RESUMEN
Developing operationally strong community coalitions is critical to actualizing their potential for public health improvement. The purpose of this study was to measure how substance use prevention coalitions in Mexico functioned across their first 1.5 years, and to test associations between initial community contextual factors and subsequent coalition functioning and outcomes. Members of 19 coalitions participated in three waves of surveys about coalition context and functioning. We used paired t-tests to assess changes in coalition functioning and outcomes. Regression models estimated associations between coalition functioning and outcomes and initial community context. Among coalition functioning factors, over coalitions' first 1.5 years, member engagement increased, as did coordinator skill and participatory leadership style. Two initial community context factors - community support for prevention and community champions - predicted several measures of process competence, but only community champions predicted perceived community improvement. Thus, community champions may play a pivotal role in later coalition success. The observed increases in member engagement and process competence may support subsequent coalition sustainability, a crucial component to realizing their potential impact on public health.
Asunto(s)
Trastornos Relacionados con Sustancias , Federación para Atención de Salud , Humanos , México , Evaluación de Programas y Proyectos de Salud , Salud Pública , Trastornos Relacionados con Sustancias/prevención & control , Encuestas y CuestionariosRESUMEN
Collaboration with diverse partners is challenging but essential for the implementation of prevention programs and policies. Increased communication with partners from diverse sectors may help community coalitions overcome the challenges that diversity presents. We examined these issues empirically in a study of 17 substance use prevention coalitions in Mexico. Building on coalition and workgroup literatures, we hypothesized that sectoral diversity would improve outcomes but undermine coalition processes. Conversely, we expected uniformly positive effects from higher levels of intersectoral communication. Data are from a 2015 survey of 211 members within the 17 community coalitions. Regression models used sectoral diversity and intersectoral communication to predict coalition processes (cohesion, leader-member communication, efficiency) and outcomes (community support, community improvement, sustainability planning). Sectoral diversity was negatively associated with coalition processes and was not associated with coalition outcomes. Intersectoral communication was positively associated with two of the three measures of coalition outcomes but not associated with coalition processes. Our findings concur with those from prior research indicating that sectoral diversity may undermine coalition processes. However, more communication between sectors may facilitate the coalition outcomes of community support and sustainability planning. Skilled team leaders and participatory decision making may also help coalitions promote intersectoral communication, thereby engaging diverse community sectors to implement preventive interventions and actualize sustained public health impact.