Coalition Capacity Research Articles

United for health to improve urban food environments across five underserved communities: a cross-sector coalition approach

BackgroundCross-sector coalitions can be a powerful vehicle to promote adoption and implementation of evidence-based programs and policies across diverse racial/ethnic communities with a high chronic disease burden. Few studies have examined coalition composition, function, or capacity to promote learning among members.MethodsWe used a mixed methods approach to examine the United for Health coalition’s implementation of multiple food environment interventions across five low-income communities of color in Los Angeles, California (USA). At the coalition-level, key measures included the collaborative environment, membership characteristics, process and structure, communication, resources, strengths, challenges/barriers, and community impact. At the organizational- and individual-levels, we collected data on participation, leadership development, intraorganizational change, perceived benefits, and learning outcomes.FindingsOverall, the United for Health coalition produced five community gardens, three pop-up produce markets, and one farmers’ market; members also expanded Electronic Benefits Transfer (EBT) access at three existing farmers’ markets. Findings indicate early coalition strengths included having a mutual purpose, which was maintained throughout the study period. Coalition participation and engagement was consistently high, while coalition and inter-organizational communication improved over time. Strengths were membership diversity and the availability of learning opportunities. Benefits included leadership development and strategic alignment across organizations. Members demonstrated an increased awareness of the importance of culturally adapted interventions and knowledge of community health planning topics. Key implementation challenges were a lack of resources and social context barriers.ConclusionsExamining coalition function and maturation in a real-world context reveals important lessons for scholars and practitioners committed to addressing nutrition-related health disparities in marginalized and historically underserved communities. Future work should investigate the sustainability of externally funded cross-sector coalitions after funding ceases.

Bicycle advocacy organizations and coalitions’ capacity for equitable programming: Findings from a national survey

PurposeBicycling as a form of active travel (AT) can provide substantial health benefits for all populations, regardless of age, gender, race/ethnicity, or sexual orientation. Despite these known benefits, disparities and inequities in bicycling are still shown in many underserved community populations. Community bicycle coalitions and advocacy organizations are considered to be a key resource for increasing bicycling throughout U.S. communities. This study aimed to understand coalition's capacity (ability to identify, mobilize, and address problems) for programming to underserved populations (racial/ethnic minorities, women, low-income, youth, LGBTQ + communities) in their community. MethodsU.S. bicycle coalitions affiliated with the League of American Bicyclists were invited to participate in an online survey via email. The survey, grounded in a community organizing framework, addressed basic information about the coalition's functioning, community demographics, barriers/desired tools to reaching underserved populations, priorities, important outcomes of coalition's advocacy work, as well as a variety of other bicycle-related equity questions for specific populations. ResultsGeographically dispersed coalitions (n = 71) completed the survey. On average, participants stated a lack of programming in underserved populations compared to the general population, and also stated many barriers/desired tools for reaching underserved populations. On average, coalitions also ranked the importance of equity low, and ranked ‘providing equitable opportunities’ as a low priority. ConclusionThe capacity for delivering programming to underserved populations throughout the community is lacking. In order to address bicycling disparities among underserved community populations, bicycle coalitions should attempt to implement strategies to provide equitable programming.

Intersectoral collaboration in a Dutch community health promotion programme: building a coalition and networks.

In health promotion programmes (HPP), it is crucial to have intersectoral collaboration within coalitions and to build networks between health and other societal sectors. A health broker role is recognized as being helpful in connecting the coalition with the broader network, and participatory action research (PAR) is deemed supportive because it facilitates evaluation, reflection, learning and action. However, there is a lack of insight into how processes that affect collaboration develop over time. Therefore, this study aimed to provide insights into the coalition's processes that facilitate building and maintaining intersectoral collaboration within a HPP coalition and network and how these processes contribute to the coalition's ambitions. As part of PAR, the coalition members used the coordinated action checklist (CAC) and composed network analysis (CNA) in 2018 and 2019. The CAC and CNA results were linked back into the coalition in five group sessions and used for reflection on pro-gress and future planning. Coalition governance, interaction with the context, network building and brokerage, and generating visibility emerged as the most prominent processes. Important insights concerned the health broker's role and positioning, the programme coordinator's leadership and the importance of visibility and trust leading to investment in continuation. The combined research instruments and group sessions supported discussion and reflection, sharing visions and adjusting working strategies, thereby strengthening the coalition's capacity. Thus, PAR was useful for evaluating and simultaneously facilitating the processes that affect collaboration.

