Building Local Infrastructure for Community Adoption of Science-Based Prevention: The Role of Coalition Functioning

Abstract

The widespread adoption of science-based prevention requires local infrastructures for prevention service delivery. Communities That Care (CTC) is a tested prevention service delivery system that enables a local coalition of community stakeholders to use a science-based approach to prevention and improve the behavioral health of young people. This paper uses data from the Community Youth Development Study (CYDS), a community-randomized trial of CTC, to examine the extent to which better internal team functioning of CTC coalitions increases the community-wide adoption of science-based prevention within 12 communities, relative to 12 matched comparison communities. Specifically, this paper examines the potential of both a direct relationship between coalition functioning and the community-wide adoption of science-based prevention and a direct relationship between functioning and the coalition capacities that ultimately enable the adoption of science-based prevention. Findings indicate no evidence of a direct relationship between four dimensions of coalition functioning and the community-wide adoption of a science-based approach to prevention, but suggest a relationship between coalition functioning and coalition capacities (building new member skills and establishing external linkages with existing community organizations) that enable science-based prevention.

Science-Based Prevention through Communities That Care: A Model of Social Work Practice for Public Health

“…These stakeholders include residents, school and human services staff, business leaders, faith leaders, concerned citizens, parents, media representatives and youth. Although the work is ambitious, the results of the CTC trial indicate that well-functioning CTC coalitions predict growth in community member skills and the engagement of diverse community sectors, which in turn predict community-wide changes in prevention practice related to reductions in substance abuse (Shapiro, Hawkins, & Oesterle, 2012a). …”

Assessing an Adapted Approach to Communities That Care for Child Maltreatment Prevention

“…In particular, adoption of a science-based approach to prevention accounted for "96% of the variation between the CTC intervention and student problem behaviors" (E. C. Brown et al, 2014, p. 629). Relatedly, two coalition capacities, involvement of diverse community sectors in the CTC process and board members' acquisition of new skills, have been found to predict communities' adoption of a science-based approach to prevention (Shapiro, Oesterle, & Hawkins, 2015b), while four dimensions of coalition functioning (goal directedness, efficiency, opportunities for participation, and cohesion) have strong relationships with these two key coalition capacities (Shapiro, Hawkins, & Oesterle, 2015a). These key indicators can provide a means for assessing whether CTC approaches adapted for purposes other than prevention of adolescent risk behavior are achieving the same implementation and system transformation success as those found in communities implementing the original CTC approach.…”

Seven Action Steps to Unleash the Power of Prevention

“…Effective preventive interventions can be unintentionally subverted in routine practice through the use of ineffective implementation strategies (Shapiro, Kim, Robitaille, LeBuffe, Ziemer, 2018). Successful implementation usually requires a backbone infrastructure to plan and coordinate implementation activities, carefully considering local needs and goals; navigating tensions between the ideals of fidelity and fit; providing the requisite time, training, materials, and technical assistance to implementers; and monitoring and facilitating implementation quality over time (Shapiro, Hawkins, & Oesterle, 2015).…”

“…This is due, in part, to public unawareness of the advances and cost savings of prevention; the lack of public funding allocated for prevention; insufficient workforce preparation and infrastructure (e.g., billing protocols) to deliver preventive interventions; and the lack of community capacity to assess local rates of behavioral health problems, to select effective, sustainable, equity-enhancing, and cost-beneficial solutions, and to implement preventive programs well. Thus, the Coalition for the Promotion of Behavioral Health (www.coalitionforbehavioralhealth.org) has articulated a series of seven action steps to unleash the power of prevention, with the ultimate goal of reducing behavioral health problems in young people-and reducing embedded racial and socioeconomic disparities-by 20% within a decade (Hawkins et al, 2015). By design, this goal is ambitious, yet achievable.…”