on substance use in existing evaluations of community interventions highlights a significant gap in the field given that community-wide interventions, including those that incorporate components targeting families and schools, have the potential to address a wider set of common risk factors comprehensively. Communities That Care, a system to help communities identify and prioritize risk factors and implement tested interventions that address those factors, is being tested in a randomized trial with positive initial results (see Box 11-1).

The media and the Internet are emerging as means to reach local communities beyond schools and families, as well as the broader community, more widely. Their extensive use by today’s young people makes development and testing of evidence-based promotion and prevention interventions using these venues particularly attractive. For example, Triple P (see Box 6-3) has had some positive results in communicating information about parenting via the media. If effective media-based interventions were available, they could be especially valuable in cases in which the local health care system has not allocated resources for preventive services, or the community, school, workplace, or family unit has chosen not to participate in preventive programs. There are early indications that interventions provided on CD-ROM can be effective at reducing risk of alcohol use, drug use, and violence (Schinke, Schwinn, et al., 2004; Schinke, Di Noia, and Galssman, 2004).

A series of creative studies has demonstrated the wide reach and effectiveness of entertainment media approaches. One of the pioneers in this area is Miguel Sabido (Singhal, Cody, et al., 2003). Using social-cognitive techniques developed by Albert Bandura (2006), Sabido has documented significant impact of these approaches in Mexico on such practices as the utilization of national literacy resources and family planning. The latter was measured by documenting the use of contraceptives, which showed annual increases of 4 percent and 7 percent, respectively, in the two years preceding the airing of a television serial novel (telenovela) addressing family planning and 23 percent in the year the program was aired.

Studies of the impact of electronic media (such as television, computer-assisted interventions, and websites) on other health-related behaviors have also found positive effects in such areas as cognitive-behavioral mood management skills (Muñoz, Glish, et al., 1982), mental health interventions (Marks, Cavanagh, and Gega, 2007; Barak, Hen, et al., 2008), and smoking cessation (Muñoz, Lenert, et al., 2006). The National Institute for Health and Clinical Excellence in the United Kingdom has approved two computerized cognitive-behavioral therapy interventions for depression and panic/phobia disorders (Christensen and Griffiths, 2002).⁴ The Psychosocial