Community Prevention Coalitions Research Articles

Going the Distance: Technical Assistance to Community Prevention Coalitions and its impact on Prevention Coalitions Over Time.

Prevention Coordinators are the linking agents providing technical assistance between universities and communities in the PROSPER model to support the implementation and sustainability of youth and family programs that have reduced substance abuse in prior research. This study examines the outcomes and trajectory of the frequency of contact of technical assistance (i.e. dosage) with community collaborative prevention coalitions across the three stages of coalition development. After communities were randomized, members of PROSPER coalitions (n=12) provided information about the quality of their operations at five time points across four and one-half years; prevention coordinators reported on the frequency of contact with their community coalitions at 14 intervals across the same period of time. This study only utilizes the intervention communities. Results from correlational models show that levels of dosage relate to the quality of internal coalition processes over time, but that the direction of the relationship changes over time: high frequency of contact early on relates to lower coalition-rated functioning initially. In contrast, early frequency of contact relates to higher levels of coalition functioning at later time points. Furthermore, longitudinal mixed models show that levels of dosage were consistent over time. These results provide empirical support of the importance of a proactive technical assistance model and add further evidence that important distinctions exist among different coalition developmental phases.

Community utilization of risk and protective factor data for prevention planning in Chile and Colombia.

Many effective community health service delivery systems implemented in the USA assess risk and protective factors (RPFs) for youth problem behaviors in a community, and report these data back to local coalitions for prevention planning. This study examined whether community prevention coalitions in Chile and Colombia perceived these reports of RPFs-based on the results of the Communities That Care Youth Survey-to be understandable, valid, useful, and worth disseminating. Thematic content analysis was used to analyze qualitative data collected from 7 focus groups with 75 coalition members. Results indicated heterogeneity between and within coalitions in terms of participants' understanding of RPFs. However, most participants found reports of RPFs to be easy to understand, thorough, 'true' to their communities, and useful for diagnosing and prioritizing needs, action planning, and mobilizing others in their communities. Findings suggest the viability of preventive systems that rely on community-level RPF data, for use in Latin America.

IMPLEMENTING THE CAPACITY BUILDING FOR CHANGE MODEL WITH SUBSTANCE ABUSE PREVENTION COALITIONS

Community prevention coalitions are a commonly utilized mechanism for supporting community‐based prevention efforts. The effectiveness of community coalitions to foster change and improvements in outcomes is inconclusive and often influenced by other factors such as community readiness and coalition capacity. Limited studies have examined the effects of technical assistance (TA) models on coalition and community capacity to facilitate change and improvements in outcomes. The present study analyzed the effects of a capacity‐building TA model on the implementation of both key coalition processes (e.g., strategic planning) and the facilitation of community changes (i.e., program, policy, and practice changes) by prevention coalitions. A between‐group randomized controlled trial, with a delayed intervention control group design, was used with eight coalitions in the Midwest. The results suggest that although internal coalition capacity increased, it did not immediately result in greater facilitation of external community changes by the community prevention coalitions.

Sustainability of the Communities That Care Prevention System by Coalitions Participating in the Community Youth Development Study

Community prevention coalitions are a common strategy to mobilize stakeholders to implement tested and effective prevention programs to promote adolescent health and well-being. This article examines the sustainability of Communities That Care (CTC) coalitions approximately 20 months after study support for the intervention ended. The Community Youth Development Study is a community-randomized trial of the CTC prevention system. Using data from 2007 and 2009 coalition leader interviews, this study reports changes in coalition activities from a period of study support for CTC (2007) to 20 months following the end of study support for CTC (2009), measured by the extent to which coalitions continued to meet specific benchmarks. Twenty months after study support for CTC implementation ended, 11 of 12 CTC coalitions in the Community Youth Development Study still existed. The 11 remaining coalitions continued to report significantly higher scores on the benchmarks of phases 2 through 5 of the CTC system than did prevention coalitions in the control communities. At the 20-month follow-up, two-thirds of the CTC coalitions reported having a paid staff person. This study found that the CTC coalitions maintained a relatively high level of implementation fidelity to the CTC system 20 months after the study support for the intervention ended. However, the downward trend in some of the measured benchmarks indicates that continued high-quality training and technical assistance may be important to ensure that CTC coalitions maintain a science-based approach to prevention, and continue to achieve public health impacts on adolescent health and behavior outcomes.

