Leveraged resources and systems changes in community collaboration

Prevalence and Predictors of Substance Use Support Programming Among U.S. Religious Congregations

We conducted a cross-sectional secondary analysis of data from the 2012 National Congregation Study, a nationally representative survey of religious congregations in the United States ( N = 1,331). Multivariate logistic regression was used to identify congregational characteristics associated with providing substance use support programing. Nearly one-third (38%) of U.S. congregations indicated that they provided substance use support programming; approximately half (52%) of all congregational attendees were in a congregation that provided some type of substance use support. The internal factors associated with a congregation providing substance use programming include having members who are unemployed and younger, being conservative Protestant, engaging in the practice of speaking in tongues, and having the resources to support social services. The analysis also identifies external factors (i.e., assessing community needs and hosting social service speakers) as being associated with a congregation’s likelihood of providing substance use programming. Findings identify factors associated with congregations providing substance use support.

Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program

Background

Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale-up, and sustainment of evidence-based interventions. Faith in Action (Fe en Acción) is an evidence-based promotora-led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women.

Methods

We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of Faith in Action and identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach.

Results

Pastors and church staff described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of physical activity; influence on churchgoers' behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: (1) health behavior change training for pastors and staff, (2) tailored messaging, (3) developing community collaborations, and (4) gaining denominational support.

Conclusions

While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.

Reframing coalitions as systems interventions: a network study exploring the contribution of a youth violence prevention coalition to broader system capacity

This longitudinal research conceptualizes community coalitions as events in local intervention systems (Hawe et al. in Am J Commun Psychol 43(3-4):267-276, 2009). It explores the potential contribution coalitions make, through the collaborative activities of their members, to the broader intervention systems in which they are embedded. Using social network analysis, it examines patterns of structural change in a network of 99 organizations focused on youth violence prevention (YVP) over a 5-year period in which 30 of the 99 organizations were involved in a local YVP Coalition. Both longitudinal modeling and cross sectional analyses are used to examine change in system capacity-strong interorganizational networks-related to patterns of network density, centralization, and hierarchy. Somewhat surprisingly, the study found that capacity in the broader YVP Intervention System actually diminished during the 5-year period of the coalition's operation, though part of the system-the sub-network that made up the YVP Coalition-was marginally strengthened. In this case, therefore, the evidence suggests that power and relational resources in the broader YVP Intervention System were redistributed. The article explores how the definition of capacity related to density and hierarchy may be contextually dependent. Implications for the role of coalitions in building system capacity are discussed.