Scottish Government

Jon Bannister and Jennifer Dillane (University of Glasgow)
ISBN 0 7559 2553 X

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Communities That Care (CTC) is an early intervention prevention programme originally developed in the USA to tackle problem behaviours exhibited by young people, including offending. This research was commissioned by the Scottish Executive Justice Department to evaluate the implementation of the CTC pilot programme in three sites in Scotland. The research was carried out between February 2000 and December 2003, and considered the three developmental phases of the Scottish CTC pilot programmes: community readiness; community mobilisation and assessment; and programme implementation.

Main Findings

• The pilot programme areas differed markedly from the expected criteria in terms of size and neighbourhood structure.
• The relationship with Social Inclusion Partnerships (SIPs) had both positive and negative consequences for the pilot programmes. Difficulties were apparent where the geographical boundaries and governance structures of the SIP and the CTC programme did not coincide.
• The various components of the CTC process promote partnership working and enable contributors to gain ownership of the programme. However, programme contributors noted a lack of consistent attendance at meetings and a relatively low number of local residents, especially young people.
• For many programme contributors, information generated by the CTC process challenged preconceptions and uncovered hidden problems encountered by children and young people.
• The evidence-based approach of the process was impeded to an extent by doubts about the methodology employed and the reliability of data. CTC (UK) have since taken steps to address these issues.
• The materials contained within CTC (UK)'s 'Promising Approaches' guide, though useful, should be expanded and updated.
• Robust monitoring and evaluatioframeworks will be necessary to expand the evidence base for preventative interventions.
• Programme co-ordinators performed a crucial function in driving forward the CTC process, and maintaining the attachment of the community and service providers.
• The philosophy underpinning the CTC approach to prevention was strongly supported by local professionals and service providers.

Introduction

Three CTC programmes, funded through a partnership between the Scottish Executive, participating local authorities, Social Inclusion Partnerships (SIPs), and Health Boards, were launched in 2000. CTC (UK), a limited, charitable company established as the sole licensed provider of CTC in the UK, provided technical assistance, training and support to these programmes.

CTC is a long-term early intervention programme that aims to ameliorate the risk factors and enhance the protective factors that international research evidence has shown to influence the likelihood that a young person will: experience school failure, school-age pregnancy, or sexually-transmitted diseases; engage in drug abuse; or become involved in violence and crime.

Guided by a co-ordinator and various training exercises, CTC programmes are community-led. CTC places local residents and representatives (service managers and agents) of the statutory and voluntary bodies engaged in the prevention and management of the problem behaviours exhibited by young people at the heart of its decision-making structures.

CTC contains three developmental phases: community readiness; community mobilisation and assessment; and programme implementation resulting in the introduction of new initiatives or the amendment of existing initiatives. Each phase has numerous components. Two groups - 'key leaders' and 'community board members' - were seen as crucial to the successful completion of each phase.

The aims of the research were to

• describe the development of the CTC Scottish pilot programme as it unfolded in three case study locations;
• assess the decision-making structures and processes that served to underpin the CTC approach to intervention; and
• consider the factors that have facilitated and hindered the effective implementation of the pilot programmes.

Findings

Community Readiness

According to the CTC model, community readiness involves assessing whether a community is both willing and able to participate in a CTC programme. CTC (UK) expected that participating areas would have a range of characteristics including: a total population of up to 12,000; covering a named geographical area with which its residents identify; and being characterised by higher than average levels of social deprivation and crime.

The pilot programme areas, however, differed markedly from these criteria. In one of the pilot areas where the population was only 6,500, the views of those involved in the programme suggested that this had a negative effect. This situation arose as a consequence of a mismatch between the geographical boundaries and governance structures of the SIP and the CTC programme. In this particular instance, the SIP held a responsibility and agenda for a larger population. As a consequence, it was felt that the CTC agenda was down played and this impacted on the implementation of many of the recommended interventions.

On the other hand, the other two areas had populations in excess of 30,000, contained numerous neighbourhoods and exhibited mixed levels of deprivation and crime. Some respondents recognised that the matching of SIP and CTC boundaries in these areas facilitated the collation of archival data, placed CTC at the heart of the regeneration process and funding mechanisms. Others, however, were concerned about the viability of both frameworks existing side-by-side. Difficulties were encountered in all areas in gathering comprehensive and reliable archival data. Problems relating to the workload pressure on the programme co-ordinator were noted in all three areas, and it is likely that these were exacerbated in the larger programme areas.

Community Mobilisation and Assessment

The community mobilisation and assessment phase contains various components intended to enable the community to assess the risks that they face and the resources at their disposal, and to produce a plan of action.

The key leader board in each pilot programme area was composed of the members of the respective SIP management board with the addition of other senior officers in the Council, Police, Health Board and other agencies. The community board, comprising representatives of the residential community and local professionals, is responsible for the majority of tasks within CTC programmes.