Using Empowerment Evaluation to Facilitate the Development of Intimate Partner and Sexual Violence Prevention Programs

This article addresses the question, “What factors contributed to successful completion of a needs and resource assessment in local communities, using the empowerment evaluation approach?” Case studies of three successful projects allow the exploration of organizational, community, state, and national factors that contributed to a strong needs and resource assessment, including original data collection, to guide the development of a plan to prevent intimate partner and sexual violence. The overall project was guided by empowerment evaluation principles. Each local community used additional conceptual frameworks, including grounded theory, Kolberg's theory of moral development, gender-role attitudes as operationalized by the rape myth acceptance and Olweis' systemic approach to bullying. Local programs focused on specific populations and collected original data through a variety of methods. For instance, one local agency utilized already existing surveys to assess bullying within their public school setting. Another community assessed the attitudes of male sex offenders and other male community members regarding gender-role attitudes, violence, and risk and protective factors for perpetration. A third community administered a random phone survey, examining attitudes toward rape, other violence against women, and gender roles. Each community integrated the results of their original data collection into their needs and resource assessment. Preliminary information regarding the communities' experience with the completion of needs and resource assessments, using the empowerment evaluation framework, indicate that successful projects used specific theories or frameworks to guide data collection. Positive collaboration with evaluators and community prevention coalitions characterized each community's experience.

Implementation of the Communities That Care prevention system by coalitions in the Community Youth Development Study

While advances in prevention science over the past 2 decades have produced a growing list of tested and effective programs and policies for preventing adolescent delinquency and drug use, widespread dissemination and high-quality implementation of effective programs and policies in communities has not been achieved. The Community Youth Development Study (CYDS) is a randomized, community-level trial of the Communities That Care (CTC) system for promoting science-based prevention in communities. This paper compares 12 community prevention coalitions implementing the CTC system in 12 intervention communities as part of the CYDS to prevention coalitions located in the 12 control communities. As hypothesized, the CYDS coalitions implemented significantly more of the CTC core intervention elements, and also implemented significantly greater numbers of tested, effective prevention programs than the prevention coalitions in the control communities. Implications of the findings for efforts to achieve widespread dissemination of effective prevention programs, policies, and practices are discussed.

Translational research in action: implementation of the communities that care prevention system in 12 communities

Translational research (Pentz, Jasuja, Rohrbach, Sussman, & Bardo, 2006; Woolf, 2008) is concerned with moving advances in prevention science into everyday practice in communities, yet there are few models for ensuring this transfer of knowledge. Communities That Care (CTC) provides a planned, structured, and data-driven system that trains community prevention coalitions to select evidence-based programs and replicate them with strong implementation fidelity. This paper describes the implementation of the CTC prevention system in 12 communities participating in the Community Youth Development Study.The results indicated that intervention communities enacted, on average, 90% of the core components of the CTC system, and achieved high rates of implementation fidelity when replicating school, afterschool, and parent training programs. These results held over time; communities successfully launched their prevention coalitions and programs and maintained the quality of their prevention services over five years. These results indicate that the CTC system can be used to foster translational research.

