Violence Prevention in Communities: Communities that Care

12 April 2010
Violence Prevention in
Communities: Communities that
Care
Richard F. Catalano, Ph.D
Bartley Dobb Professor for the Study and Prevention of Violence
Director, Social Development Research Group
School of Social Work
University of Washington
www.sdrg.org

Intervention Spectrum
Treatment
Source: Institute of Medicine (2009). Preventing Mental, Emotional and
Behavioral Disorders Among Young People. O’Connell, Boat & Warner
(eds.) Washington DC: National Academy Press

Prevention Science
Framework
Program
Implementation
and
Evaluation
Define the
Problem
Identify Risk
and Protective
Factors
Interventions
Problem
Response

Prevention Science
Research Advances
Etiology/Epidemiology of Problem Behaviors
• Identify risk and protective factors that
predict problem behaviors and describe
their distribution in populations.
Efficacy Trials
• Design and test preventive interventions
to interrupt causal processes that lead to
youth problems.

Risk Factors for
Adolescent Problem Behaviors
Risk Factors
Substance Abuse
Delinquency
Teen Pregnancy
School Drop-Out
Violence
Depression &
Anxiety
Community
Availability of Drugs
Availability of Firearms
Community Laws and Norms Favorable
Toward Drug Use, Firearms, and Crime
Media Portrayals of Violence
Transitions and Mobility
Low Neighborhood Attachment and
Community Disorganization
Extreme Economic Deprivation

Family
School
Individual/Peer

Protective Factors
Individual Characteristics
– High Intelligence
– Resilient Temperament
– Competencies and Skills
In each social domain (family, school, peer
group and neighborhood)
– Positive Opportunities
– Reinforcement for Positive Involvement
– Bonding
– Healthy Beliefs and Clear Standards

Prevalence
Prevalence of 30 Day Alcohol Use
by Number of Risk and Protective Factors
Six State Student Survey of 6th-12th Graders, Public School
Students
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Number of
Protective Factors
0 to 1
2 to 3
4 to 5
6 to 7
8 to 9
0%
0 to 1 2 to 3 4 to 5 6 to 7 8 to 9 10+
Number of Risk Factors

Prevalence
Prevalence of “Attacked to Hurt”
By Number of Risk and Protective Factors
60%
50%
40%
30%
20%
Protection, Level 0
Protection, Level 1
Protection, Level 2
Protection, Level 3
Protection, Level 4
10%
0%
Risk, Level
0
Risk, Level
1
Risk, Level
2
Risk, Level
3
Risk, Level
4

Prevalence of Other Problems
by Number of Risk Factors
50
40
%
30
20
10
depressive
symptomatology
deliberate self harm
homelessness
early sexual activity
0
0-1 2-3 4-6 7-9 >=10
Risk factors
Bond, Thomas, Toumbourou,
Patton, and Catalano, 2000

Number of School Building Level Risk
Factors and Probability of Meeting
Achievement Test Standard
(10 th Grade Students)
Probability of Meeting Standard
1.0
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Number of Risk Factors
Arthur et al., 2006
Math Reading Writing

Snowball: Snowstorm: Risk Extended Accumulates
Exposure to
Antisocial Norms and Models of
Problem Behavior without Protection
Factors Shaping Child and
through Early Developmental
Adolescent Development
Challenges without Protection
Community
Peers
School
Parents
Toumbourou and Catalano, 2005
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Violence Specific Research Questions
1. To what extent is there continuity between primary
school aggression and age 19 violence?
2. Do Year 7,8 family, peer, and school influences predict
age 19 violence?
13

Answers to Violence Specific Question 1
Aggression in primary strongly predicts Age 19
violence, however;
There is a lot of discontinuity, and
Many youth take up violence in adolescence
without a history of aggression
14

Transitional Probabilities
Transitional Probabilities from Childhood Aggression to
Youth Violence age 19
15

