Society for Social Work and Research

Sixteenth Annual Conference Research That Makes A Difference: Advancing Practice and Shaping Public Policy
11-15 January 2012 I Grand Hyatt Washington I Washington, DC

16654 Exploring the Sustainability of Community-Based Interventions: Community-Level Effects of “Communities That Care” 1.5 Years Later

Saturday, January 14, 2012: 5:30 PM
Penn Quarter B (Grand Hyatt Washington)
* noted as presenting author
Kari M. Gloppen, MPH, Doctoral Student, University of Washington, Seattle, WA
Michael W. Arthur, PhD, Research Associate Professor, University of Washington, Seattle, WA
Valerie B. Shapiro, PhD, Social Development Research Group, University of Washington, Seattle, WA
J. David Hawkins, PhD, Endowed Professor of Prevention, University of Washington, Seattle, WA
Background and Purpose: Preventing adolescent substance use, delinquency, and other problem behaviors is important to adolescent and community wellbeing. Coalitions are a popular change strategy for mobilizing stakeholders to address community goals, but the evidence is mixed about the effectiveness and sustainability of such strategies (Feinberg, et al., 2008). There have been recent calls within social work literature to establish a deeper evidence-base for community-based strategies (Ohmer, 2008). Communities That Care (CTC) is a coalition-based system that empowers community stakeholders to address local problems through the implementation of a science-based prevention system. A randomized trial showed that communities using the CTC system have a) higher rates of adoption of a scientific approach to prevention (Brown, et al., 2007) and b) lower rates of delinquency and substance use relative to control communities (Hawkins, et al., 2009). This presentation will discuss the sustainability of the CTC system by coalitions after funding to support CTC ended. Three research questions will be addressed: 1) To what extent did the CTC coalitions sustain implementation of the CTC prevention system 20 months after support from the study ended? 2) Were the CTC coalitions initially supported by the Community Youth Development Study (CYDS) able to obtain ongoing funding for a paid staff person to facilitate the coalition's work? And, 3) Did the CTC coalitions maintain significantly greater implementation of the CTC prevention system in comparison to prevention coalitions in the control communities 20 months after intervention funding ended?

Methods: This study reports findings from the CYDS, a randomized control trial of the CTC system in 12 matched pairs of communities across seven states. Chi-squares and independent sample t tests tested for significant differences between the CTC coalitions and non-CTC prevention coalitions 20 months after the trial ended. Cochrane's Q and paired sample t tests were used to test for changes in the adoption of a scientific approach to prevention among the CTC coalitions from 2007 to 2009.

Results: Results indicate that 11 of 12 CTC coalitions were still implementing CTC 20 months after the trial ended. Moreover, the remaining coalitions did not decline significantly in their use of a scientific approach to prevention, and were significantly more likely to use a science based approach in 2009 than coalitions in control communities. However, significantly fewer CTC coalitions employed paid staff in 2009 than in 2007.

Conclusions and Implications: Sustaining community prevention coalitions, especially after initial funding ends, is a challenge for communities. Once established and supported to implement the CTC prevention system, 11 of 12 coalitions in this study continued to use a science-based approach to prevention for at least 20 months after the study ended. However, the significant decline in the proportion of coalitions that maintained a paid facilitator, and observed declines in some indicators from 2007 to 2009 (e.g., the proportion reporting that their coalition has a written action plan), suggest that additional support and/or technical assistance may be needed to ensure that coalitions are able to maintain all components of the CTC system.

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