Influencers and connectors in community prevention of drug abuse: balance between multi-site consistency and local community fit in program implementation

Abstract

espanolRESUMEN La implementacion de un programa en multiples lugares simultaneamente supone un reto para la coordinacion adecuada y la consistencia interna de la intervencion. El funcionamiento de la red de facilitadores del programa puede ser decisiva para la efectividad y el ajuste comunitario de tales intervenciones. En este articulo realizamos un estudio de casos de un programa de prevencion comunitaria de drogodependencias que se aplica en un amplio conjunto de ciudades de Andalucia, en el sur de Espana. Analizamos y describimos dos tipos de posiciones relevantes de los facilitadores locales: aquellos que tienen un papel central de coordinacion para el conjunto de aplicadores del programa, frente a los “conectores” perifericos, que tienen un papel de puente entre areas geograficas diferenciadas. La red del programa Ciudades ante las Drogas (n = 45) en la provincia de Sevilla mostro una estructura centro-periferia, con patrones de coordinacion claramente influidos por la ubicacion geografica de los facilitadores. La capital y su area metropolitana no solo tienen mayor centralidad geografica sino un papel central en la red social. Por su parte, el papel de los “conectores” parece ser funcional para evitar la fragmentacion de los nucleos comarcales mas alejados. Finalmente, discutimos la tension entre la coordinacion central del programa y la adaptacion a las peculiaridades de cada contexto local. EnglishABSTRACT The simultaneous implementation of a program in multiple sites poses a challenge for the adequate coordination and internal consistency of an intervention. The operation of the network of program facilitators can be critical for effectiveness and community adjustment of such interventions. In this paper, we conducted a case study of a community prevention program for drug addiction applied in a large group of cities in Andalusia, in southern Spain. The aim was to explore how integrated planning and local adaptation are combined in community prevention, through the collaboration network between program facilitators. For this aim, we analyze and describe two types of relevant roles of local facilitators: those that have a central coordinating role, versus peripheral “connectors”, which have a bridge role between different geographical areas. The network of the “Cities against Drugs” program in the province of Seville (n = 45) showed a core-periphery structure, with coordination patterns clearly influenced by the geographical location of facilitators. The capital and its metropolitan area not only have greater geographic centrality but also a central role in the social network. On the other hand, the role of “connectors” seems to be functional to avoid the fragmentation of the remotest regional nuclei. Finally, we discuss the tension between central coordination of the program and the adaptation to peculiarities of each local context.