Children at Risk (CAR) was a drug and delinquency prevention program for high-risk adolescents aged 11 to 13 years who lived in narrowly defined, severely distressed neighborhoods in: Austin, Texas; Bridgeport, Connecticut; Memphis, Tennessee; Savannah, Georgia; and Seattle, Washington. CAR delivered integrated services to the 338 young participants and all members of their households. Case Managers collaborated closely with staff from criminal justice agencies, schools, and other community organizations. Compared with youths in the control and comparison groups, CAR youths participated in a significantly higher number of positive activities during the program period. They were also more likely to report attending drug and alcohol abuse programs. CAR households used more services than comparison groups, although the majority of CAR households did not report getting most core program services. CAR youths appeared to receive more positive peer group support and to associate less frequently with delinquent peers. Compared with control group youths, CAR youths were significantly less likely to have used gateway and serious drugs, sold drugs, or committed violent crimes. Lessons drawn from program implementation are discussed. (SLD)