Long-Term Sustainability of the Communities That Care Prevention System by Coalitions Participating in the Community Youth Development Study

Background/Purpose:  Community coalitions have become a widely used strategy for mobilizing stakeholders to address community prevention goals with coordinated preventive interventions, but evidence is mixed about their effectiveness and sustainability. Communities That Care (CTC) is a coalition-based system that empowers community stakeholders to address local problems through implementation of a science-based prevention system. Coalitions supported by the Community Youth Development Study (CYDS) reported significantly higher levels of implementation of the CTC system than prevention coalitions in control communities 4.5 years after the start of the study. This research examines the sustainability of the CTC system 4.5 years later, or 4 years after grant funding to support CTC ended. Three research questions are addressed: 1) To what extent did the CTC coalitions sustain implementation of the CTC prevention system? 2) To what extent did prevention coalitions in control communities take up the CTC system? And, 3) were CTC coalitions able to obtain ongoing funding for a paid staff person to facilitate the coalition's work?

Methods: Data were obtained from telephone interviews conducted with either the chair or staff of 62 prevention coalitions in 2007 and 53 coalitions in 2012. Cochrane's Q and paired sample t tests tested for changes in implementation of core elements of the CTC prevention system among the CTC coalitions from 2007 to 2012. Chi-square and independent samples t tests tested for significant differences between CTC coalitions and non-CTC coalitions four years after the trial ended. Results indicated that 11 of the 12 study-funded CTC coalitions were still active in 2012. Moreover, 10 of these 11 coalitions continued to implement many aspects of the CTC prevention system, and were still significantly more likely to use the CTC system than coalitions in control communities. One coalition in the control communities had started to implement the CTC system. However, the CTC coalitions did show significant declines in current training, having a current action plan, and in monitoring the effects of their interventions.

Conclusions/Implications: Sustaining community prevention coalitions, especially after initial funding ends, can be a challenge for communities. Ten of twelve CTC coalitions in this study continued to use the CTC system for four years after study support ended. However, the observed declines in some indicators from 2007 to 2012 (e.g., the proportion reporting that their coalition has a written action plan), suggest that additional support and/or technical assistance is needed to ensure that coalitions are able to sustain all components of the CTC system.