Bridges Healthcare proposes to utilize the process, infrastructure and prevention capacity created over the past 10 years to create a sustainable prevention infrastructure and strategies/activities in 4 neighboring communities within its south central Connecticut area. The program will target excessive use of alcohol, growing use of electronic cigarettes, and high levels of depression and anxiety, which have been shown to have a "multiplier effect" on substance use. The project - Bridges Connecticut Region Two Prevention Initiative - targets students in grades 7-12 in the towns of Milford and West Haven, and in Bethany, Orange and Woodbridge (the Amity Region) - a student population of over 8,000. Over the project lifetime, more than 13,000 students will receive services. Demographics and Clinical Characteristics West Haven, the largest of the communities, has large minority populations, with low income and poverty rates well above the state average. Nearly 65% (over 1,500) of West Haven students are eligible for the state's Free/Reduced Price Lunch (FRL) program, a standard index of low income. The other communities are largely white and middle-income, with less than 17% (over 900) FRL-eligible. Binge drinking rates in the Amity region, West Haven, and Milford far exceed rates in the state and the U.S. In West Haven, 44.8% of 11th graders report feeling sad or hopeless, far exceeding the state rate of 30%. Although recent electronic cigarette use data falls slightly below the state rate, community stakeholders are concerned with the growth rate and the variety of substances (e.g. marijuana, and other illicit substances) which can be consumed with vaping devices. Proposed Project: The proposed project will build on the experience of the Milford Prevention Council (MPC) and the support of a variety of community organizations and leaders in all 5 towns. As a result of sustained implementation of the Strategic Prevention Framework (SPF) process, MPC achieved reductions in the use of alcohol and marijuana in Milford exceeding 60% over the past 10 years. The Project Director, who led the Milford Prevention Council for 8 of those years, is thoroughly versed in the SPF process. Principal goals are to 1) increase prevention capacity in the Amity region, Milford and West Haven ("the 5 towns") by creating a West Haven Prevention Coalition and expanding sector engagement and training in all targeted areas; 2) complete community needs assessments and strategic plans for Amity, Milford and West Haven; 3) conduct ongoing and cumulative evaluations; 4) reduce mental health risk it the 5 towns; 5) reduce youth binge drinking in the 5 towns; and 6) reduce youth electronic cigarette use in the 5 towns. Strategies chosen will depend on the outcome of needs assessments and strategic planning in year 1. Principal measurable outcomes will be 1) reduce by 25% the number of youth (7-12 grade students) in the 5 towns who report binge use of alcohol in the past 30 days; 2) decrease by 22% the number of youth in the 5 towns reporting feeling "sad or hopeless" and the number who "thought of attempting suicide" in the past year; and 3) reduce by 33% the number of youth in the 5 towns reporting e-cigarette use in the past 30 days.