Technical Assistance and Training Needs of Comprehensive Cancer Control Programs: a Qualitative Analysis.

The National Comprehensive Cancer Control Program (NCCCP) was established in 1998 by the Centers for Disease Control and Prevention (CDC) to advance national cancer control implementation across US states and affiliated tribes and territories. To build capacity of NCCCP recipients, technical assistance and training (TAT) is offered in the form of online trainings, webinars, toolkits, workshops, tip sheets, and other products. To determine TAT needs of NCCCP recipients, the George Washington University (GW) Cancer Center conducted a qualitative evaluation to inform TAT planning and implementation. Data on the utilization, applicability, impact, and dissemination of TAT received were collected from comprehensive cancer control practitioners through semi-structured interviews. Detailed memos of interviewee responses were documented and deductively coded based on three themes: promotion of TAT, use of existing TAT, and recommendations for future TAT. Interviewees reported a need for diverse topics, modalities, and TAT reminders. The most widely used TAT resources were social media toolkits, webinars, newsletters, patient navigation resources, and online trainings. Recommendations for future TAT included a focus on coalition support, adaptation and evaluation of evidence-based cancer control strategies, and health equity. Offering a blend of TAT, including educational webinars and trainings, was preferred by CCC professionals and could increase use. Future TAT will provide new opportunities for coalition capacity building, adaptation of evidence-based strategies for cancer control, and center health equity.

Building and Advancing Coalition Capacity to Promote Health Equity: Insights from the Health Equity Collective's Approach to Addressing Social Determinants of Health.

This article presents the structure and function of the Health Equity Collective in developing a systemic approach to promoting health equity across the Greater Houston area. Grounded in Kania and Kramer's five phases of collective impact for coalition building, The Collective operationalizes its mission through its backbone team, steering committees, and eight workgroups; each has goals that mutually reinforce and advance its vision. To date, Phase I (generating ideas), Phase II (initiating action), and Phase III (organizing for impact) have been completed. Phases IV (implementation) and Phase V (sustainability) are currently underway.

Study protocol: a non-randomised community trial to evaluate the effectiveness of the communities that care prevention system in Germany

BackgroundThe Communities That Care (CTC) prevention planning and implementation system trains communities throughout a five-phase cycle to (1) build capacity for prevention, (2) adopt science-based prevention, (3) assess the prevention needs of adolescents living in the community, (4) select, and (5) implement evidence-based programs according to their needs. After CTC proved to be effective and cost-effective in the U.S., it is being used by an increasing number of communities in Germany. The aim of this study is to evaluate the effectiveness and cost-effectiveness of CTC in Germany.MethodsCommunities in CTC-phases 1 to 3 (n = 21) and individually-matched comparison communities (n = 21) were recruited for a non-randomised trial. To assess long-term outcomes, (1) a cohort of 5th Grade students will be surveyed biennially concerning behaviours (antisocial behaviour and substance use) and well-being as well as risk and protective factors. Additionally, (2) biennial cross-sectional surveys will be conducted in 6th, 8th, 10th, and 11th Grade in each community. To assess short-term outcomes, a cohort of ten key informants per community will be surveyed biennially concerning adoption of science-based prevention, collaboration, community support and community norms. (4) In a cross-sectional design, all ongoing prevention programs and activities in the communities will be assessed biennially and data will be collected about costs, implementation and other characteristics of the programs and activities. (5) To monitor the CTC implementation, the members of the local CTC-boards will be surveyed annually (cross-sectional design) about team functioning and coalition capacity. Data analysis will include general and generalised mixed models to assess the average treatment effect of CTC. Mediation analyses will be performed to test the logical model, e.g., adoption of science-based prevention as a mediator for the effectiveness of the CTC approach.DiscussionThis is the first controlled study to evaluate the effectiveness of a comprehensive community prevention approach in Germany. Evaluating the effectiveness of CTC in Germany is an important prerequisite for further diffusion of the CTC approach.Trial registrationThis study was registered with German Clinical Trial Register: DRKS00022819 on Aug 18, 2021.

