The Communities That Care model: promoting positive development for children and young people

1
The Communities That Care model promoting
positive development for children and young people
Professor John W.Toumbourou, PhD
Chair in Health Psychology, Deakin
University Chief Executive Officer, Communities
That Care Ltd., VicHealth Senior Research Fellow,
Centre for Adolescent Health, Murdoch Childrens
Research Institute
2
Youth child health Australia

• SUCCESSES
• continuing reductions in mortality
• successes in containing HIV/ AIDS
• recent reductions in high rates of tobacco use
• some recent reductions in illicit drug use

3
Youth child health Australia

• CHALLENGES
• high rates of illicit drug use
• high rates of mental health problems
• increasing rates of alcohol misuse
• increasing threat of obesity/ diabetes
• increasing sexual health problems
• rising child health problems (eg., abuse)

4
building on strengths tobacco prevention
5
Increased social marketing expenditure
? sales to minors, smoke free spaces,
White et al, (2007) National School Survey
6
High school illicit drug use reductions

• Cannabis use
• (lifetime use 12-17 29 1999 to 18 2005)
• Other illicit use
• (lifetime use 12-17 13 1999 to 8 2005)

White et al, 2007 Schools survey
7
Why has illicit drug use reduced?

• youth employment
• generational cycles
• social marketing cannabis harms
• effective policing and diversion
• drug education and school resilience programs
• harm minimisation (rates are higher in the US)

8
We have not yet addressed high rates of alcohol
misuse
9
National Alcohol Indicators Bulletin. 7
10
to address youth alcohol misuse we need to
implement a range of community health promotion
and prevention
11
youth demand
less alcohol harm
alcohol markets
social disadvantage
12
Laslett, A-M., Matthews, S.M. Dietze, P.
(2006).
13
Laslett, A-M., Matthews, S.M. Dietze, P.
(2006).
14
developmental influences 1999
Hospital admissions 2001/04
Liquor License density
Social disadvantage ABS
15
Alcohol-related hospital admissions 2001/04

• Mixed-effects REML regression
  Number of obs 8247
• 
  Wald chi2(4) 1811.87
• Log restricted-likelihood -26474.967
  Prob gt chi2 0.0000
• --------------------------------------------------
  ----------------------------
• hospad Coef. Std. Err. z
  Pgtz 95 Conf. Interval
• -------------------------------------------------
  ----------------------------
• seifa2001 -.0322589 .0009524 -33.87
  0.000 -.0341257 -.0303921
• licenp .0117764 .000422 27.90
  0.000 .0109492 .0126035
• alcfreq .0002868 .0150782 0.02
  0.985 -.0292659 .0298394
• 1999 risk 1.165462 .2106922 5.53
  0.000 .7525127 1.578411
• _cons 68.24016 .9720611 70.20
  0.000 66.33495 70.14536
• --------------------------------------------------
  ----------------------------

16
enriching local health promotion by enhancing
healthy development influences
17
Public Health Approach
identify problem
review risk factors
disseminate
trial interventions
Institute of Medicine, 1994
18
Prevention influences differ across communities
early life childhood
adolescence adulthood
19
HealthyBehavioursHealthy beliefs
bonding
Recognition
Opportunities
Skills
Individual Characteristics
Protective Factors
20
Communities That Care Youth Survey
21
Prevalence of Risk Factors by Year Level
22
Elevated risk factors for recent substance use
80
70
60
50
alcohol
cigarettes
40

marijuana
30
other drugs
20
10
0
0-1
2-3
4-6
7-9
gt10
Risk factors
23
Elevated risk factors for mental health and
social problems
Early sexual activity
40
Depressive symptoms
30
20

Deliberate self-harm
10
At risk of homelessness
0
0-1
2-3
4-6
7-9
gt10
Risk factors
24
(No Transcript)
25
Binge alcohol use (past 2 weeks)
S.W. Vic Victoria Year 7 4 6
Year 9 18 17
Year 11 48 39
Geelong Area 18 Other SW 26
Centre for Adolescent Health
26
Prevention Strategies

• Community
• Well organised and rewarding
• build on existing strengths
• coalitions with crime prevention and around
  sexual health promotion

27
Prevention Strategies

• Family
• Favourable parental attitudes to alcohol use
• primary school parent education
• social marketing
• community mobilisation

28
Prevention Strategies

• Individual peer
• More favourable attitudes to antisocial behaviour
  drug use
• Low moral reasoning high sensation seeking
• Bullying
• school curricula (build social and emotional
  competence)
• school organisation
• youth recreation

29
Communities That Care
30
CTC assists community prevention system

• Empowers community partnerships
• Comprehensively assesses the predictors of youth
  health and social problems (risk factors and
  protective factors)
• Tailors proven prevention programs to local
  communities to address problem root-causes
• Monitors and evaluates results

31
Communities that Care Stages

• 1. establishes a local community prevention task
  force - key leaders and community members
• 2. comprehensive risk and protection assessment
• 3. local assessment of services resources
• 4. identifies community prevention priorities
• 5. implementation of an effective community
  prevention plan
• 6. ongoing monitoring

32
Communities that Care Stages
State regional staff
Local government residents

• 1. establishes a local community prevention task
  force - key leaders and community members
• 2. comprehensive risk and protection assessment
• 3. local assessment of services resources
• 4. identifies community prevention priorities
• 5. implementation of an effective community
  prevention plan
• 6. ongoing monitoring

Common training events
33
Communities that Care Stages
Youth forums, surveys

• 1. establishes a local community prevention task
  force - key leaders and community members
• 2. comprehensive risk and protection assessment
• 3. local assessment of services resources
• 4. identifies community prevention priorities
• 5. implementation of an effective community
  prevention plan
• 6. ongoing monitoring

Archival data
Local perspectives
34
CTC is one of few community prevention
approaches supported by peer-reviewed evaluation
35
Pennsylvania evidence for CTC
Build local coalitions
Greenberg et al, 2005
36
Communities That Carein Australia
37
Communities That Care Ltd a partnership between
the Royal Childrens Hospital, the Rotary Club of
Melbourne the University of Washington
38
(No Transcript)
39

• strong community coalition
• six local area plans
• set priorities
• completed initial plans
• gained state funding
• implemented range of activities

40
WANTED community partners to establish the
Communities That Care process in- Geelong-
Warrnambool
41
PULSE project Monitoring the community heart

• School of Psychology from 2008 will increase its
  regional focus
• implement CTC surveys for Geelong primary and
  secondary school students
• survey their parents
• study work life
• community involvement
• impacts on children

42
john.toumbourou_at_deakin.edu.au
43
(No Transcript)