Community-Based Prevention: Findings From Nearly 3 Decades of the Drug-Free Communities Support Program.

چکیده اصلی

CONTEXT: Community-based coalitions are a central strategy for preventing youth substance use, yet evidence describing how coalition-based prevention functions at scale and in contemporary practice contexts remains limited. The Drug-Free Communities (DFC) Support Program represents a long-standing national investment in locally driven, multisector prevention efforts. OBJECTIVE: To examine recent trends in youth substance use in DFC-funded communities and describe coalition infrastructure and practices that provide context for these trends. DESIGN: Descriptive trend analyses of coalition-reported data and youth substance use indicators. Long-term patterns were examined among coalitions with repeated core measures collections from all DFC funded since inception with the earliest data collected in 2002, and recent national trends were summarized using data collected from DFC coalitions implementing grants between 2021 and 2025. SETTING: Community-based prevention coalitions operating across rural, suburban, urban, and tribal contexts in the United States. PARTICIPANTS: Drug-Free Communities-funded coalitions submitting annual reporting data and core measures data during the study period, including 1014 DFC-funded coalitions that received funding at some point between 2021 and 2025. Coalitions collect core measures data from youth in their service area using surveys reviewed by the National Evaluation team to ensure data harmonization. INTERVENTION: Coalition-based environmental prevention model emphasizing multisector collaboration, evidence-informed strategies, and youth engagement tailored to local community conditions. MAIN OUTCOME MEASURES: Past 30-day use of alcohol, marijuana, tobacco, and prescription drugs (misuse), reported by grade level (6 thru 12) through locally administered surveys conducted at least every 2 years. RESULTS: Across all DFC implementing from inception through 2025 with at least 2 core measures collection time points (first and most recent), significant declines over time in past 30-day use of substances (alcohol, tobacco, marijuana, prescription drug misuse) across middle and high school grade levels were observed within DFC-supported communities. Focusing on data from DFC cohorts with repeated observations from 2021 to 2025, DFC funding was again generally associated with declines in past 30-day substance use, with larger reductions among high school youth and for substances with higher baseline prevalence. Among middle school youth, declines over time for prescription drug misuse was small and was nonsignificant in 2021; the same was true for middle school tobacco use in 2025. During the same period, coalitions demonstrated stable infrastructure, consistent multisector engagement, widespread school partnerships, and sustained youth involvement. CONCLUSIONS: Overall and recent declines in youth substance use occurred within the context of the DFC coalition model characterized by multisector engagement, sustained youth involvement, and implementation of comprehensive, evidence-based and evidence-informed strategies. While correlational in nature, these findings highlight the importance of maintaining long-term community-based prevention capacity focused on youth substance use prevention. Although factors outside of DFC may also contribute to youth substance use reductions, it is possible that DFC efforts may have contributed to national youth substance use declines.

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