Utilization of Risk and Protective Factor Data By Local Communities: Voices from Prevention Coalition Members in Chile and Colombia

Introduction: A key element of the Communities That Care (CTC) prevention system is measuring risk and protective factors for youth problem behaviors in a community. Information on levels of risk and protection is provided to prevention coalitions in the form of a community prevention report. In the United States, coalitions use these data to prioritize and select evidence-based interventions that are aligned with local needs. We examined whether using these reports also was useful in two Latin American countries implementing adaptations of the CTC system (i.e., Chile and Colombia). This study relied on qualitative data collected from prevention coalition members to assess whether local communities understand this type of data, if and how they use it, and what adaptations are needed to make it useful.

Methods:  We conducted seven focus groups with members of CTC community prevention coalitions in Chile and Colombia. The total sample consisted of 75 participants, with an average of 10 members per group. A structured focus group interview protocol was used to ask community prevention coalition members about their experience with the CTC process (e.g., how they would describe the system, what they had learned so far) and about the interpretability, utility, validity and sustainability of the reports of risk and protective factor (RPF) data (e.g., have they understood the content; have they been able to use it and if so, for what; does the information feel “true;” what supports do they need to sustain the work in the long run; etc.). The focus groups were conducted and transcribed in Spanish, by native speakers. They were then analyzed using thematic content analysis with NVivo software.

Results: There was notable heterogeneity between and within community coalitions in terms of participants’ level of understanding of RPFs and the role RPFs play in local prevention programming. However, in each group, there were several members who had a strong understanding and who could clearly articulate how the assessment of RPFs was crucial to prevention system development.  Many focus group participants found that the RPF data expanded their knowledge and provided valuable information that could help them “diagnose” the challenges and strengths of their community. They found reports to be easy to understand, thorough, and highly useful for prioritizing needs, developing community action plans and potentially for mobilizing other people in their communities. Participants discussed adaptations they had undertaken to the CTC system, and offered suggestions for improvement. In general, prevention coalitions saw value in sharing the reports with others in their communities and provided ideas on how to do this.

Conclusions: Coalition members in both countries found the reports to be of high utility. Although some adaptations to the U.S. developed CTC prevention system were deemed necessary for implementation in Chilean and Colombian communities, the viability of CTC—with regard to its use of RPF data for local ownership and decision making—was largely supported.   Results of this study underscore the need to collect epidemiologic data on adolescent RPFs and disseminate these data in culturally appropriate ways to community members.