Evaluation of the science-based community prevention system Communities That Care: study design and baseline equivalence of intermediate outcomes

Abstract

Background: Communities That Care (CTC) is an approach to translate prevention science into the practice of community-based health promotion. Through training and tools, CTC supports communities to build local networks to promote the psychosocial health of children and adolescents. Citizen participation, intersectoral collaboration, science-based prevention, monitoring, and quality development are key elements of CTC. From an US American study, it is known that the effect of CTC on health behavior is mediated by five intermediate outcomes. The article presents first results of the study “Effectiveness of the community-based prevention system Communities That Care” (CTC-EFF), which investigates the effectiveness of CTC in Germany. Data and methods: CTC-EFF is a quasi-experimental study. It includes 21 communities implementing CTC (IC) and 21 a priori matched comparison communities (CC) that are similar in terms of demographics, economy, and crime. In 2021, we conducted interviews with 192 community key informants (e.g., heads of community departments or facilities). Bivariate analyses were conducted to investigate whether the respondents from IC and CC differed in terms of eight sociodemographic characteristics and their perceptions of prevention collaboration, intersectoral collaboration, financial support, community support, and the adoption of science-based prevention. Results: The respondents from IC and CC differ neither regarding sociodemographic characteristics—with the exception of university entrance qualification (IC 86% vs. CC 96%)—nor regarding perceived prevention collaboration, intersectoral collaboration, financial support, or community support. An exception is the adoption of science-based prevention. Conclusion: The matching largely led to baseline equivalence in the characteristics under investigation. The small advantage of ICs over CCs in the adoption of science-based prevention is plausible, as ICs had already completed initial training and implementation steps prior to being surveyed.