What Year 7/8 Factors Predict Age 19 Violence?
Drug use
risk
index
Low vs.
high
violence
Parental monitoring
-.41*
Family rules
-.36*
Appropriate consequences for youth behavior
-.40*
-.17*
-.14*
-.14*
Bonding to parents
-.22*
-.10*
Interaction with prosocial peers
Peers’ recognition for prosocial involvement
-.34*
-.25*
-.18*
-.12*
Prosocial structured after school activities
Academic achievement
Attachment to school
Commitment to school
Teachers’ recognition for school work
-.13*
-.33*
-.25*
-.32*
-.35*
-.09*
-.16*
-.08*
-.15*
-.14*
Control: Drug Use Risk Index
-
.22*
16

Parental Monitoring Provides Additional
Protection for Early Aggressive Youth
17

Answer to Violence Specific Question 2
‣Do influences in early secondary school predict
age 19 youth violence?
Bonding to prosocial parents, prosocial peer
association, structured after school activities,
academic achievement, and school commitment
directly reduce risk of youth violence
Among highly aggressive children, parental
monitoring reduces violence to the level of those
without high levels of childhood aggression.
18

Prevention Implications
‣ Childhood aggression remained a significant predictor of youth
violence in presence of promotive and protective factors .
Therefore, a two pronged approach may be most effective:
Early universal intervention to prevent childhood aggression
Targeted or indicated prevention for those who are aggressive;
enhancing parental monitoring may be particularly important.
‣ The large number of early secondary school violence onsetters
suggests that universal strategies designed to intervene in
early adolescence are also needed.
‣ Enhancing prosocial influences within family, peer, and school is
important for universal and selected violence prevention.
‣ Given the important influence of drug use on youth violence,
violence prevention programs need to target drug use
19

But…
• Different neighborhoods have
different profiles of risk,
protection, and outcomes.

Distribution of Risk in a City
Neighborhood #2
Insufficient number of
students in this area.
No students
in this area.
Neighborhood #1 Neighborhood #3
John A. Pollard, Ph.D. Developmental Research and Programs

Prevention Science
Research Advances
Etiology/Epidemiology of Problem Behaviors
• Identify risk and protective factors that
predict problem behaviors and describe
their distribution in populations.
Efficacy Trials
• Design and test preventive interventions
to interrupt causal processes that lead
to youth problems.

Ineffective Prevention
Strategies
Universal Prevention
• Peer counseling,
mediation, positive peer
culture
• Non-promotion to
succeeding grades
• After school activities with
limited supervision,
programming
Selected, Indicated
Prevention
• Gun buyback programs
• Firearm training
• Mandatory gun ownership
• Redirecting youth behavior
• Shifting peer group norms
• Neighborhood Watch
• Drug information, fear
arousal, moral appeal.
• DARE (new and old)
U.S. Surgeon General, U.S. Department of Health and Human Services,
2001; National Institute of Justice, 1998; Gottfredson, 1997.

Wide Ranging Approaches
Have Been Found To Be
Effective
1. Prenatal & Infancy Programs
2. Early Childhood Education
3. Parent Training
4. After-school Recreation
5. Mentoring with Contingent
Reinforcement
6. Youth Employment with
Education
7. Organizational Change in
Schools
(Hawkins & Catalano, 2004)
8. Classroom
Organization,
Management, and
Instructional Strategies
9. School Behavior
Management Strategies
10. Classroom Curricula for
Social Competence
Promotion
11. Community & School
Policies
12. Community
Mobilization

Summary of Benefits and Costs (2003 Dollars)
Dollars Per Youth (PV
lifecycle)
Selected Benefit Cost Findings
Benefits Costs B - C
Early Childhood Education $17,202 $7,301 $9,901
Nurse Family Partnership $26,298 $9,118 $17,180
Life Skills Training $746 $29 $717
Seattle Soc. Dev. Project $14,246 $4,590 $9,837
Guiding Good Choices $7,605 $687 $6,918
Multi-D Treat. Foster Care $26,748 $2,459 $24,290
Intensive Juv. Supervision $0 $1,482 -$1,482
Big Brothers/Sisters (all costs) $4,058 $4,010 $48
(taxpayer costs only) $4,058 $1,283 $2,775
Steve Aos, Associate Director
Washington State Institute for Public Policy
saos@wsipp.wa.gov www.wa.gov/wsipp

