The EPISCenter is a project of the Prevention Research Center, College of Health and Human Development, Penn State University, and is funded by the Pennsylvania Commission on Crime and Delinquency and the Pennsylvania Department of Public Welfare as a component of the Resource Center for Evidence-Based Prevention and Intervention Programs and Practices.

Please visit www.episcenter.psu.edu

Research from cross-sectional and longitudinal studies comparing youth reports on

the PA Youth Survey in CTC communities vs. youth in similar non-CTC communities

showed differences in risk and protective factors and behavioral outcomes.

A TEST-BED FOR TYPE 2 TRANSLATIONAL RESEARCH

• The Pennsylvania Commission on Crime and Delinquency (PCCD) has promoted

and supported Communities that Care (CTC) coalitions since 1994.

• Nearly 120 CTC coalitions were formed from 1994-2001; approximately 70

continue to function.

• Through CTC and non-CTC coalitions, PCCD has funded nearly 200 replications

of a variety of evidence-based programs (EBPs).

• Since 1998, Penn State’s Prevention Research Center (PRC) has conducted a

series of cross-section and longitudinal studies to understand what factors

influence effective processes and outcomes for both CTC teams and for PA youth.

• Through annual web-based surveys to EBP grantees & CTC coalition members,

the Evidence-based Prevention and Intervention Support Center (EPISCenter)

and PRC collect data on program planning, connection to and functioning and

support of coalitions, program implementation, barriers & assets, and technical

assistance needs.

• The PA Youth Survey (PAYS), a statewide survey of 6th, 8th, 10th, and 12th grade

students, was used to study CTC’s effectiveness at reducing youth problem

behaviors and their associated risk and protective factors.

Brittany L. Rhoades, Brian K. Bumbarger, Julia Moore, & Sebrina Doyle

Supporting the High-Quality Implementation and Sustainability

Of Evidence-based Programs: The Role of Community Coalitions

Introduction

The EPISCenter, Prevention Research Center, Penn State University

Research on the CTC Model in Pennsylvania

Communities That Care: Creating Fertile Ground for Prevention

THEORIZED ADVANTAGES OF COALITIONS

Historical Context of CTC in Pennsylvania

Population Level Youth Outcomes

Collect local data

on risk and

protective

factors

Use data to

identify

priorities

Select and implement

evidence-based program

that targets those factors

Re-assess risk

and protective

factors

Form local coalition

of key stakeholders

Leads to community

synergy and

focused resource allocation

CTC CHARACTERISTICS

• Comprised of local key

stakeholders

• Choices are data-driven

• Programs implemented

are evidence-based

• Receive adequate

training and technical

assistance to support

fidelity and sustainability

• Receive regular

evaluation and feedback

Training and Technical Assistance

Sustainability of CTC Coalitions

Over 10 years of research in Pennsylvania has demonstrated the importance of well-functioning coalitions for the high quality implementation

of Evidence-Based Programs (EBPs) and improved population-level youth outcomes.

•Technical assistance includes feedback reports based on responses of CTC

board members and staff to an annual online survey regarding functioning of the

coalition. The data is used to problem solve and create action plans to improve

CTC functioning (Feinberg, Puddy, Gomez, & Greenberg, 2008).

•Receiving sufficient training in the CTC model has lead to:

-Positive coalition member attitudes toward prevention

-Better CTC coalition functioning

•Technical assistance dosage is related to better board functioning in younger

CTC sites (Feinberg, Greenberg, Osgood, Anderson, & Babinski 2002; Feinberg,

Ridnour, & Greenberg, 2008)

Support for High Quality Implementation of EBPs

The following factors have been found to predict a CTC site’s ability to support

high quality implementation of EBPs (Brown, Feinberg, & Greenberg, 2010):

• Coalition age: older sites provide less support, perhaps as a result of ‘mission

drift’

• Community poverty: higher poverty sites provide less support

• Coalition functioning: sites with higher levels of funding, leadership strength,

board efficiency, strong internal/external relationships, fidelity to the CTC model

provide greater support

0

5

10

15

20

25

30

35

10.8

33.2

10.8

16.4

Delinquency Academic Performance

< Negative Peer Influence School Engagement

• 66% of CTC sites were operating 4 years after termination of the 3-year state

seed grant.

• Factors that predict fundraising success and sustained CTC activity include:

-Board member knowledge of prevention

-Positive coalition functioning (leadership quality, member involvement,

communication, social cohesion, task focus)

-Fidelity to CTC model

-Planning for sustainability

(Feinberg, Bontempo, & Greenberg, 2008; Gomez, Greenberg, & Fienberg, 2005)

Feinberg, Jones, Greenberg, Osgood, & Bontempo (2010)

Longitudinal Study of CTC in PA

A cross-sectional study (Feinberg, et al., 2007) found:

• Less favorable attitudes toward antisocial behavior and ATOD use

• Greater school commitment

• Fewer friends who showed drug using or delinquent behavior

• Less alcohol/cigarette use and delinquent behavior

• These effects were strongest and most consistent for CTC sites implementing EBPs

that targeted the grade cohorts that were the focus of this study

In addition, a longitudinal study found similar results when examining change across time:

• CTC communities had 7X as many positive effects than would be expected by chance

• CTC communities that were implementing universal EBPs had 11X as many

CTC Coalition Functioning

In a recent study, 146 representatives from organizations implementing EBPs

and connected to some form of coalition completed surveys. 63% of respondents

reported being affiliated with a CTC coalition.

The data indicated

that CTC Coalitions

performed better

than non-CTCs in

areas related to

connection,

functioning and

support.

Coalition Effectiveness in CTC and Non-CTC Coalitions

• Proxy prevention system,

increasing community readiness

for adoption and implementation of

evidence-based programs (EBPs).

• Improves EBP implementation

quality and population-level public

health outcomes

• Greater community connections

may also increase and diversify

program support and the likelihood

of sustainability.

Research Summary

1. CTC board functioning (communication, task-focus, leadership, social

cohesion) is a key predictor of local perceptions of CTC effectiveness, ability to

support the high quality implementation of EBPs and sustainability of CTCs

2. Regular evaluation and feedback to local sites assists the joint work of TA

providers and CTC boards in maintaining high-quality site functioning and

program fidelity

3. CTC board functioning is dependent on adequate training and ongoing

technical assistance (TA), and as a result PA has undergone continuous quality

improvement to increase the quality of technical assistance

4. With such support, CTC sites are capable of

achieving positive population level change

We followed 419 age-grade cohorts over a 5-year period and found youth in CTC communities using EBPs had significantly lower rates of delinquency, greater resistance to negative peer influence, stronger school engagement and better academic achievement