the advantages to this analytic strategy by examining the effectiveness of the Communities That Care (CTC) prevention system on 8th-grade delinquent behavior in a randomized matched-pair trial. We estimate the intervention effect within each of the matched-pair communities, aggregate the effect sizes across matched pairs to derive an overall intervention effect, and test for heterogeneity in the effect of CTC on delinquency across matched pairs of communities. The meta-analysis finds that CTC reduces delinquent behavior and that the effect of CTC on delinquent behavior varies significantly across communities. The use of meta-analysis in randomized matched-pair studies can provide a useful accompaniment to other analytic approaches because it opens the possibility of identifying factors associated with differential effects across units or matched pairs in the context of a randomized control trial.

%B Prev Sci %V 14 %P 1-12 %8 2013 Feb %G eng %N 1 %R 10.1007/s11121-012-0298-x %0 Journal Article %J J Soc Social Work Res %D 2013 %T Variation in the effect of Communities That Care on community adoption of a scientific approach to prevention %A Shapiro, Valerie B %A Hawkins, J D %A Oesterle, Sabrina %A Monahan, Kathryn C %A Brown, Eric C %A Arthur, Michael W %X

Tested and effective approaches are available to prevent mental, emotional, and behavioral problems in youth, but such approaches are underused. Communities That Care (CTC) is a coalition-based strategy that aims to increase the use of tested and effective programs by combining the use of scientific evidence and stakeholder consensus to support the community adoption of a scientific approach to preventing mental, emotional, and behavioral problems in youth. A community-randomized trial of CTC was conducted with a sample of 24 communities matched in pairs and assigned randomly to a control or an intervention condition. The findings demonstrate that CTC significantly increases the community-wide adoption of a science-based approach to prevention. Using a meta-analysis technique, this study shows that despite uniformly high-fidelity implementation of CTC in intervention communities, the effect of CTC on the adoption of a scientific approach to prevention varies significantly across the 12 community pairs. Understanding the extent of variation in the effect of CTC on adopting a science-based approach to prevention lays a foundation for identifying aspects of coalition structure, functioning, or capacity that not only may help explain variation in adoption, but may in turn be targeted to strengthen the effect of CTC on the adoption of a science-based approach to prevention within communities.

%B J Soc Social Work Res %V 4 %8 2013 Aug 20 %G eng %N 3 %R 10.5243/jsswr.2013.10 %0 Journal Article %J Journal of Community Psychology %D 2012 %T Community-level effects of individual and peer risk and protective factors on adolescent substance use %A Egan, Elizabeth A %A Van Horn, M l %A Monahan, Kathryn C %A Arthur, Michael W %A Hawkins, J D %X

The association between community-aggregated levels of peer and individual risk and protective factors and prevalence of adolescent substance use was examined in repeated cross-sectional data among youth in 41 communities ranging in population from 1,578 to 106,221. The association between community levels of these peer and individual risk and protective factors in 2000 and substance use 2 years later was examined by using within-cohort analyses (e.g., sixth grade in 2000 predicting eighth grade in 2002) and cross-cohort analyses (e.g., sixth grade in 2000 predicting sixth grade in 2002). In both within- and across-cohort analyses, community-aggregated levels of peer and individual risk and protective factors predicted the prevalence of adolescent substance use 2 years later, suggesting that focusing on elevated peer and individual risk factors and depressed peer and individual protective factors at the community level to guide the selection of preventive interventions may be a viable strategy for community efforts to prevent adolescent substance use community wide.

%B Journal of Community Psychology %V 39 %P 478-498 %8 2012 May %G eng %N 4 %R 10.1002/jcop.20437 %0 Journal Article %J Arch Pediatr Adolesc Med %D 2012 %T Sustained decreases in risk exposure and youth problem behaviors after installation of the Communities That Care prevention system in a randomized trial. %A Hawkins, J D %A Oesterle, Sabrina %A Brown, Eric C %A Monahan, Kathryn C %A Abbott, Robert D %A Arthur, Michael W %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Adolescent Health Services %K Child %K Community Health Services %K Humans %K Incidence %K Juvenile Delinquency %K Multivariate Analysis %K Outcome Assessment (Health Care) %K Prevalence %K Risk Reduction Behavior %K Smoking %K Substance-Related Disorders %K United States %K Violence %X

OBJECTIVE: To test whether the Communities That Care (CTC) prevention system reduced levels of risk and adolescent problem behaviors community-wide 6 years after installation of CTC and 1 year after study-provided resources ended.

DESIGN: A community randomized trial.

SETTING: Twenty-four small towns in 7 states, matched within state, randomly assigned to control or intervention condition in 2003.

PARTICIPANTS: A panel of 4407 fifth-grade students was surveyed annually through 10th grade from 2004 to 2009.

INTERVENTION: A coalition of community stakeholders received training and technical assistance to install CTC, used epidemiologic data to identify elevated risk factors and depressed protective factors in the community, and implemented programs to address their community's elevated risks from a menu of tested and effective programs for youths aged 10 to 14 years, their families, and schools.

OUTCOME MEASURES: Levels of risk and incidence and prevalence of tobacco, alcohol, and other drug use; delinquency; and violent behavior by grade 10.

RESULTS: Mean levels of targeted risks increased less rapidly between grades 5 and 10 in CTC than in control communities and were significantly lower in CTC than control communities in grade 10. The incidence of delinquent behavior, alcohol use, and cigarette use and the prevalence of current cigarette use and past-year delinquent and violent behavior were significantly lower in CTC than in control communities in grade 10.

CONCLUSIONS: Using the CTC system can produce enduring reductions in community-wide levels of risk factors and problem behaviors among adolescents beyond the years of supported implementation, potentially contributing to long-term public health benefits.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01088542.

%B Arch Pediatr Adolesc Med %V 166 %P 141-8 %8 2012 Feb %G eng %N 2 %R 10.1001/archpediatrics.2011.183 %0 Journal Article %J Psychol Addict Behav %D 2011 %T Changes in self-control problems and attention problems during middle school predict alcohol, tobacco, and marijuana use during high school. %A King, Kevin M %A Fleming, Charles B %A Monahan, Kathryn C %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Alcohol Drinking %K Attention %K Child %K Disruptive, Impulse Control, and Conduct Disorders %K Female %K Humans %K Internal-External Control %K Longitudinal Studies %K Male %K Models, Psychological %K Self Concept %K Smoking %X

Although deficits in impulse control have been linked to adolescent use of alcohol and illicit drugs, less attention has been given to variability in change in impulse control across adolescence and whether this variability may be a signal of risk for early substance use. The goals of the current study were to examine growth in two aspects of impulse control, self-control problems and attention problems, across middle adolescence, and to test the prospective effects of level and change in these variables on levels and change over time in substance use. Data are from a community sample of 955 adolescents interviewed (along with their parents and teachers) annually from 6th to 11th grade. Results indicated that greater self-control problems and attentional problems in the 6th grade and increases in these problems over time were associated with higher levels of substance use at 11th grade. Our results suggest that modeling change over time enhances the understanding of how impulse control influences the development of substance use.

%B Psychol Addict Behav %V 25 %P 69-79 %8 2011 Mar %G eng %N 1 %R 10.1037/a0021958