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Rural Health Information Hub

Community Coalitions Prevention Models

Community coalitions have the potential to prevent substance use disorder (SUD) in communities. Coalitions can strengthen collaboration between public and private organizations in communities, address factors in the community that increase the risk of substance misuse, and support interventions that promote environmental strategies to address SUD in the community.

Community coalitions can be an important strategy to address adverse childhood experiences (ACEs) — traumatizing events that occur before the age of 18. Multiple studies have shown that ACEs can be caused by growing up in a household with family members who have an SUD, and also contribute to the development of SUD in adolescents and adults.

Examples of Rural Evidence-Based Community Coalition-based Prevention Models

  • The Wabanaki Pathway to Hope and Healing initiative was implemented by a consortium of five tribal communities in rural Maine and the statewide Diversion Alert program as part of a naloxone distribution program. Diversion Alert was a program that maintained a secure database of drug arrest data. Data were shared with healthcare professionals to help them respond to patients who may be at risk for overdose, in need of treatment, or illegally selling prescriptions. Diversion Alert also provided tip sheets to providers on how to respond to at-risk individuals who may be seeking opioid prescriptions. Wabanaki Pathway to Hope and Healing created protocols for checking both Diversion Alert and the state PDMP as part of their standard practice.
  • PROmoting School-community-university Partnerships to Enhance Resilience (PROSPER) is a partnership-based model that connects school systems with local universities and other community-based organizations to form PROSPER teams. These teams work to implement evidence-based programs, conduct needs assessments, monitor implementation, and evaluate outcomes. Once teams are formed, they are charged with selecting the most appropriate universal family or school-based programs for youth and their families within the community. PROSPER has been shown to decrease SUD among youth in rural communities. PROSPER is listed in The Surgeon General's Report on Alcohol, Drugs, and Health as an evidence-based prevention program. Learn more about the benefits and costs of the PROSPER program.
  • Communities That Care PLUS (CTC) is a universal, coalition-based community prevention model created to prevent SUDs and other problem behaviors among youth. CTC is an ongoing process involving five phases: identifying stakeholders, organizing workgroups, developing a community profile, creating an action plan, and implementing and evaluating the action plan. CTC training materials are free of charge and available for download on the CTC website. This intervention is listed in The Surgeon General's Report on Alcohol, Drugs, and Health as an evidence-based prevention program. Rural Franklin County in Massachusetts is implementing CTC to address SUD among youth. Learn more about the benefit to cost ratio of the Communities That Care program.
  • Project Northland is a universal, multilevel intervention designed to delay the onset of alcohol use among students in grades six through eight. The program focuses on different themes at different grade levels, with sixth grade focusing on home-based activities, seventh grade focusing on teacher-led curriculum, and eighth grade focusing on peer-led programs. Project Northland is listed in The Surgeon General's Report on Alcohol, Drugs, and Health as an evidence-based prevention program. Learn more about the benefit to cost ratio of the Project Northland program.

Considerations for Implementation

Community coalition prevention models may focus on developing new policies related to SUD, changing social norms and beliefs in the community about SUD, and supporting schools and other organizations in addressing SUD.

Program Clearinghouse Example

Resources to Learn More

Community Anti-Drug Coalitions of America
Offers resources and training for building an effective and sustainable community coalition for the prevention of substance use and misuse.
Organization: Community Anti-Drug Coalitions of America (CADCA)

The Community Tool Box: Chapter 5, Section 5 – Coalition Building 1: Starting a Coalition
This section identifies strategies and tools for developing and maintaining an organizational or community coalition. Discusses why starting a coalition is important for solving complex community problems and describes in detail specific examples of community coalitions.
Organization: Community Health and Development, University of Kansas

Drug-Free Communities Support Program
A federal grant program that funds and supports community-based coalitions whose goal is to prevent substance use among youth.
Organization: Center for Substance Abuse Prevention (CSAP), Substance Abuse and Mental Health Services Administration (SAMHSA)