However…
• Prevention approaches that do not
work or have not been evaluated
have been more widely used than
those shown to be effective.
(Gottfredson et al 2000, Hallfors et al 2000, Hantman
et al 2000, Mendel et al 2000, Silvia et al 1997; Smith
et al 2002)

Challenges for States and
Communities in Using
Prevention Science
• Matching tested, effective programs to local
need
• Tested, effective programs/systems compete
with “best,” usual, or new practice
• Tested, effective programs require training,
technical assistance, and monitoring to be
delivered with fidelity
• Achieving population wide outcomes
• Need for coordinated planning and funding,
and accountability for youth outcomes

Communities that Care Model
for Achieving the Vision of
Science Informing Practice
Provides the education, skills and
tools to build community
capacity to be accountable to
change youth outcomes
through choosing and
implementing tested, effective
programs matched to their
needs

The Communities That Care
Operating System
Get Started
• Community readiness
assessment.
• Identification of key
individuals, stakeholders,
and organizations.
Implement and
Evaluate
Creating
Communities
That Care
Get Organized
Create a Plan
Develop a Profile

The Communities That Care
Operating System
Implement and
Evaluate
Get Started
Creating
Communities
That Care
• Training key leaders
and board in CTC
• Building the
community coalition.
Get Organized
Create a Plan
Develop a Profile

The Communities That Care
Tools for Decision Making
Get Started
Implement and
Evaluate
Creating
Communities
That Care
• Collect
risk/protective factor
Get Organized
and outcome data.
• Construct a
community profile
from the data.
Create a Plan
Develop a Profile

Better Youth Services Pilot
Learnings
Guiding principles for the provision of data that
could inform local planning
•Specific to young people of each area
•Able to measure locally prioritised issues
•Presented in a standardised, easy to analyse format
•Provided consistently over a period of time to enable
monitoring and evaluation of local initiatives
•Format that allows patterns across the age span 10-
25 years
•Easy to replicate and produce on a regular basis
•Replicated on a state, regional and/or local level in
order to allow data analysis through benchmarking

The CTC Youth Survey Tool
Helps Match Need to Tested,
Effective Programs
• Identifies levels of 21 risk and 9
protective factors and academic and
behavioral outcomes
• Guides planners to select tested, effective
actions
• Monitors the effects of chosen actions
• Basis of the Victorian Adolescent Health
and Wellbeing Survey

The Communities That Care
Tools for Decision Making
Get Started
Implement and
• Define outcomes.
•Prioritize risk factors to be
Evaluate
targeted.
• Select tested, effective
interventions.
• Create action plan.
• Develop evaluation plan.
Creating
Communities
That Care
Get Organized
Create a Plan
Develop a Profile

Percentage of Youth at Risk
Low Neighborhood Attachment
Community Disorganization
Laws & Norms Favor Drug Use
Perceived Availability of Drugs
Perceived Availability of Handguns
Poor Family Management
Family Conflict
amily History of Antisocial Behavior
Parent Attitudes Favorable to ASB
Parent Attitudes Favor Drug Use
Academic Failure
Low Commitment to School
Rebelliousness
Early Initiation of ASB
Early Initiation of Drug Use
Attitude Favorable to ASB
Attitude Favorable to Drug Use
Perceived Risk of Drug Use
Interaction with Antisocial Peers
Friends' Use of Drugs
Rewards for ASB
Depressive Symptoms
Intention to Use Drugs
Schenectady High School
Gang Involvement
Total Risk
School A
2005 Risk Profile
100%
Community Family School Peer-Individual Total
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%

