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Rural Health Information Hub

Communities that Care Coalition

  • Need: To improve the health, well-being, and equity of young people in the rural area of Massachusetts's Franklin County and North Quabbin, and to reduce youth drug and alcohol use.
  • Intervention: A community-based prevention coalition was formed to improve youth health, well-being, and equity and reduce youth drug and alcohol use use. The coalition brings together stakeholders from across the community and uses the Communities That Care evidence-based community planning system.
  • Results: CTC has seen significant reductions in substance abuse among local youth in the 30 rural towns they serve.


Promising (About evidence-level criteria)


The Communities 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 and equity of young people by combating substance abuse through CTC.

Communities that Care Coalition Logo

The Coalition is based on the national Communities That CareTM model, an evidence-based, prevention initiative that builds community capacity to implement evidence-based programs, policies, and practices. Their model was designed to be replicated on a local level.

CTC operates through a Collective Impact Model, engaging with community agencies to work toward preventing harmful behaviors and promoting positive youth development through these work groups:

CTC Parent Education Workgroup
Members of the Communities That Care Coalition's Parent Education Workgroup in front of one of the Coalition's billboards.

CTC is co-hosted by Community Action and the Partnership for Youth at the Franklin Regional Council of Governments. 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.

Services offered

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 Student Health Survey to evaluate high school students' risky behaviors and underlying risk factors. Since then, annual surveys as well as periodic interviews and focus groups have helped guide CTC's efforts.

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 supports the evidence-based PreVenture program, which teaches cognitive behavioral skills along with motivational enhancement to youth whose thinking patterns put them at high risk for substance use.

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.

Students Involved in CTC
Greenfield High School students involved in the Communities That Care Coalition's "Above the Influence" campaign.

CTC's Parent Education Workgroup helps support 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.

The coalition has a new effort aimed at advancing racial justice in schools, supported by the state's pooled "Determination of Need" hospital funding."


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 and reductions in the coalition's priority risk factors:

Line charts showing priority risk factors and youth substance abuse from 2003-2018

The Coalition has advocated for change on a local and national level and has received recognition for its innovation and accomplishments:


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:

  • 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. Involve youth voice and community voice from the start. Value lived experience and center the voices of people whose voices have traditionally been silenced.
  • 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.

Contact Information

Kat Allen, Co-Chair
Communities that Care

Children and youth
Community engagement and volunteerism
Substance use and misuse
Wellness, health promotion, and disease prevention

States served

Date added
May 5, 2016

Date updated or reviewed
April 17, 2023

Suggested citation: Rural Health Information Hub, 2023. Communities that Care Coalition [online]. Rural Health Information Hub. Available at: [Accessed 25 May 2024]

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.