Flewelling Robert L, Hanley Sean M
Chapel Hill Center, Pacific Institute for Research and Evaluation, 1516 E. Franklin Street Suite 200, Chapel Hill, NC, 27514, USA.
Prev Sci. 2016 Oct;17(7):830-40. doi: 10.1007/s11121-016-0675-y.
Community coalitions are a prominent organizational structure through which community-based substance abuse prevention efforts are implemented. There is little empirical evidence, however, regarding the association between coalition attributes and success in achieving community-level reductions in substance abuse behaviors. In this study, we assessed the relationship between coalition capacity, based on coalition coordinator responses to 16 survey items, and reductions in underage drinking prevalence rates. The coalitions were funded through the federally sponsored Strategic Prevention Framework State Incentive Grant (SPF SIG). We first examined whether coalition capacity increased over the life of the projects. Mean capacity scores increased for all 16 capacity items examined (N = 318 coalitions), the majority of which were statistically significant. Analysis of the associations between capacity and reductions in underage drinking was limited to coalitions that targeted underage drinking and provided usable outcome measures based on student survey data for either past 30-day alcohol use (N = 129) or binge drinking (N = 100). Bivariate associations between the capacity items and prevalence reductions for each outcome were consistently positive, although many were not statistically significant. Composite measures of correlated items were then created to represent six different capacity constructs, and included in multivariate models to predict reductions in the targeted outcomes. Constructs that significantly predicted reductions in one or both outcome measures included internal organization and structure, community connections and outreach, and funding from multiple sources. The findings provide support for the expectation that high functioning community coalitions can be effective agents for producing desirable community-level changes in targeted substance abuse behaviors.
社区联盟是实施基于社区的药物滥用预防工作的一种重要组织结构。然而,关于联盟属性与成功实现社区层面药物滥用行为减少之间的关联,实证证据很少。在本研究中,我们根据联盟协调员对16个调查项目的回答评估了联盟能力与未成年饮酒流行率降低之间的关系。这些联盟由联邦政府资助的战略预防框架州激励拨款(SPF SIG)提供资金。我们首先研究了联盟能力在项目实施过程中是否有所提高。在所调查的所有16项能力项目(N = 318个联盟)中,平均能力得分均有所提高,其中大多数具有统计学意义。对能力与未成年饮酒减少之间关联的分析仅限于以未成年饮酒为目标并基于学生调查数据提供过去30天饮酒情况(N = 129)或暴饮情况(N = 100)可用结果测量的联盟。尽管许多能力项目与各结果的流行率降低之间的双变量关联并非都具有统计学意义,但始终呈正相关。然后创建了相关项目的综合测量指标,以代表六种不同的能力结构,并纳入多变量模型以预测目标结果的减少情况。显著预测一种或两种结果测量指标减少的结构包括内部组织和结构、社区联系与外展以及来自多个来源的资金。这些发现支持了这样一种预期,即高效运作的社区联盟可以成为在目标药物滥用行为方面产生理想的社区层面变化的有效推动者。