Testing Practice Wisdom: Does Building Community Capacities Enable Community Practice Strategies to Achieve Community Change?
Methods: Using data from the community-randomized trial of CTC, this paper first examines between-coalition variation in coalition member self-reported capacities (member knowledge and member acquisition of new skills), member attitudes, and organizational capacity (organizational linkages and influence on organizations) using unconditional multi-level statistical models. This paper then explores whether these capacities are related to intervention outcomes, specifically the extent to which coalition member reported capacities moderate the relationship between the CTC prevention strategy and the community’s adoption of a science-based approach to prevention, relative to matched control communities, as reported by community leaders in 24 communities within 7 states. A series of mixed-effect meta-regressions are used to determine if coalition capacities explain the heterogeneity in intervention effect size differences between matched pairs of communities.
Results: Findings indicate high and favorable coalition member knowledge, attitudes, and perceptions of influence, with minimal variance between coalitions. Coalition member self-reported acquisition of skills primarily varies at the coalition member level, but when aggregated to the coalition-level, predicts greater community-wide adoption of a science-based approach to prevention. Findings also indicate that linkages between organizations, as reported by coalition members, explain 25% the variance in the community-wide adoption of a science-based approach to prevention (β=.50; QR=3.92; p=.0476).
Implications: This study provided a unique opportunity to identify malleable community capacities, such as skill acquisition and organizational linkages, which predict the success of community level interventions in making community-wide change, and thus may be used to improve the overall effectiveness of community practice.