Implementing Communities That Care in Colombia: Challenges and Lessons Learned

Introduction

In 2011, the Nuevos Rumbos Corporation, with support of the Pan-American Health Organization and the Colombian Ministry of Health, carried out a pilot study of a community-based prevention initiative in three communities in the Bogotá area. This initiative, Comunidades Que Se Cuidan (CQC), was modeled after the Communities That Care (CTC) prevention system, which was developed in the U.S. and is used world-wide. Within the following year, the Colombian Institute of Social Welfare supported expansion of CQC implementation in five additional communities in the Department of Quindío, with the long-term goal of making CQC a national strategy for drug abuse prevention.

Method

All publically available CTC training and assessment materials were translated into Spanish for use in Colombia. Implementation of CQC followed activities specified in Phases 1 (community readiness and organization) through 4 (creating a community action plan) of the CTC Milestones and Benchmarks Implementation Tool. In each community, key leaders and stakeholders in each community were identified and a local prevention coalition was formed. Focus group methodology was used to qualitatively assess the communities’ understanding and use epidemiologic data for local prevention programming.

Results

By the end of 2013, CQC was implemented successfully in all eight pilot communities. Five of the eight pilot communities completed Phase 4 of CQC implementation in an average of 6 months. Three other communities have started to execute their community action plans. Across all communities, approximately 40,000 6^th- through 11^th-grade students were administered the CQC Youth Survey in local public schools. Results indicated substantial variation in levels of risk, protection, and drug use outcomes across communities. Despite the limited number of tested-effective preventive interventions to draw from, communities were able to identify and implement several program and strategies (e.g., early identification of at-risk youth, motivational enhancement interviewing, parenting classes). Despite successful implementation of CQC, several “lessons” were learned in the process (e.g., how to deal with turnover at coalition meetings) and adaptations to the CTC system were necessary (e.g., changes in the organization of trainings’ timetables).  

Conclusions

Preliminary results of the pilot implementation of CQC in Colombia show it to be a highly promising prevention system for Latin America; however, researchers and practitioners are advised to pay attention to specific cultural differences with the US-based CTC. Nonetheless, we believe that CQC can be a valuable mechanism for the development, implementation, and evaluation of prevention programs and strategies in Latin America.