from multiple randomized trials in different types of communities, are being implemented in specific communities using this approach. There is some evidence that they are flexible enough to provide benefit across communities with diverse ethnic backgrounds (Botvin, Griffin, et al., 2001).

However, it often takes decades of longitudinal follow-up for a program to be designated as evidence-based, and the original program may not address the current needs or priorities of communities. Research-based programs rarely can meet the triple challenges of maintaining an active research program, a successful marketing strategy, and a qualified technical assistance and training program. In addition, it may be difficult to reproduce in the community the level of expertise of staff used to deliver the intervention in the original study. Finally, importing a program may result in a lack of ownership in the community, negatively affecting the ability to sustain the program over time.

Given increasing evidence of the importance of community engagement and technical assistance, several models have been developed to help communities build the infrastructure needed to identify and implement specific evidence-based programs (see Box 11-1). For example, the Communities That Care (CTC) model leads a community through an assessment process to select specific evidence-based programs. The CTC model strongly discourages

BOX 11-1

Models for Community Implementation of Evidence-Based Programs

Communities That Care


Communities That Care (CTC), a prevention system designed to reduce adolescent delinquency and substance use, was built as part of the Center for Substance Abuse Prevention approach to effective implementation (see http://ncadi.samhsa.gov/features/ctc/resources.aspx). It provides a process for communities, through a community prevention board, to identify their prevention priorities and develop a profile of community risk and protective factors. The CTC logic model involves community-level training and technical assistance for three steps: (1) community adoption of a science-based prevention framework, (2) creation of a plan for changing outcomes through a menu of evidence-based programs that target risk and protective factors identified by the community, and (3) implementation and evaluation of these programs using both process and outcome evaluations. Currently, there are 56 available programs that meet CTC’s required standard of evidence.



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