The Communities That Care Coalition Model for Improving Community Health through Clinical-Community Partnerships: A Population Health Case Report (original) (raw)

of Partnership for Youth Ruth Potee of Valley Medical Group BACKGROUND In rural western Massachusetts, a coalition with members from many sectors of the community has been working for more than a decade to support youth well-being and reduce youth substance abuse. In that time, youth drinking, cigarette smoking, and marijuana use have declined substantially, as have targeted risk factors underlying problem behaviors. The Communities That Care Coalition serves a region encompassing 30 townships in Franklin County and the North Quabbin region, with a population of 87,000 distributed over 894 square miles. The region is economically depressed, with median household income 20 percent lower than the state median. The four largest towns (Greenfield, Athol, Montague, and Orange) are all low-income centers (median income 28, 30, 32, and 33 percent below the state level respectively), with many urban-style problems despite the rural surroundings (U.S. Census Bureau, 2010, 2013). In 2002, representatives from the local hospital (Baystate Franklin Medical Center), local government, schools, social services, law enforcement, business, and faith-based organizations convened to address community concerns about substance abuse among the region's young people. The community effort was spurred by the availability of substantial long-term funding from both the federal government and private sources given to two different agencies. 1 The two agencies, Community Action of the Franklin, Hampshire, and North Quabbin Regions, and the Franklin Regional Council of Governments' Partnership for Youth, chose to cohost the initiative, with dozens of collaborating partners unified in a regionwide approach. The group adopted the Communities That Care (CTC) process to guide assessment, planning, and implementation of research-tested strategies. CTC is a community change process based on more than 2 decades of research by the University of Washington Social Development Research Group; in randomized trials, CTC has produced results both in achieving high-functioning coalitions and in reducing risky youth behaviors (Hawkins and Catalano, 2005). 2 A core multisectoral group participated in a series of five trainings and created a structure for the coalition. Five local school districts administered a survey to their 8th-, 10th-, and 12th-grade students to assess health behaviors and underlying risk factors, and on that foundation the newly formed Communities That Care Coalition developed its first community action plan.