Communities that Care (CTC) Coalition
- Need: A way to address substance abuse among teenagers in Massachusetts's predominately rural areas of Franklin County and the North Quabbin Region.
- Intervention: A community-based prevention initiative was formed to reduce youth violence, delinquency, and alcohol and tobacco use.
- Results: CTC has seen significant reductions in substance abuse among local youth in the 30 rural towns they serve.
Promising (About evidence-level criteria)
That Care Coalition (CTC) of Massachusetts’s
predominately rural areas of Franklin County and the
North Quabbin Region began out of a concern for their
area’s youth. In 2002, a group of community members
gathered to discuss effective ways to address substance
abuse that had become prevalent among teenagers. Since
then, concerned youth, parents, schools, community
agencies, and local governments have united to promote
the health of young people by combating substance abuse
The Coalition is based on the national CTC program, a community-based prevention initiative that aims to reduce youth violence, delinquency, and alcohol and tobacco use. Their tested methods, prevention policies, and programs were designed to be replicated on a local level.
CTC operates through the following workgroups:
- Parent Education - connects the Coalition to the agencies that work with families and youth.
- Regional School Health Task Force - connects the Coalition to the 9 public school districts in the area.
- Policy and Practice Change - consists of health department personnel, town officials, law enforcement, and those involved in creating and enforcing policies.
- Youth Leadership Initiative - connects young people from youth groups throughout the region to the work of the Coalition.
CTC is co-hosted by Community Action and Partnership for Youth. Several dozen partners have contributed to CTC’s success. CTC includes more than 200 members with representation from local government, businesses, schools, law enforcement, faith-based organizations, media, hospitals, mental health providers, parent advocates, and out-of-school-time programs.
In 2002, a federal Drug Free Communities grant, distributed by the Substance Abuse and Mental Health Services Administration, provided the initial funds to run the program for several years. In addition, CTC has raised more than $5 million over the last 13 years toward the program’s efforts.
This video explains more about CTC Franklin County and the North Quabbin Region.
The CTC system is data-driven and evidence-based and uses information collected about local youth to identify areas of need and measure the program’s success. In 2003, they conducted a Teen Health Survey to evaluate high school students’ risky behaviors and underlying risk factors. Since then, annual surveys have helped guide CTC’s efforts. This past year, the Coalition conducted a series of interviews and focus groups and to inform their work.
The Coalition publishes and maintains a Community Action Plan for reducing youth substance use and improving youth health in the region. The plan is updated regularly by the coalition’s workgroups based on updated local data and community input.
CTC sponsors Botvin LifeSkills Training for middle school teachers. LifeSkills equips youth with tools like decision making, anger management, conflict resolution, and effective communication. It has a proven track record of reducing youth substance abuse and violence.
The Coalition also works to support Screening, Brief Intervention, and Referral to Treatment (SBIRT) for all students in all of their school districts. They work with local schools to help ensure that school policies related to substance use follow best practices and principles of restorative justice.
Marketing is a large part of CTC's efforts. The Coalition works with school districts to coordinate a student-led campaign to promote healthy behaviors. Billboards, PSAs, advertisements, materials, and events have helped shed light on the harmful results of substance abuse. For instance, youth partner with alcohol vendors for a “Sticker Shock” campaign, using messages on stickers to encourage parents to help prevent underage drinking.
CTC’s Parent Education Workgroup offers mini-grants with funding from the Baystate Franklin Medical Center to member agencies working on family education efforts. The funds provide evidence-based training for parents and child caregivers, as well as efforts that strengthen family connection.
Thirty rural towns in Franklin County and the North Quabbin have benefited from CTC. Since the program’s launch in 2002, Franklin County and the North Quabbin Region have seen significant reductions in substance abuse in local youth:
- Alcohol use dropped by 36%
- Binge drinking dropped by 35%
- Cigarette smoking dropped by 52%
- Marijuana use dropped by 24%
From October, 2015 through January, 2016, CTC completed a set of interviews and focus groups as part of a community assessment on youth substance abuse. Findings were compiled into a report. Students made videos that include personal testimony of the impact of substance abuse in their schools.
The Coalition has received recognition across Massachusetts and the nation for its innovation and accomplishments:
- In 2007, CTC was named “Coalition of the Year” by Community Anti-Drug Coalitions of America (CADCA).
- In 2008, CTC Co-Chair Kat Allen received CADCA's “Advocate of the Year” award.
- In 2009, the Massachusetts Department of Public Health awarded CTC its “Healthy Communities Principles Award.”
- In 2012, CTC’s accomplishments were outlined in a Stanford Social Innovation Review (SSIR) article entitled Channeling Change: Making Collective Impact Work.
- In 2016, the National Academy of Medicine published a discussion paper entitled The Communities That Care Coalition Model for Improving Community Health through Clinical–Community Partnerships: A Population Health Case Report.
- Two additional high-profile articles were published on Collective Impact highlighting CTC’s work: Embracing Emergence: How Collective Impact Addresses Complexity, Stanford Social Innovation Review (2013) and How Public Policy Can Support Collective Impact, Collective Impact Forum (2015).
- CTC Coalition Coordinator presented at the White House Summit on prevention in education in June, 2014.
Finding and sustaining funding in a low-income rural community has consistently been the greatest challenge for the Coalition, particularly as federal dollars have faded. CTC handled this challenge by including improving youth nutrition and physical activity. Now, the challenge is to maintain the Coalition’s focus while working on multiple related issues.
CTC has become a mentor site to sister coalitions across the state. Below are some principles they suggest for those who are interested in starting something similar:
- Create boundaries. Prioritize the greatest needs of your area’s youth and focus on those first. While you should limit your service area to be a manageable size, be willing to expand your boundary lines as your capacity allows.
- Develop your strategic framework. Keep it simple, but comprehensively outline the issues that need addressing and your plans to achieve improvement.
- Secure community involvement and support before launching the program. With programs like this, the buy-in from local stakeholders is necessary. Seek out those who share a similar mission and are already taking steps to build up their youth.
Children and youth
Community engagement and volunteerism
Wellness, health promotion, and disease prevention
May 5, 2016
May 16, 2017
Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.