Hawkins J David, Catalano Richard F, Arthur Michael W
Social Development Research Group, University of Washington, 9725 3rd Avenue NE, Suite 401, Seattle, WA 98115, USA.
Addict Behav. 2002 Nov-Dec;27(6):951-76. doi: 10.1016/s0306-4603(02)00298-8.
In the past decade, prevention science has emerged as a discipline built on the integration of life course development research, community epidemiology, and preventive intervention trials [Am. Psychol. 48 (1993) 1013; Am. J. Community Psychol. 27 (1999) 463; Kellam, S. G., & Rebok, G. W. (1992). Building developmental and etiological theory through epidemiologically based preventive intervention trials. In J. McCord & R. E. Tremblay (Eds.), Preventing antisocial behavior: interventions from birth through adolescence (pp. 162-195). New York: Guilford Press.]. Prevention science is based on the premise that empirically verifiable precursors (risk and protective factors) predict the likelihood of undesired health outcomes including substance abuse and dependence. Prevention science postulates that negative health outcomes like alcohol abuse and dependence can be prevented by reducing or eliminating risk factors and enhancing protective factors in individuals and their environments during the course of development. A growing number of interventions have been found to be effective in preventing adolescent tobacco, alcohol, and other drug abuse, delinquency, violence, and related health risk behaviors by reducing risk and enhancing protection. During the same decade, comprehensive community-based interventions to prevent adolescent health and behavior problems have been widely implemented in the U.S. with federal and foundation support. Despite the advances in the science base for effective preventive interventions and the investments in community-wide preventive interventions, many communities continue to invest in prevention strategies with limited evidence of effectiveness [Am. J. Public Health 84 (1994) 1394; J. Res. Crime Delinq. 39 (2002) 3; J. Community Psychol. 28 (2000) 237; J. Community Psychol. 28 (2000) 237; J. Consult. Clin. Psychol. 67 (1999) 590; Eval. Program Plann. 20 (1997) 367.]. Translating prevention science into community prevention systems has emerged as a priority for prevention research [J. Community Psychol. 28 (2000) 363; J. Appl. Behav. Anal. 28 (1995) 479.]. The Communities That Care (CTC) prevention operating system is a field-tested strategy for activating communities to use prevention science to plan and implement community prevention systems. CTC provides tools that assist communities to use local data on risk and protective factors to identify elevated risks and depressed protective factors in geographic areas where levels of risk are high and levels of protection are low and then to implement tested, effective preventive interventions that reduce the identified risks and enhance protection in these [Developmental Research and Programs. (1997). Communities That Care: a comprehensive prevention program. Seattle, WA: Author; Developmental Research and Programs. (2000a). Communities That Care: a comprehensive prevention program. Seattle: Author; Hawkins, J. D., Catalano, R. F., et al. (1992). Communities That Care: action for drug abuse prevention (1st ed.). A joint publication of the Jossey-Bass social and behavioral science series and the Jossey-Bass education series. San Francisco: Jossey-Bass]. The CTC system is widely implemented, and process evaluations of CTC suggest that it can assist communities to develop more effective prevention systems. This paper describes the background and use of the CTC operating system and results of evaluations of implementation of the system.
在过去十年中,预防科学已发展成为一门基于生命历程发展研究、社区流行病学和预防性干预试验整合的学科[《美国心理学家》48 (1993) 1013;《美国社区心理学杂志》27 (1999) 463;凯拉姆,S. G.,& 雷博克,G. W. (1992)。通过基于流行病学的预防性干预试验构建发展和病因理论。载于J. 麦科德 & R. E. 特伦布莱 (编),《预防反社会行为:从出生到青春期的干预》(第162 - 195页)。纽约:吉尔福德出版社。]。预防科学基于这样一个前提,即经验上可验证的先兆因素(风险因素和保护因素)能够预测包括药物滥用和成瘾在内的不良健康结果的可能性。预防科学假定,诸如酒精滥用和成瘾等负面健康结果可以通过在个体及其成长环境的发展过程中减少或消除风险因素并增强保护因素来预防。越来越多的干预措施已被证明通过降低风险和增强保护作用,在预防青少年烟草、酒精及其他药物滥用、犯罪、暴力以及相关健康风险行为方面是有效的。在同一时期,在美国联邦政府和基金会的支持下,旨在预防青少年健康和行为问题的综合性社区干预措施得到了广泛实施。尽管有效预防性干预的科学基础取得了进展,并且在全社区范围的预防性干预方面进行了投入,但许多社区仍在继续采用一些效果证据有限的预防策略[《美国公共卫生杂志》84 (1994) 1394;《犯罪与违法行为研究杂志》39 (2002) 3;《社区心理学杂志》28 (2000) 237;《社区心理学杂志》28 (2000) 237;《咨询与临床心理学杂志》67 (1999) 590;《评价与项目规划》20 (1997) 367。]。将预防科学转化为社区预防体系已成为预防研究的一个优先事项[《社区心理学杂志》28 (2000) 363;《应用行为分析杂志》28 (1995) 479。]。“关爱社区”(CTC)预防操作系统是一种经过实地检验的策略,用于促使社区运用预防科学来规划和实施社区预防体系。CTC提供工具,帮助社区利用关于风险因素和保护因素的本地数据,在风险水平高且保护水平低的地理区域识别出升高的风险因素和降低的保护因素,然后实施经过检验的有效预防性干预措施,以降低所识别出的风险并增强这些区域的保护作用[发展研究与项目。(1997)。《关爱社区:一项综合性预防计划》。华盛顿州西雅图:作者;发展研究与项目。(2000a)。《关爱社区:一项综合性预防计划》。西雅图:作者;霍金斯,J. D.,卡塔拉诺,R. F.,等。(1992)。《关爱社区:预防药物滥用行动》(第1版)。乔西 - 巴斯社会与行为科学系列及乔西 - 巴斯教育系列联合出版物。旧金山:乔西 - 巴斯]。CTC系统得到了广泛实施,对CTC的过程评估表明它能够帮助社区建立更有效的预防体系。本文描述了CTC操作系统的背景、使用情况以及该系统实施评估的结果。