Building Coalitions to Study Coalition Building

There exist numerous evidence-based practices (EBP) for the prevention of substance abuse and other risk behaviors.  However, these practices are rarely used routinely.  It has long been assumed that one of the keys to sustaining EBPs is developing and building a community coalition in the belief that engaging the community in the implementation process will engender a sense of ownership over the EBP, thereby insuring that the coalition will seek to sustain the EBP once external (i.e., federal or state) funding for the EBP has ended.  This view has been adopted by the Substance Abuse and Mental Health Services Administration (SAMHSA), the major federal agency responsible for delivering drug abuse and mental health prevention programs in the United States. Several of their RFAs have mandated a community coalition component as a critical requirement for many of its evidence-based behavioral health prevention programs, and SAMHSA is considering expanding that requirement to other programs.  However, to date there is no evidence that community coalitions in general or specific components of coalition building are necessary or sufficient for EBP sustainment.

            Several models, including community-based participatory research (CPBR) (Minkler & Wallerstein, 2005), and political base building (Kellam, 2012), offer guidelines for building coalitions within communities and between communities and researchers for the purpose of studying and facilitating EBP implementation and sustainment. When studying the process of coalition building, however, perhaps the most important coalition that must be constructed involves stakeholders with a commitment to understanding this process from a research perspective and from a practitioner perspective.  In this presentation, we describe this process of building a coalition involving SAMHSA policy makers, National Institute of Drug Abuse funded researchers, community leaders,  and practitioners.  Collectively, these groups support the development of concepts and measures that can bring precision to testing what structures and processes of community coalitions are required for implementing and sustaining EBPs while simultaneously facilitating EBP implementation and sustainment. We examine this coalition building process from the perspective of a model of cultural exchange. In this particular instance, researchers are placed in the role of culture brokers who operate within the organizational cultures of different stakeholders to identify common goals and values, negotiate aims and objectives, and implement a course of action that is supported by all involved stakeholders. These activities, in turn, produce certain “microtransformations” in the operational cultures of each stakeholder group. These microtransformations are critical to the translation of research into effective practice.