Predictors and Level of Sustainability of Community Prevention Coalitions

Background: 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. Methods: 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. Results: 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. Conclusions: 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.