Valente Thomas W, Chou Chich Ping, Pentz Mary Ann
Institute for Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Alhambra, CA 91803, USA.
Am J Public Health. 2007 May;97(5):880-6. doi: 10.2105/AJPH.2005.063644. Epub 2007 Feb 28.
We examined the effect of community coalition network structure on the effectiveness of an intervention designed to accelerate the adoption of evidence-based substance abuse prevention programs.
At baseline, 24 cities were matched and randomly assigned to 3 conditions (control, satellite TV training, and training plus technical assistance). We surveyed 415 community leaders at baseline and 406 at 18-month follow-up about their attitudes and practices toward substance abuse prevention programs. Network structure was measured by asking leaders whom in their coalition they turned to for advice about prevention programs. The outcome was a scale with 4 subscales: coalition function, planning, achievement of benchmarks, and progress in prevention activities. We used multiple linear regression and path analysis to test hypotheses.
Intervention had a significant effect on decreasing the density of coalition networks. The change in density subsequently increased adoption of evidence-based practices.
Optimal community network structures for the adoption of public health programs are unknown, but it should not be assumed that increasing network density or centralization are appropriate goals. Lower-density networks may be more efficient for organizing evidence-based prevention programs in communities.
我们研究了社区联盟网络结构对一项旨在加速采用循证药物滥用预防项目的干预措施效果的影响。
在基线期，24个城市进行匹配并随机分配到3种条件下（对照组、卫星电视培训组以及培训加技术援助组）。我们在基线期对415名社区领袖进行了调查，并在18个月随访时对406名社区领袖进行了调查，询问他们对药物滥用预防项目的态度和做法。通过询问领袖们在联盟中就预防项目向谁寻求建议来衡量网络结构。结果是一个包含4个子量表的量表：联盟功能、规划、基准达成情况以及预防活动进展。我们使用多元线性回归和路径分析来检验假设。
干预对降低联盟网络的密度有显著影响。密度的变化随后增加了循证实践的采用率。
采用公共卫生项目的最佳社区网络结构尚不清楚，但不应假定增加网络密度或集中化是合适的目标。低密度网络在社区组织循证预防项目方面可能更有效。
