Relating community capacity to the adoption of an evidence-based prevention strategy: a community-level analysis

Abstract

Abstract Background: In community-based prevention, adopting an evidence-based strategy is known to predict prevention success. Evidence-based prevention includes a theoretical framework, empirical assessment of prevention needs, use of tested and effective prevention programs, monitoring of community prevention efforts and outcomes, and integration of practice experiences. Also known is that adopting evidence-based prevention requires community capacity. However, it is unclear which domains of community capacity are most important for the adoption of evidence-based prevention. This study aims to examine the extent to which specific capacity domains explain variation in evidence-based prevention. Methods: The present study is a secondary data analysis based on a survey of 182 key informants in 38 communities. To determine the validity of the measurement, structural validity, internal consistency, and inter-rater agreement were assessed. Associations between adoption of evidence-based prevention and ten domains of community capacity (participation, knowledge & skills, resources, leadership, community power, collaboration consisting of prevention collaboration and sectoral-collaboration, sense of community, critical awareness & problem solving, and community structure) were investigated at the community level using logistic regression models. Results: Regarding the validation analyses, most findings indicate that the ten community capacity domains could be reliably measured using key informant reports. Results of logistic regression models indicate that adopting evidence-based prevention is related to increased sense of community (OR 6.62; 95 % CI 2.39-18.39), prevention collaboration (OR 26.05; 95 % CI 5.98-13.39), sectoral-collaboration (OR 10.49; 95 % CI 4.04-27.25), community power (19.29; 1.74-28.12), and community structure (OR 4.79; 95 % CI 1.85-12.43). Availability of leadership was predictive of higher chances of adopting evidence-based prevention (OR 5.21; 95 % CI 1.93-14.02). Conclusion: Our findings suggest that communities with higher community capacity have increased chances of adopting an evidence-based prevention strategy.