While the composition of the boards in the pilot areas largely met these criteria, programme contributors in all three areas noted a lack of consistent attendance at meetings and a relatively low number of local residents, especially young people.

In the first step of this phase of a CTC programme, a purpose-designed school questionnaire and a range of archival data are used to compile a Risk Audit Report. This report identifies the scale of each of the seventeen risk factors investigated by CTC, from which between two and five are prioritised by programme contributors for further action.

The Risk Audit was viewed by some respondents as a useful tool for uncovering hidden problems and challenging preconceptions. The risk prioritisation process also served to foster partnership working and enable participants to gain ownership of the programme. However programme contributors and experts expressed concerns about their ability to prioritise risks on the basis of the data provided by the audit alone. Doubts were expressed about the methodology used to score risk factors, and the data on which they were based. CTC (UK) have since taken steps to address the issue of how risk factors are scored and have provided national data to allow comparisons.

The next step entails the compilation of a Resources Audit that aims to identify gaps in service provision ( i.e., where new interventions are required) in relation to the prioritised risk factors, as well as noting existing strategies which might be modified or strengthened.

While the collection of resource data was facilitated by having SIP board members on the Key Leader boards, the resource audits still took considerably longer to complete than was envisaged. This was primarily a result of the scale of the task and the loss/turnover of contributors. This led to out-of-date and incomplete resource data being identified as a problem at the action planning stage.

The resource audit in one of the pilot areas, which was reviewed by an expert panel, revealed that service providers were already committing a significant level of resources to the programme area. However, the apparent lack of an evidence-based or standardised approach to the provision of these services raised concerns amongst the panel: firstly that this meant a lack of information on which to base a judgment regarding the selection of new initiatives; and secondly that agencies might consider their own interventions to be comparable with those listed in the 'Promising Approaches' guide without having strong evidence for this comparison.

The action plan, the final component of this phase of the CTC developmental process, aims to identify actions that will ameliorate the set of prioritised risk factors. The 'Promising Approaches' guide, though impressive and vital to this component of the CTC process, was perceived by some to contain numerous shortfalls. For example, details regarding the precise nature of the interventions and their associated costs were sometimes found to be unavailable. There was a consensus of opinion that the guide should be updated on an ongoing basis. It should be noted that CTC has, in April 2005, published a second edition of 'Promising Approaches'.

Relative and overall levels of contribution were consequential in this stage of the process. While the generally low levels of participation increased the length of time taken to complete the plan, the relative contribution of particular agencies was found to have an impact on the strategic focus of recommendations.

Implementation

Implementation, resulting in the introduction of new initiatives or the amendment of existing initiatives, is the final phase in the CTC process. Programme contributors expressed a concern as to whether the time and effort devoted to the CTC process would be matched by the commitment of agencies and key leaders to invest in the action plan. There was also some anxiety regarding the sustainability of the CTC programmes as there would no longer be a co-ordinator once the initial funding came to an end.

By the completion of the research data gathering exercise, the pilot programmes had each implemented a variety of initiatives aimed at achieving recommendations relating to their prioritised risk factors. Some of these were CTC driven, whereas others were in-line with the wider organisational plans of other agencies.

While it is at this stage too early to examine the impact of these interventions, it is unclear whether a robust monitoring and evaluation framework for these interventions was in place at the pre-implementation stage. In terms of accountability and service improvement, these are crucial aspects of any intervention and should be planned alongside the intervention itself. Failure to do so will also perpetuate the problem of not having a sound UK evidence base for interventions, as alluded to above in relation to the 'Promising Approaches' guide.

Conclusions

The CTC approach to prevention is evidence-based. While laudable steps were taken to remain true to this evidence-base in the Scottish pilots, several factors including the choice of pilot programme areas and methodological and practical problems relating to data collection and analysis seem to have hindered the successful transference of this approach to a Scottish context. Whether any effects of these problems on the impact of interventions in the pilot areas will be discernible will depend on the quality of the monitoring and evaluation frameworks implemented by the service providers.

CTC programmes are community-led. In the Scottish pilots, the various components of the CTC developmental process served to promote the participation, and counsel the experience, of a range of local stakeholders. This promoted partnership working and enabled contributors to gain ownership of the programme. These processes were, however, impeded by the lack of a fully inclusive and consistent range of contributors.

While there was widespread support for and acceptance of the CTC philosophy, there were some concerns as to the availability of resources and sustained commitment to implementing the recommendations of the programme following the pilot phase.

This study has therefore raised numerous issues that merit further consideration, including:

• how/whether CTC programmes could be integrated with broader policy contexts (which also address the management of problem behaviours) such as SIPs, Community Planning, and the social inclusion agenda;
• how CTC's evidence-based approach to early intervention, and 'Promising Approaches', could be incorporated in to mainstream services; and
• the evaluation and monitoring of new and existing interventions to expand the evidence base.

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