Predictors and Level of Sustainability of Community Prevention Coalitions

After many years in which evaluations had generally not found the coalition approach to be effective, the community-coalition approach has recently been shown to produce a public health impact if best practices are utilized. The next challenge is to foster sustainability among coalitions in order to achieve long-term public health outcomes. This study examined the level of and predictors of sustainability among Communities That Care (CTC) sites in Pennsylvania. Board functioning and the funding of 110 CTC sites were assessed through the reports of board members, staff, and technical-assistance providers from 2003 through 2006; data were analyzed in 2007. Ninety percent of CTC coalitions continued after the 3-year initial funding period, with 3%-8% of sites terminating each year thereafter. Approximately two thirds of CTC sites continued to operate 4 years after the termination of the original 3-year implementation grant. Many of the sites attracted funding at a level equivalent to or greater than the initial grant. Overall coalition functioning, as reported by either board members or technical-assistance providers, along with planning for sustainability, predicted both survival and post-launch funding. Evidence suggests that board functioning predicts survival, at least in part independently of its influence on funding; and that planning for sustainability predicts sustainability, at least in part independently of overall coalition functioning.

Evaluation and Community Prevention Coalitions: Validation of an Integrated Web-Based/Technical Assistance Consultant Model

Community coalitions (CCs) have labored with some difficulty to demonstrate empirical evidence of effectiveness in preventing a wide range of adolescent problem behaviors. Training and technical assistance (TA) have been identified as important elements in promoting improved functioning of CCs. A reliable, valid, and inexpensive method to assess functioning of CCs has been developed and is tested in this article in the context of Pennsylvania's Communities That Care (CTC) model. A CC Web-based questionnaire was developed and administered to more than 79 communities (867 participants) and the validity and reliability were assessed through multiple means, including the use of a companion TA implementation feedback questionnaire completed by TAs assigned to each of the sites. Results indicated adequate to good psychometric properties on internal reliability of the Web-based questionnaire, moderate construct validity across different reports of functioning, and relative stability throughout the course of 1 year. Implications for a variety of community prevention coalitions interested in a relatively low-cost, user friendly, and suitable methodology for evaluating coalition functioning are discussed. In addition, areas of application for future research including linking coalition functioning with the quality and nature of technical assistance, levels of risk and protective factors, and large data sets of youth risk factor and problem behavior data are highlighted.

Social Networks and Community Prevention Coalitions

This study investigates the links between community readiness and the social networks among participants in Communities That Care (CTC), community-based prevention coalitions. The coalitions targeted adolescent behavior problems through community risk factor assessments, prioritization of risk factors, and selection/implementation of corresponding evidence-based family, school, and community programs. Key leaders (n = 219) in 23 new CTC sites completed questionnaires focusing on community readiness to implement CTC and the respondents' personal, work, and social organization links to other key leaders in the community. Outside technical assistants also completed ratings of each community's readiness and early CTC functioning. Measures of network cohesion/integration were positively associated with readiness, while centralization was negatively associated. These results suggest that non-centralized networks in which ties between members are close and direct may be an indicator of community readiness. In addition, we found different associations between readiness and different domains of social relations. EDITORS' STRATEGIC IMPLICATIONS: The authors present the promising practice of using social network analysis to characterize the functioning of local prevention coalitions and their readiness to implement a community-based prevention initiative. Researchers and community planners will benefit from the lessons in this article, which capitalizes on a large sample and multiple informants. This work raises interesting questions about how to combine the promotion of coalition functioning while simultaneously encouraging diversity of coalition membership.

Readiness, functioning, and perceived effectiveness in community prevention coalitions: a study of communities that care.

This paper examined whether community readiness, prevention knowledge, coalition functioning, and barriers are linked to perceived effectiveness of community prevention coalitions. Interviews were conducted with 203 key leaders in Communities That Care (CTC) prevention boards in 21 Pennsylvania communities. Community-level means for the reliable self-report measures were utilized separately and in combination with research staff ratings, state technical assistant staff ratings, and other data. The results indicated that the strong link between readiness and perceived effectiveness was mediated by internal coalition functioning. The extent of CTC linkage with outside community entities was not linked to perceived effectiveness. The study concludes that community readiness is an important condition for success of a prevention coalition, and exerts effects mainly through the quality of the coalition's internal functioning. Member turnover and infighting appear to be important factors related to internal functioning. Linkage with outside entities may be more important for coalition models where the coalition is more dependent on local institutions for resources.