Predictors and Level of Sustainability of Community Prevention Coalitions

Background After many years in which evaluations had generally not found the coalition approach to be effective, the community-coalition approach has recently been shown to produce a public health impact if best practices are utilized. The next challenge is to foster sustainability among coalitions in order to achieve long-term public health outcomes. This study examined the level of and predictors of sustainability among Communities That Care (CTC) sites in Pennsylvania. Methods Board functioning and the funding of 110 CTC sites were assessed through the reports of board members, staff, and technical-assistance providers from 2003 through 2006; data were analyzed in 2007. Results Ninety percent of CTC coalitions continued after the 3-year initial funding period, with 3%–8% of sites terminating each year thereafter. Approximately two thirds of CTC sites continued to operate 4 years after the termination of the original 3-year implementation grant. Many of the sites attracted funding at a level equivalent to or greater than the initial grant. Overall coalition functioning, as reported by either board members or technical-assistance providers, along with planning for sustainability, predicted both survival and post-launch funding. Conclusions Evidence suggests that board functioning predicts survival, at least in part independently of its influence on funding; and that planning for sustainability predicts sustainability, at least in part independently of overall coalition functioning.