Building and sustaining a healthy alliance and network facilitated by participatory action research

Abstract Background In health promotion programmes (HPP), it is crucial to have intersectoral collaboration within coalitions and to build networks between health and other societal sectors. However, collaboration in coalitions and networks does not develop just because it is needed. Several factors that affect intersectoral collaboration are identified and defined as prerequisites for success in coordinated action for health in the Healthy Alliances (HALL) framework. A health broker role is recognised as being helpful in connecting the coalition with the broader network, and participatory action research is deemed supportive because it facilitates evaluation, reflection, learning, and action. Because insight into how processes that affect collaboration develop over time lack, this study aimed to provide insights into the processes that facilitate building and maintaining a coalition and its network within a HPP programme. Methods As part of participatory action research, the coordinated action checklist (CAC) and a composed network analysis (CNA) were used in 2018 and repeated in 2019. Respondents were coalition members (n = 6). The CAC and CNA results were linked back into the coalition in five group sessions and used for reflection on progress and future planning. Results Coalition governance, interaction with the context, network building and brokerage, and generating visibility emerged as the most prominent processes. Important insights concerned the health broker's role and positioning, the programme coordinator's leadership, and the importance of visibility and trust leading to investment in continuation. Conclusions The combined research instruments and group sessions supported discussion and reflection, sharing visions, and adjusting working strategies, thereby strengthening the coalition's capacity. Thus, participatory action research was useful for evaluating and simultaneously facilitating the processes that affect collaboration. Key messages Participatory action research is useful for evaluating and simultaneously facilitating the processes that affect collaboration. Besides insights into the processes that facilitate building and sustaining a coalition and its network, the yields of the collaboration became visible through participatory action research.

Protocol for a hybrid type 3 cluster randomized trial of a technical assistance system supporting coalitions and evidence-based drug prevention programs

BackgroundOver 5000 community anti-drug coalitions operating in the USA serve as a cornerstone of federal drug prevention. These coalitions, however, have demonstrated effectiveness in preventing substance use only when they use technical assistance (TA) and implement evidence-based programs (EBPs). The absence of TA and EBP implementation by coalitions is a key research-to-practice gap. The Coalition Check-Up TA system is designed to fill this gap by supporting community coalition implementation of EBPs. Existing TA models for evidence-based coalition approaches are resource intensive and coalition model specific. The Coalition Check-Up is a lower cost strategy that works with a variety of types of coalitions to support sustainable implementation of EBPs. This study protocol describes a hybrid type 3 effectiveness-implementation trial applying Wandersman’s Interactive Systems Framework to test the effects of the Coalition Check-Up on coalition EBP implementation capacity and outcomes. The Interactive Systems Framework outlines how the prevention support system—especially TA—bolsters EBP dissemination and implementation.MethodsUsing a cluster randomized controlled design, this trial will test the overall effectiveness of the Coalition Check-Up, including how it contributes to EBP implementation and prevention of youth substance use. The first aim is to estimate the impact of the Coalition Check-Up on coalitions’ capacity to do their work. We will recruit 68 anti-drug coalitions for random assignment to the Coalition Check-Up or “TA as usual” condition. We will evaluate whether the Coalition Check-Up improves coalition capacity using measures of coalition member responses about team processes, coalition network composition, and collaborative structure. Our second aim is to estimate the impact of the Coalition Check-Up on implementation of EBPs, and our third aim is to estimate the impact of the Coalition Check-Up on youth substance use.DiscussionThis project will clarify how the Coalition Check-Up, a scalable approach to TA due to its low cost, affects coalition capacity to support EBP implementation. Analyses also provide insight into causal pathways from the prevention support system to the prevention delivery system outlined by the Interactive Systems Framework. Results will build the evidence-base for how to support community coalitions’ sustainable implementation of evidence-based prevention programs and policies.Trial registrationClinicaltrials.gov registration number NCT04592120. Registered on October 19, 2020.