Individual/Peer Domain
Protective Factors
Risk Factor Addressed
Rebelliousness
Program Strategy
Healthy
Beliefs
& Clear
Standards
Bonding Opport. Skills Recog.
Developmental
Period
Family Therapy 6-14
Classroom Curricula for Social Competence
Promotion
6-14
School Behavior Management Strategies 6-14
Afterschool Recreation 6-10
Mentoring with Contingent Reinforcement 11-18
Youth Employment with Education 15-18
Friends Who Engage in the
Problem Behavior
Favorable Attitudes
Toward the Problem
Behavior
Early Initiation of the
Problem Behavior
Parent Training 6-14
Classroom Curricula for Social Competence
Promotion
6-14
Afterschool Recreation 6-14
Mentoring with Contingent Reinforcement 11-18
Classroom Curricula for Social Competence
Promotion
Community/School Policies
6-14
Parent Training 6-14
Classroom Organization Management and
Instructional Strategy
6-10
Classroom Curricula for Social Competence 6-14
Community/School Policies all
Constitutional Factors Prenatal/Infancy Programs prenatal-2
© 1998 Developmental Research and Programs

Classroom Curricula for Social and
Emotional Competence Promotion -
Elementary School
• (PATHS ® ) Promoting Alternative Thinking
Strategies (Greenberg et al., 1995)
• Metropolitan Area Child Study (Huesmann et
al., 1996)
• Second Step: A Violence Prevention
Curriculum (Grossman et al. 1997)
• The Children of Divorce Intervention
Program (Pedro-Carroll et al., 1992)
38

Classroom Curricula for Social/
Emotional Competence Promotion-
Secondary School
• The Life Skills Training Program (Botvin et
al., 1995)
• Project Alert Drug Prevention Curriculum
(Ellickson et al., 1993; Ellickson and Bell,
1990)
• Alcohol Misuse Prevention
(Maggs et al., 1998)
• Towards No Drug Use
(Sussman et al. 2003; 2003)

Percentage of Youth at Risk
Low Neighborhood Attachment
Community Disorganization
Laws & Norms Favor Drug Use
Perceived Availability of Drugs
Perceived Availability of Handguns
Poor Family Management
Family Conflict
Family History of Antisocial Behavior
Parent Attitudes Favorable to ASB
Parent Attitudes Favor Drug Use
Academic Failure
Low Commitment to School
Rebelliousness
Early Initiation of ASB
Early Initiation of Drug Use
Attitude Favorable to ASB
Attitude Favorable to Drug Use
Perceived Risk of Drug Use
Interaction with Antisocial Peers
Friends' Use of Drugs
Rewards for ASB
Depressive Symptoms
Intention to Use Drugs
Gang Involvement
Total Risk
School A
2005 Risk Profile
100%
Community Family School Peer-Individual Total
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Schenectady High School

School Domain
Protective Factors
Risk Factor Addressed
Program Strategy
Healthy
Beliefs
& Clear
Standards
Bonding Opport. Skills Recog.
Developmental
Period
Academic Failure
(continued)
Classroom Organization, Management and
Instructional Strategies
6-18
Classroom Curricula for Social
Competence Promotion
6-14
School Behavior Management Strategies 6-14
Youth Employment with Education 15-21
Lack of Commitment
to School
Early Childhood Education 3-5
Organizational Changes in Schools 6-18
Classroom Organization, Management and
Instructional Strategies
6-18
School Behavior Management Strategies 6-14
Mentoring with Contingent Reinforcement 11-18
Youth Employment with Education 15-21

Classroom Organization,
Management, and Instructional
Tested, Effective Strategies
• The Good Behavior Game (Kellam and Rebok,
1992)
• Seattle Social Development Project (Hawkins et al.,
1999; 2005; 2008)
• Behavioral Intervention for Middle School Students
(Bry, 1982)
• Cooperative Learning Programs (Slavin, 1983)
• Tutoring Programs (Coie et al., 1984; Greenwood
et al., 1993)
• Success for All (Slavin et al., 1990)

