Long-Term Sustainability of Evidence-Based Prevention Interventions and Community Coalitions Survival: a Five and One-Half Year Follow-up Study
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This study examines (1) coalition survival, (2) prevalence of evidence-based prevention interventions (EBPIs) to reduce substance abuse implemented as part of the Tennessee Strategic Prevention Framework (SPF) State Incentive Grant (SIG), (3) EBPI sustainability, and (4) factors that predict EBPI sustainability. Secondary data were collected on 27 SPF SIG-funded coalitions and 88 EBPI and non-EBPI implementations. Primary data were collected by a telephone interview/web survey five and one-half years after the SPF SIG ended. Results from secondary data show that 25 of the 27 coalitions survived beyond the SPF SIG for one to five and one-half years; 19 coalitions (70%) were still active five and one-half years later. Further, 88 EBPIs and non-EBPIs were implemented by 27 county SPF SIG coalitions. Twenty-one (21) of 27 coalitions (78%) implemented one to three EBPIs, totaling 37 EBPI implementations. Based on primary survey data on 29 of the 37 EBPI implementations, 28 EBPIs (97%) were sustained between two and five and one-half years while 22 EBPI implementations (76%) were sustained for five and one-half years. When controlling for variability among coalitions (nesting of EBPIs in coalitions), increases in data resources (availability of five types of prevention data) was a strong predictor of length of EBPI sustainability. Positive change in extramural funding resources and level of expertise during SPF SIG implementation, as well as level of coalition formalization at the end of the SPF SIG predicted EBPI sustainability length. One intervention attribute (trialability) also predicted length of sustainability. Implications are discussed.
KeywordsSustainability Substance abuse prevention Evidence-based interventions Community coalitions
This study was funded in part by the Pacific Institute for Research and Evaluation–Louisville Center and the University of South Carolina, Department of Psychology. We thank Leah Festa, the Director of the Prevention Alliance of Tennessee, the many former and current community coalition staff members, and the Tennessee Department of Mental Health and Substance Abuse Services staff for their assistance in providing data to the study. Chris Bayer, Louisville Center Production Manager, also provided important manuscript editing and formatting. A special thank you goes to the Prevention Science reviewers who provided valuable feedback on an earlier version of the manuscript.
Compliance with Ethical Standards
This study was conducted using internal funding including in-kind funding from the Pacific Institute for Research and Evaluation and the University of South Carolina, Department of Psychology.
Conflict of Interest
The authors declare that they have no conflict of interest.
PIRE’s IRB reviewed the protocols for this study and deemed the study exempt under 45 CFR 46.101(b)(2). This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Written informed consent was not obtained from key respondents of our telephone interview/web-based survey conducted in 2015 since the PIRE IRB board deemed this study exempt under 45 CFR 46.101(b)(2). However, we did obtain verbal informed consent from the 2015–2016 sustainability survey participants.
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