The Community Health Demonstration Project (CHDP) was organized to dev
elop, implement, and evaluate substance abuse prevention programming i
n a resource-poor rural Appalachian area. The goals of the CHDP were t
o develop new community-initiated and community-based programs and ser
vices for the prevention of alcohol, tobacco, and other drug (ATOD) us
e during pregnancy and for the first 2 years after birth by women and
their families in the target community, to increase use of prevention
services, and thereby to reduce ATOD use among this population. Measur
able results of the communitywide prevention project included increase
d awareness and knowledge of problems associated with ATOD use during
pregnancy and postpartum, new services adopted by local agencies and o
rganizations, more cooperative efforts to provide prevention programs
for all ages throughout the community, a range of new or expanded prog
rams to enhance development, and a reduction in ATOD use during and af
ter pregnancy by women in this rural area.