Pathways to Sustainability: 8-Year Follow-Up From the PROSPER Project

Abstract

The large-scale dissemination of evidence-based practices (EBPs) is often hindered by problems with sustaining initiatives past a period of initial grant funding. Communities often have difficulty generating resources needed to sustain and grow their initiatives, resulting in limited public health impact. The PROSPER project, initiated in 2001, provided community coalitions with intensive technical assistance around marketing, communications, and revenue generating strategies. Past reports from PROSPER have indicated that these coalitions were successful with sustaining their programming, and that sustainability could be predicted by early aspects of team functioning and leadership. The current study examines financial sustainability eight years following the discontinuation of grant funding, with an emphasis on sources of revenue and the relationships between revenue generation, team functioning, and EBP participation. This study used four waves of data related to resource generation collected between 2004-2010 by PROSPER teams in Iowa and Pennsylvania. Teams reported annually on the amount and sources of funding procured, as well as annual reports of team functioning and leadership and annual reports of EBP participation by youth and parents. Data revealed that teams' overall revenue generation increased over time. There was significant variation in success with revenue generation at both the community level and across the two states. Teams accessed a variety of sources. Cash revenue generation was positively and predictively associated with EBP participation, but relationships with team functioning and leadership ratings varied significantly by state. State level differences in in-kind support were also apparent. The results indicated that there are different pathways to sustainability, and that no one method works for all teams. The presence of state level infrastructures available to support prevention appeared to account for significant differences in sustainability success between Pennsylvania and Iowa.

Examining the Highs and Lows of the Collaborative Relationship Between Technical Assistance Providers and Prevention Implementers

“…We hypothesized that a model that accounted for the distinct phases of coalition development would be the best way to describe the data; this hypothesis was supported. This finding adds to prior evidence of measureable differences across phases in community coalition prevention or public health efforts (Butterfoss & Kegler, 2002; Welsh et al, 2016). Specifically, TA collaboration is relatively high during organization and decreases during implementation, then increases again during sustainability.…”

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

“…A study of 110 CTC sites in Pennsylvania found that 90% of coalitions continued after the three-year initial funding period, with 3-8% of sites terminating each year after (36). Studies suggest that some factors may be uniquely important for sustaining coalitions, including board/team functioning, data/evaluation resources, and planning for sustainability (56,64,96,127,145). What may be particularly important and should be explored is the degree of collaboration, planning, and ability needed to respond to changes in policy, funding, populations, and personnel in this context.…”

For Whom Do Parenting Interventions to Prevent Adolescent Substance Use Work?

“…As parenting programs are scaled-up (Chamberlain, 2017; Haggerty, & Shapiro, 2013; Welsh, et al, 2016), providers need information to understand how different populations may respond to available interventions. This review summarizes the effectiveness of parent training programs in reducing substance use across gender, age/school grade, and race/ethnicity of youth participants.…”

“…Although potentially beneficial for lowering population-level substance misuse, parenting interventions for parents of adolescents have not been systematically scaled-up. Interventions that have succeeded in community dissemination beyond research studies are the PROmoting School–community–university Partnerships to Enhance Resilience (PROSPER; Welsh, Chilenski, Johnson, Greenberg, & Spoth, 2016) and the Communities that Care (CTC; Haggerty, & Shapiro, 2013) models, which include strong collaboration between community organizations and intervention developers.…”