Testing a Community Prevention Focused Model of Coalition Functioning and Sustainability: A Comprehensive Study of Communities That Care in Pennsylvania

There is evidence that community action approaches can reduce problems related to alcohol use and youth substance use. However, to date there has been little attention to the processes underlying successful community approaches. Coalitions and partnerships have become a popular vehicle for community action to reduce adolescent substance abuse and promote positive youth development. This chapter provides a broad overview of results of a detailed study of the Communities That Care (CTC) initiative in the state of Pennsylvania. CTC is a systematic approach to community action that includes the formation and training of a local coalition to identify factors underlying child and youth development in order to redress adverse influences through empirically supported programs. Findings emphasize the importance of community organizational and motivational readiness, initial training and ongoing technical assistance (TA) for the effective functioning of coalitions. Further, the prevention knowledge of coalition members, the quality of coalition functioning, and their fidelity to the CTC model all are predictive of sustainability of effort. Finally, coalitions that function more effectively showed greater changes in the rate of youth delinquency in their communities. Data on youth substance abuse changes were not available. These findings have clear implications for practitioners and policy-makers who can focus resources and attention early in the coalition lifecycle. Important areas of focus include adequate early training of key leaders and ongoing, high quality TA that helps the coalition's local committee (board) maintain fidelity to the model and effective internal board functioning. Maintaining a critical mass of knowledgeable board members is crucial and this requires orientation for new board members as well as ongoing TA to help community leaders sustain a sense of direction. Finally, it is important to note that while coalitions in themselves do not ensure positive outcomes in addressing adolescent problem behaviors, such outcomes are more likely to be achieved when communities are better poised for effectively developing, managing and sustaining coalition preventive efforts.