Creating and Applying the Coalition Vitality Assessment Tool: A Brief Report

This report describes the efforts of a technical assistance organization to build coalition capacity among 20 substance use prevention coalitions using a tool developed via eight principles of participatory research methods. Preliminary application of the self-assessment measure and feedback from coalitions suggests its value in strengthening coalition functioning.

O3 Longitudinal SNAP-Ed Study of Community Coalition Characteristics in Arizona

Background Collective impact theory suggests coalitions can encourage community-level policy and systems changes supported by the Supplemental Nutrition Assistance Program – Education (SNAP-Ed). A recent Cochrane review found coalition efforts improved health disparities, but insufficient knowledge of coalition characteristics limited understanding of underlying mechanisms. Objective Measure community coalition characteristics across time to identify potential areas for improvement. Study Design, Setting, Participants Trained SNAP-Ed staff administered the research-tested Wilder Collaboration Factors Inventory (Wilder) as a pretest and 2 years later as a posttest, at the level of the coalition. Community coalitions were established for at least 6 months, worked in the food systems (FS) or active living (AL) SNAP-Ed focus areas, and included at least 5 organizations and a SNAP-Ed representative. Seven coalitions (n = 73 members) completed the Wilder in both years, including 3 FS (n = 36) and 4 AL (n = 37) coalitions. Measurable Outcome/Analysis Within-group (by focus area) analyses across time: Wilcoxon signed-rank tests to compare scores for the 20 Wilder factors. Descriptive statistics for percentage of respondents whose scores for individual factors decreased. Results Across 2 years, coalition members reported improvements related to coalition purpose, collaborative environment, and perception of resources. Coalition processes and membership characteristics showed decreases. For FS coalitions: Unique Purpose improved significantly (P Conclusion Coalitions that persist over time may increase their level of collaboration, collective purpose, and resource security. They may need ongoing support to maintain internal processes and address membership characteristics. Implications of this work include successful measurement of short-term changes in coalition capacity outcomes; this highlighting of strengths and weaknesses may improve coalition efforts to address longer-term community-level objectives. Funding Supplemental Nutrition Assistance Program-Education.

Doing What We Know, Knowing What to Do: Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC).

Given the lack of progress in breast cancer prevention, the California Breast Cancer Research Program (CBCRP) plans to apply current scientific knowledge about breast cancer to primary prevention at the population level. This paper describes the first phase of Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC). The foci of Phase 1 are building coalitions and coalition capacity building through community engagement in community-based participatory research (CBPR) and dissemination and implementation (D&I) research training. Based on the successful implementation and evaluation of Phase 1, the foci of Phase 2 (presented separately in this special issue) will be to translate the California Breast Cancer Prevention Plan overarching goal and specific intervention goals for 23 breast cancer risk and protective factors strategies into evidence-informed interventions (EIIs) that are disseminated and implemented across California. CLASP-BC is designed to identify, disseminate and implement high-impact, population-based prevention approaches by funding large scale EIIs, through multi-jurisdictional actions, with the intent to decrease the risk of breast cancer and other chronic diseases (sharing common risk factors), particularly among racial/ethnic minorities and medically underserved populations in California.

