Session: Effectiveness of Large-Scale Substance Use Prevention Coalitions: Process and Outcome Results from Three Community-Driven Initiatives (Society for Prevention Research 25th Annual Meeting)

A growing body of research shows that substance use prevention coalitions can be effective, and some have demonstrated through rigorous research trials that they reduce community-level youth substance use and related risk factors. Despite their popularity and promise, however, less is known about the functioning and effectiveness of large-scale, natural roll-outs of community-driven coalition initiatives across diverse settings. This symposium will present process and outcome results from the evaluations of three such efforts – two examples from state-wide initiatives in the US and one example from Mexico.

The first paper describes results from a cross-sectional evaluation of the Community Prevention and Wellness Initiative (CPWI) in Washington State. Using propensity score analysis and multilevel modeling, results show that 18 CPWI communities were at higher risk for most outcomes in comparison to 139 similar, non-CPWI communities at baseline. By 2014 (three years following the start of CPWI), however, CPWI communities had closed the gap on six of the seven risk factors, and for 10^thgrade alcohol use, suggesting a positive impact. Findings for tobacco and marijuana use were more mixed.

The second paper will describe results from a 10-year longitudinal evaluation of Communities that Care (CTC) in Pennsylvania. Preliminary cross-sectional results show that quality of programming (i.e., degree of evidence) and reach (universal vs. indicated) are affecting the sensitivity of CTC-sponsored programming to have an impact on youth outcomes. Future analyses will utilize propensity-score weighting and multi-level modeling to compare change in youth risk and substance use in CTC communities compared to non-CTC communities.

The third paper presents results from a longitudinal, process evaluation of coalition functioning for 19 substance use prevention coalitions across Mexico. Results from four annual assessments of coalition members found that functioning improved during the first 18 months of implementation, but after startup funding and intensive technical assistance were removed at the end of the third year, member engagement declined.

Taken together, the findings from these three papers have important implications for the scale-up and impact of substance use prevention coalitions. They also provide insight into how best to support community-driven coalition initiatives implemented across diverse settings and across time. Following the presentations, the discussant, a national expert in dissemination and implementation science, will conclude by providing a summary overview and will moderate the discussion between the presenters and the symposium attendees.