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AJPH First Look, published online ahead of print Feb 28, 2007
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May 2007, Vol 97, No. 5 | American Journal of Public Health 880-886
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2005.063644

RESEARCH AND PRACTICE

Community Coalitions as a System: Effects of Network Change on Adoption of Evidence-Based Substance Abuse Prevention

Thomas W. Valente, PhD, Chich Ping Chou, PhD and Mary Ann Pentz, PhD

Thomas W. Valente, Chih Ping Chou, and Mary Ann Pentz are with the Institute for Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Alhambra.

Correspondence: Requests for reprints should be sent to Thomas W. Valente, PhD, Keck School of Medicine, 1000 S Fremont Ave, Bldg A, Rm 5133, Alhambra CA 91803 (e-mail: tvalente{at}usc.edu).

Objectives. 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.

Methods. 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.

Results. Intervention had a significant effect on decreasing the density of coalition networks. The change in density subsequently increased adoption of evidence-based practices.

Conclusions. 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.






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