Community Coalition Kick-Off Events: Lessons Learned on the Launchpad

Research has found that collaboration is important for family service agencies, and community coalition building is a common form of collaboration. Guided by Community Coalition Action Theory, this article analyzes a community coalition convening around health and housing in a resource-challenged, large Midwestern metropolitan area. Implications for practice are discussed, describing initial lessons learned from the coalition kick-off event for community coalition convening. Using theory to anticipate coalition challenges and barriers, looking beyond simple meeting agenda objectives to identify specific coalition tactics, and asking hard questions about coalition capacity at kick-off are ways to strengthen health and housing interventions within family-based services.

Citizen Science: A New Approach to Smoke-Free Policy Advocacy.

Kentucky has the second highest adult smoking rate, has the highest incidence of lung cancer in the nation, and does not have a state law prohibiting smoking inside workplaces. These tobacco disparities and policy gap leave Kentucky behind tobacco control progress made in other areas of the United States. Williamstown is a rural community with a population of 3,900 and a strong history of tobacco use. In 2017, the Northern Kentucky Health Department, in partnership with Interact for Health, worked with two coalitions to collect data, educate the community, and advocate for a local smoke-free policy. Coalition members collected 227 public opinion surveys. Community leaders-including the mayor-and advocates participated in Citizen Science, a research collaboration between scientists and volunteers. Advocates were trained on AirBeam monitors, wearable devices that gather air quality data in real time, and then were deployed in six establishments. The indoor air quality in smoking establishments was two times worse than the outdoor air quality standard. Community leaders and advocates then mobilized to educate City Council members on the benefits of a smoke-free policy, focusing on business, health, and tourism. In 2018, the Williamstown City Council voted in favor of the smoke-free policy, becoming the first jurisdiction in the Northern Kentucky region with a comprehensive smoke-free policy. The Citizen Science process helped develop coalition capacity, build community support, and engage policymakers in a successful smoke-free policy effort. Through participatory and inclusive efforts, local residents were able to affect policy change in the direction of health for all people.

Models and evidence of intersectoral cooperation in prevention and health promotion

Abstract Background Inter-sectoral coalitions are regarded as a key principle of health promotion. The study examines the questions of how these are defined, which scientific theories and models are available, and which methods and parameters are used for their evaluation. Methods The scoping review in three databases (PubMed, Web of Science, LIVIVO) included studies in English and German published in 1/2010 to 5/2018. The results were analyzed qualitatively. In addition, relevant websites and textbooks in the field of public health, health promotion and social work were subjected to a document analysis in an iterative procedure. Results The database searches yielded 186 hits, of which 48 publications were systematically examined. Document analysis revealed 128 materials. Six common terms on inter-sectoral cooperation (network, collaboration, partnership, coalition, cooperation, alliance) were identified. Uniform definitions and unambiguous distinctions do not exist. Overall, only a few of the identified inter-sectoral collaborations are theoretically based, nine publications present models. Only seven studies provide insights into the effectiveness of model/theory-based strategies, whereby these almost exclusively examine output parameters. In particular, there are parameters on structure and process (e.g. team functioning, coalition capacity). Qualitative success factors and barriers were identified (e.g. integration of different actors, development of new financial sources, formalization). Eight validated instruments are identified. Four studies also examine the outcome level and demonstrate intended effects on behavioral parameters. Conclusions For research and practice, it is necessary to sharpen the terminology of intersectoral cooperation. Existing models should be systematically used and evaluated. In the future, an evaluation of the outcome of inter-sectoral cooperation and long-term effects will be increasingly necessary. Key messages Inter-sectoral coalitions are an evolving field, and both their theoretical foundation and empirical testing are still in their infancy. While success factors are well investigated, evaluations at the outcomes level are particularly necessary.