• Form task forces.
• Identify and train implementers.
• Sustain collaborative relationships.
• Evaluate processes and outcomes
for programs annually.
•Evaluate community outcomes
every two years.
• Adjust programming.
The Communities That Care
Tools for Accountability
Get Started
Implement and
Evaluate
Creating
Communities
That Care
Get Organized
Create a Plan
Develop a Profile

Community Youth Development Study
A 24 Community Randomized Trial of CTC
PI: J. David Hawkins
Co-PI: Richard F. Catalano
Funded in 2003 by:
National Institute on Drug Abuse
Center for Substance Abuse Prevention
National Cancer Institute
National Institute on Child Health and Development
National Institute on Mental Health

Communities That Care
Theory of Change
CTC Training and
Technical Assistance
(Brown
et al,
2007)
Adoption of Science-based
Prevention Framework
Collaboration
Regarding Prevention Issues
(Quinby
et al,
2008;
Fagan et
al.,
2008,
Hawkins
et al.,
2008)
Appropriate Choice
and Implementation
of Tested, Effective
Prevention Programs &
Adoption of Social Development
Strategy as Community’s Way of
Bringing Up Children
Decreased Risk and
Enhanced Protection 2
years post initiation
Positive Youth
Outcomes 3+
years post
initiation

Effects of CTC on Onset of
Drug Use and Delinquency
• Onset of substance use and delinquency between
grade 6 and 8:
‣ Alcohol use*
‣ Cigarette smoking*
‣ Smokeless tobacco use*
‣ Marijuana use
‣ Other illicit drug use
‣ Delinquent behavior*
• Among 5 th grade students who had not yet
initiated.
*=Significant at p

Effects of CTC on Current Drug
Use and Delinquency in the Panel
• Alcohol use*
• Binge drinking*
• Tobacco Use*
• Delinquency*
*=significant at p

Percentage
Prevalence of Binge Drinking in Past
Two Weeks
In Panel
In Control and CTC Communities
25.00
20.00
15.00
10.00
5.00
0.00
9.0 p < .05
5.7
1.3 ns 1.0
Grade 5 Grade 8
Controls
CTC
Note. Observed rates averaged across 40 imputations. ns = nonsignificant. N = 4407.
Hawkins et al., 2009

Number
3.00
Mean Number of Different Delinquent
Behaviors
Committed by Panel in Past Year
In CTC and Control Communities
2.00
1.00
.36 ns .31
1.13 p < .01
.78
0.00
Grade 5 Grade 8
Controls
CTC
Note. Observed means averaged across 40 imputations.
ns = nonsignificant. N = 4407
Hawkins et al., 2009

Communities That Care:
Quasi-Experimental Effectiveness
Trial in Pennsylvania
Investigators:
Mark Feinberg
Mark Greenberg
Louis Brown
Damon Jones
Collaborative Policy Innovators:
Mike Pennington
Clay Yeager

Summary of Findings
• Overall, CTC communities showed lower
levels of risk factors, substance abuse, and
delinquency (7x as many as chance)
• Even greater impact where evidence-based
prevention programs were used (11x)

Summary and Implications
There is evidence that we can advance
public health and reduce delinquency and
violence in our communities by using
CTC to:
‣Promote the collection of data on levels
of risk and protection to focus community
action on elevated risks.
‣Engage in community efforts to
strengthen protection and reduce risks.
‣Sponsor, endorse and use tested and
effective prevention programs.
‣Deliver effective programs with fidelity

Communities That Care
has been pioneered in
Australia, Canada, UK,
Netherlands, and Cyprus

Bunbury
Ballarat
Mornington

Communities That Care Ltd
a partnership between the Rotary Club of
Melbourne , the Royal Children’s Hospital
& the University of Washington
www.wch.org.au/ctc
john.toumbourou@deakin.edu.au