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The substance misuse prevention system in New Jersey includes a network of state-wide coalitions to implement environmental strategies targeting substance misuse and related consequences in their communities. While the coalitions have well-established practices to implement this work, adaptations to interventions were necessary due to the COVID-19 pandemic. As part of a larger annual evaluation, this study explored strengths and challenges related to coalition function and identified changes that were adopted by the coalitions to ensure continuity of their prevention work. This mixed methods study analyzed coalition functioning and members’ perceptions related to opportunity role structure, leadership, sense of community, perceived effectiveness, skills capacity and engagement, and psychological empowerment.
Methods
Survey participants (n = 254) were volunteers and paid staff affiliated with 19 prevention coalitions. Cross-sectional data were collected through a web-based, self-administered survey containing items from existing, validated instruments designed to assess the constructs of interest. Additional items were piloted to assess the degree to which coalitions changed due to COVID-19.
Structural equation modeling was performed to examine the relationships between observed variables. Researchers began with a fully saturated & over-identified model between given constructs. The final model only included coefficients presented are statistically significant standardized beta weights (p<.05).
The evaluation team conducted qualitative interviews using standardized, open-ended interview schedules with coalition staff and members. Questions centered on coalition membership and function with specific attention to how coalition practice had changed during COVID-19. Interviews were analyzed using cross-case analysis and sensitizing concepts. Themes were identified and triangulated with the data patterns presented from survey results.
Results
The final model was found to fit appropriately for the sample, X^2 (7) = 13.201, p = .067, with a CFI of 0.989 and RMSEA of 0.49. The model accounted for 9% of the variance in COVID-19 activities, 10% of the variance in opportunity role structuring, 33% of the variance in sense of community, 57% of the variance in perceived effectiveness, 30% of the variance in skills capacity and engagement, and 28% of the variance in psychological empowerment.
Leadership was found to positively predict perceived effectiveness by coalition members. This occurred directly and via sense of community (the strongest), opportunity role structure, and via COVID-19 activities. Interestingly, having continued activities amidst the pandemic was found to have a significant effect on effectiveness, suggesting effective leaders continued to operate with their coalitions with results that were perceived as effective.
Qualitative results were consistent with this model. Coalition members emphasized most coalitions continued activities remotely without much change to their coalition priorities or effectiveness. many coalitions highlighted the opportunities that remote coalition work offered, such as meetings that were more inclusive.
Implications
Coalitions faced interruptions to service delivery and implementation strategies during the COVID-19 pandemic. Results from this study highlight the importance of leadership and sense of community within substance misuse prevention organizations to maintain perceptions of effectiveness, engagement, and empowerment. Findings show how fostering leadership and role structure opportunities within these organizations may support sustainability and continued implementation during large scale service disruptions.