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.
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.
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
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
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
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 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
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.
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
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:
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
Develop your strategic framework. Keep it simple, but
comprehensively outline the issues that need addressing
and your plans to achieve improvement.
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.