Exploring the Decision-Making Process of Prevention Providers in Adopting or Rejecting a Community-Level Approach to Substance Abuse Prevention
Interventions for the prevention of alcohol, tobacco and other drug use (ATOD) have become more sophisticated (Biglan, Mrazek, Carnine, & Flay, 2003; Botvin & Griffin, 2005), partly because the demand for accountability from federal and private funding has increased (Gorman, 2002a, 2002b). Community-level interventions1,2 are multi-component interventions that combine individual and environmental change strategies across multiple settings to prevent dysfunction and promote well-being among population groups in a defined local community (Wandersman and Florin, 2003). A community-level intervention delivered by a community coalition is a model being advocated in the academic literature (Warner, 2000) and increasingly promulgated by federal funding agencies. There is, however, little or no literature on the decision-making process of the community-based organizations and coalitions who must choose whether to adopt or reject this model.
This study sought to answer three main questions: 1) to determine how many characteristics3 in the individual and organizational stages of Rogers' innovation-decision process (1995) were used by the community-based organizations and coalitions in their decision making process; 2) to determine which characteristics were most influential in the decision to adopt or reject the community-level intervention; and 3) to determine whether the characteristics that influence a decision to adopt differ for organizations representing culturally diverse communities.
Fourteen participants from seven organizations funded through the community-level intervention funding pool and seven organizations funded through an alternative funding pool to implement evidence-based curricula completed a mixed-method, semi-structured interview between February 21 and April 4, 2008. The questionnaire was designed to capture information regarding the decision-making process of the organization. Participants were first asked a number of non-guiding, open-ended questions before progressing through the remaining sections of the interview which intentionally guided the respondent systematically through select stages in Rogers' individual and organizational innovation-decision process.
Findings from the analyses support the application of Rogers' organization innovation-decision process model in combination with specific characteristics from the individual model for understanding community-based organization and coalition funding decisions. The most relevant and influential stages and overarching characteristics from the models were the Matching stage, Characteristics of the Decision-maker, Characteristics of the Innovation, and Communication Behavior. An analysis of organizations serving culturally diverse organizations did not reveal any differences in coded themes, however, the low number of such organizations in this sample may have been a factor.
A discussion of the findings and relevant implications are provided as well as a summary of the limitations of this study.