A Mixed-Methods Approach to Evaluate the Effectiveness of Rural Community Health Coalitions: Comparing Coalition Capacity and Social Network Analysis

To determine how multiple indicators of coalition capacity (robustness, strength, sustainability, and growth) may predict effectiveness of community health coalitions in rural settings. Community coalitions in two rural Midwestern counties focusing on building capacity to reduce obesity participated in this study. Local community facilitators were hired to assist coalitions in forming partnerships, creating mission statements and goals, and identifying/addressing community needs. We are taking a novel mixed-methods approach to assess associations across indicators of coalition capacity within and between counties to determine which variables are most salient to coalition effectiveness. Participants are completing interviews and surveys over a two-year period that measure the study variables. Indicators of coalition capacity are being assessed using social network analysis and factor analysis to determine how assessment approaches converge. We are comparing network robustness, density, and centrality to coalition growth, health, and sustainability. We expect to demonstrate the unique and shared power of coalition capacity indicators and determine which indicators may serve as instrumental predictors of coalition effectiveness. Comparing quantitative network parameters (i.e. density and centrality) with other capacity building assessments will allow us to determine how specific modifications to the network (e.g. increasing density and/or centrality or restructuring the network geometry) may predict and improve coalition effectiveness over time. This novel methodology can be used for long-term evaluation and planning for local, state, and regional coalitions.

Using the Wilder Collaboration Factors Inventory to Assess SNAP‐Ed Coalitions in Arizona: Results from Four Counties

BackgroundIn 2014, the Supplemental Nutrition Assistance Program ‐ Education (SNAP‐Ed) incorporated Policy, Systems and Environmental (PSE) approaches to reinforce obesity prevention efforts. This expansion included engagement in multi‐sectoral coalitions which provide community‐level supports for healthy eating and active living. Coalition success depends on creating well‐defined collaborations that share authority, accountability, resources, and achievements. Arizona's SNAP‐Ed utilized the Wilder Collaboration Factors Inventory (WCFI) to evaluate coalitions' effectiveness in supporting food systems and active living PSE goals at the community level.MethodsThe University of Arizona Nutrition Network (UANN), part of the SNAP‐Ed program in Arizona, used the WCFI to assess six coalitions in four counties (Maricopa, Mohave, Pima, and Pinal).The WCFI uses a 40‐question Likert scale (1.0–5.0) questionnaire to evaluate collaborations on 20 success factors. The WCFI identifies areas of collaboration strength (4.0–5.0) and weakness (1.0–3.9). Coalition members were invited to complete the WCFI online or in‐person. Of the 117 surveys distributed, 64 were returned, and 61 provided complete responses. The results (N=61) were aggregated to identify similar factor scores across coalitions.ResultsFour out of six coalitions (66%) scored highly in the same success factor: members see collaboration in their self‐interest (average score: 4.5). Half of the coalitions identified unique purpose as a stronger success factor within their collaboration (average score: 4.2).All coalitions identified the same weaker success factor: lack of sufficient funds, staff, materials, and time (average score: 2.8). Three coalitions had the development of clear roles and policy guidelines as a weak success factor within their coalition (average score: 3.0).ConclusionThe WCFI results suggest that community coalitions in which SNAP‐Ed staff participate in Arizona reflect an invested membership and a unique purpose in their communities, yet sufficient resources and clear goals are areas that should be strengthened. By providing timely and actionable WCFI data and recommendations to these active living and food systems coalitions in Arizona, capacity can be strengthened to achieve the goals of the collaborations in which SNAP‐Ed participates. The coalitions that use the WCFI results to encourage the strengthening of their coalition's capacity will be more likely to succeed in achieving PSE changes in their communities.Support or Funding InformationUSDA HI050073

Improving Community Readiness for Change through Coalition Capacity Building: Evidence from a Multi-Site Intervention.

Often, community coalitions are facilitators of community-level changes when addressing underage drinking. Although studies have shown that enhancing coalition capacity is related to improved internal functioning, the relationship between enhanced capacity and community readiness for change is not well established. The present study used a pretest-posttest design to examine whether enhancing coalition capacity through training and technical assistance was associated with improved community readiness and coalition-facilitated community-level changes. Seven Kansas communities engaged in an intensive capacity building intervention through implementation of the Strategic Prevention Framework. The results indicated strong correlations between increased coalition capacity, changes in community readiness stages, and the number of community changes facilitated. The results suggest that strengthening coalition capacity through training and technical assistance may improve community readiness for change and enable the implementation of community-wide program and environmental changes.

