When prevention needs a helping hand

In the US and UK alike, the last decade has seen growing interest in the value of local community partnerships as a vehicle for improving the co-ordination and outcomes of human services.

Such collaborative efforts have generally produced mixed results in terms of their ability to demonstrate that they have improved outcomes for children. In the US the record of PROSPER, a university-community project designed at Penn State University, continues to be one of the few exceptions.

PROSPER’s local community teams implement evidence-based programs intended to support positive youth development and reduce early substance use, as well as helping to build the community’s broader capacity to provide prevention services.

In two recent articles about PROSPER, Penn State’s Prevention Research Center examine the role ground conditions and team building play separately and together in paving the way for successful implementation.

Unusually, they also track how the relationship evolves over time – how paying attention to team formation, for example, will influence how the intervention is functioning at six months, and how those conditions and circumstances combine to determine how things are likely to stand a year later.

The researchers hypothesized that at each stage of the coalition process a different set of factors was likely be critical to progress toward full implementation and sustainability.

In their analysis of how conditions prevailing when the teams were being set up predicted the standard of team functioning at six months, they identified as key factors team members’ attitudes toward prevention, expectations of the project and perceived partnership skills of members.

More surprisingly, the level of poverty in the community was found to have an impact, particularly on team leadership and culture. The authors suggest that such an association might be a measure of social disorganization. Poverty in a community might put agencies and institutions under so much stress that it has a knock-on effect on actual services as well as on the relational and psychological aspects of community life.

A year later at the 18-month checkpoint the level of poverty continued to predict the general quality of team leadership and cohesion. Higher levels of community readiness and collaboration were associated with better team functioning.

The simple implication is that in communities where there are low levels of economic and social resources, greater levels of support may be required if they are to adopt collaborative prevention approaches successfully.

At 18 months teams whose members had reported at pre-test that they valued prevention highly and were less accepting of adolescent alcohol use, tended to function better. Previous experience of collaboration and the skills associated with it were not related to team functioning, however.

All things considered, the findings suggest that teams are more likely to work well if they are provided with training, technical assistance and continuous moral support – and have clear logic models to guide them.

The need for structured support was highlighted by the finding that overall team functioning at 18 months was improved through contact with a designated prevention coordinator.

[For more about PROSPER see: Communities that Care under US spotlight [1] and Kids, science, communities – can they prosper together? [2]]

• See: "Community and Team Member Factors that Influence the Early Phase Function of Community Prevention Teams: The PROSPER Project” Mark Greenberg, (and others) Journal of Primary Prevention, Vol 28, pp485-504 and "Community and Team Member Factors that Influence the Operations Phase of Local Prevention Teams: The PROSPER Project” Mark Feinberg, (and others) Journal of Primary Prevention, June 2007, Vol 28, pp214-226.