Early Effects of Communities That Care on the Adoption and Implementation Fidelity of Evidence-Based Prevention Programs in Communities: Results from a Quasi-experimental Study.

Abstract

To date, few evidence-based prevention programs (EBP) have been implemented in Germany, despite their growing availability. Some prevention researchers have stated that prevention support systems such as Communities That Care (CTC) could contribute to the wider spread of EBP in Germany and improve the fidelity of EBP implementation. Our study aims to investigate whether CTC leads to greater adoption of EBP in German communities. A quasi-experimental study was conducted with 22 intervention communities (IC) and 22 comparison communities (CC). Data collection occurred at two time points (T0: 2021/2022 and T1: 2023/2024), capturing information on which EBP were implemented in these communities during the prior school year, the number of people reached, and the quality of EBP implementation. Data from 17 IC and 12 CC were included in the final analyses. At T0, there were no significant differences between IC and CC in the number of EBP implemented or the number of people reached. In the IC, the average number of EBP implemented was 3.57 per 10,000 residents at T0, which increased significantly to 8.57 at T1 (p = .004). In the CC, the average number rose from 1.88 at T0 to 3.41 at T1, though this change was not statistically significant (p = .089). Regarding reach, an average of 140 people per 10,000 residents were reached with EBP at T0 in IC, increasing to 407 by T1, while in CC, the average increased from 77 at T0 to 300 at T1. Neither group showed a statistically significant increase in reach. Implementation fidelity remained consistently high in both groups at both time points. The results suggest that CTC may encourage communities to implement more EBP. However, the findings may be influenced by confounding factors and the relatively short observation period. Further research with an extended follow-up is therefore recommended.