Barriers and facilitators to implementing Communities That Care (CTC) in different countries

Communities That Care (CTC) is a prevention system that aims to support the healthy development of children and adolescents through the organization and training of community coalitions aimed at implementing evidence-based preventive interventions, focusing on drug abuse and involvement with violence. The objective of this article is to present the current state of knowledge on the primary barriers and facilitators for implementing or adapting CTC in different communities and countries. This is an integrative review, with a search performed in the databases: Pubmed, Web of Science, Scopus, PsycINFO and Virtual Health Library (VHL), using the indexes ("Communities That Care" OR "CTC") AND (fidelity OR implementation). Among the 16 studies selected based on the inclusion/exclusion criteria, most had a quantitative or mixed approach, with an experimental or quasi-experimental, longitudinal design, published between 2005 and 2021. The main barriers faced were: coalition mobilization, community readiness challenges, epidemiological data collection, and the use and implementation of evidence-based preventive interventions. As facilitators, the use of training and provision of technical assistance was identified to increase community readiness, to leverage the work of the coalition and to sensitize the community on the importance of implementing evidence-based interventions.