RESUMO
This study examined how participation in a universal family skills-building program may interact with community risks and resources to produce youth outcomes. Prior research has noted community-level variability in risk and protective factors, but thus far no study has examined the role that participation on a community-wide intervention may play in moderating the effects of community risks or resources. The study included 14 communities (seven in Iowa, seven in Pennsylvania) that implemented a family focused evidence-based program as part of the PROSPER project. Community level variables included both risk factors (percent of low income families, the availability of alcohol and tobacco, norms regarding adolescent substance use, incidence of drug-related crimes) and community resources (proactive school leadership, availability of youth-serving organizations, and student involvement in youth activities). The proximal youth and family outcomes included youth perceptions of their parents' management skills, parent-child activities, and family cohesion. Results indicated that the Strengthening Families Program:10-14 may have moderated the impact of the community risks and resources on community-level youth outcomes; risk levels meaningfully associated with community-level change in program participants, though these results varied somewhat by outcome. Generally, higher levels of resources also meaningfully associated with more positive change after participating in the family-focused intervention. These results suggest that the effect of some evidence-based programs may be even stronger in some communities than others; more research in this area is needed.
Assuntos
Alcoolismo/prevenção & controle , Serviços Comunitários de Saúde Mental/organização & administração , Educação não Profissionalizante/métodos , Educação não Profissionalizante/organização & administração , Terapia Familiar/métodos , Drogas Ilícitas , Delinquência Juvenil/prevenção & controle , Resiliência Psicológica , Prevenção do Hábito de Fumar , Apoio Social , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Criança , Prática Clínica Baseada em Evidências , Feminino , Humanos , Delinquência Juvenil/psicologia , Masculino , Avaliação de Resultados em Cuidados de Saúde , Fatores de Proteção , Fatores de Risco , Meio Social , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
Effective planning for community health partnerships requires understanding how initial readiness-that is, contextual factors and capacity-influences implementation of activities and programs. This study compares the context and capacity of drug and violence prevention coalitions in Mexico to those in the United States. Measures of coalition context include community problems, community leadership style, and sense of community. Measures of coalition capacity include the existence of collaborative partnerships and coalition champions. The assessment was completed by 195 members of 9 coalitions in Mexico and 139 members of 7 coalitions in the United States. Psychometric analyses indicate the measures have moderate to strong internal consistency, along with good convergent and discriminant validity in both settings. Results indicate that members of Mexican coalitions perceive substantially more serious community problems, especially with respect to education, law enforcement, and access to alcohol and drugs. Compared to respondents in the United States, Mexican respondents perceive sense of community to be weaker and that prevention efforts are not as valued by the population where the coalitions are located. The Mexican coalitions appear to be operating in a substantially more challenging environment for the prevention of violence and substance use. Their ability to manage these challenges will likely play a large role in determining whether they are successful in their prevention efforts. The context and capacity assessment is a valuable tool that coalitions can use in order to identify and address initial barriers to success.