Pseudo use value and output legitimacy of local growth coalitions in China: A case study of the Liede redevelopment project in Guangzhou

Existing research on the growth coalition of China mainly focuses on the process of urban land development and concludes that the strategic alliance of local states and market gradually emerged with the exclusion of communities in the course of development. Empirical evidence on whether or not a coalition can involve the villagers and how a coalition capacity is delivered with legitimacy is lacking. This research revisits the growth machine thesis in the redevelopment of an urban village in Guangzhou where pseudo use value is examined. Pseudo use value reflects a hybrid of the appreciation of land, which incorporates the nostalgia for the rural past and the desire for improvement. Results show that complementary expectations in the redevelopment of urban village formed an ad hoc growth coalition that incorporates the municipal government, private developers, and villagers. The generation of output legitimacy is grounded on frequent exchange of resources (i.e., land, private capital, manpower, and regulatory capacities), which also relies on empowerment and an intermediary made of the rural collective to stimulate coalition capacity. Pseudo use value makes indigenous villagers a part of the growth machine. Although the formation of local growth coalition acknowledges the role of private developers and villagers, a counterpart emerged in which the development became a political rhetoric for achieving recentralized land governance.

Assessing Community Coalition Capacity and its Association with Underage Drinking Prevention Effectiveness in the Context of the SPF SIG.

Community coalitions are a prominent organizational structure through which community-based substance abuse prevention efforts are implemented. There is little empirical evidence, however, regarding the association between coalition attributes and success in achieving community-level reductions in substance abuse behaviors. In this study, we assessed the relationship between coalition capacity, based on coalition coordinator responses to 16 survey items, and reductions in underage drinking prevalence rates. The coalitions were funded through the federally sponsored Strategic Prevention Framework State Incentive Grant (SPF SIG). We first examined whether coalition capacity increased over the life of the projects. Mean capacity scores increased for all 16 capacity items examined (N = 318 coalitions), the majority of which were statistically significant. Analysis of the associations between capacity and reductions in underage drinking was limited to coalitions that targeted underage drinking and provided usable outcome measures based on student survey data for either past 30-day alcohol use (N = 129) or binge drinking (N = 100). Bivariate associations between the capacity items and prevalence reductions for each outcome were consistently positive, although many were not statistically significant. Composite measures of correlated items were then created to represent six different capacity constructs, and included in multivariate models to predict reductions in the targeted outcomes. Constructs that significantly predicted reductions in one or both outcome measures included internal organization and structure, community connections and outreach, and funding from multiple sources. The findings provide support for the expectation that high functioning community coalitions can be effective agents for producing desirable community-level changes in targeted substance abuse behaviors.

Who's who in the crew? Exploring participant involvement in the Active Living Coalition

Health coalitions serve as an important “vehicle” to strengthen horizontal and vertical ties between organizations, community groups, and individuals whose intent and purpose is to improve wellness. Having a strong and diverse group of participants is essential for highly effective coalitions to carry out their mission in an organized and participatory manner. However, the extent that individuals become involved in coalition operations and activities remains ambiguous. A grounded theory approach was used to explore expressions of participant involvement of a local health coalition known as the Active Living Coalition (ALC). Open, axial, as well as domain and taxonomic coding were used to analyze transcripts from four focus groups (n=37 participants) in order to develop a participant continuum that captured six network aggregates within the coalition. Findings suggest that participation, for the most part, was heterogeneous and ever-changing given the expectations of the level of partnership that best individuals’ personal and professional interests. Differentiating the type of participants in health coalitions can help coalition leaders more successfully “manage” new and existing relationships. Findings imply that health coalitions can maximize coalition capacity by drawing upon the full range of potential human and material resources by further understanding the types of individuals that make up their network.