Am J Community Psychol (2012) 50:347356

DOI 10.1007/s10464-012-9506-x

ORIGINAL PAPER

Community-Based Prevention Support: Using the Interactive

Systems Framework to Facilitate Grassroots Evidenced-Based
Substance Abuse Prevention
E. Kelly Firesheets Mary Francis
Ann Barnum Laura Rolf

Published online: 24 March 2012

Society for Community Research and Action 2012

Abstract The community plays an important role in the

success of substance abuse prevention efforts. However,
current funding structures and a focus on limited approaches to prevention delivery have created a large gap
between what substance abuse prevention professionals
practice and what the community at large knows about
prevention. The concept of community has not always
been well-defined in the field of prevention, and there are
few mechanisms to engage grassroots community members
in evidence-based substance abuse prevention. This article
explains how Wandersman et al.s (Am J Community
Psychol 41:171181, 2008) Interactive Systems Framework can be applied to grassroots prevention efforts. The
authors describe a Community Prevention Support System
that collaborates with the Professional Prevention Support
System to promote the adoption of evidence-based substance abuse prevention practices at the grassroots, community level.
Keywords Community
Prevention
Grassroots support

Addiction
Substance use disorders

E. K. Firesheets (&)
A. Barnum

The Health Foundation of Greater Cincinnati,
Cincinnati, OH, USA
e-mail: kfiresheets@healthfoundation.org
M. Francis
Assistance for Substance Abuse Prevention Center,
Cincinnati, OH, USA
L. Rolf
Big Brothers Big Sisters of Greater Cincinnati,
Cincinnati, OH, USA

Introduction
The prevention of disease is a challenge for the
whole community, not just for clinicians and their
patients. National Research Council and Institute of
Medicine 2009
In the past decade, the field of prevention research has
advanced considerably. Unfortunately, advances in prevention research have not always translated into advances
in prevention practice. Researchers, policymakers and
prevention experts have noted the critical role of the
community in successful prevention practices, and there
are a wide variety of tools and approaches that attempt to
bridge the gap between research and practice. There are
tools to assist in the identification and selection of evidence-based prevention practices (EBPPs), programs that
provide technical assistance to prevention professionals
and coalitions, and funding (federal, state and private) that
supports program implementation. Even as the number of
EBPPs has increased, significant barriers continue to limit
the implementation of those programs in communities, and
research-based prevention approaches have not been
adopted on a broad scale at the community level.
The Interactive Systems Framework for Dissemination
and Implementation (ISF) advances the dialogue on the
transfer of prevention knowledge because it shifts the focus
away from specific activities and toward the infrastructure
or systems that are needed to carry out prevention activities in a community (Wandersman et al. 2008, p. 173). The
ISF is comprised of three separate, interacting systems that
move prevention knowledge from research into the hands
of the community: The Prevention Synthesis and Translation System (PSTS), the Prevention Support System (PSS),
and the Prevention Delivery System (PDS).

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348

In this article, we will describe the ISF as it applies to

grassroots substance abuse prevention. The article will
highlight the work of the Assistance for Substance Abuse
Prevention (ASAP) Center, a Prevention Support System
that provides community prevention supportcapacity
building and technical assistance for grassroots community
members who are interested in adopting substance abuse
EBPPs. We begin by identifying several key concepts in
community-based prevention, and examine how the ASAP
Center has conceptualized and evaluated prevention support over time. We will also present data from the ASAP
Centers program evaluation. Finally, we will discuss how
the ISF helps to clarify the systems and processes that
facilitate substance abuse prevention at the community
level.
Definitions of Community
In order to discuss how the ISF can support communitybased adoption of EBPPs, it is important to clearly define
the concept of community. In the past decade, community has become a buzzwordit is so widely used that it
almost lacks meaning. When discussing prevention, people
may use community to refer to a targeted population, a
specific prevention framework, a geographic area or
neighborhood or the general public.
The use of the term community can be even more
confusing in discussions about prevention support. In discussions about community-based prevention, there is
often a lack of distinction between prevention approaches
that are provided to the community by service providers
and prevention approaches that are provided by the community (e.g., Biglan and Hinds 2009; Julien et al. 2008).
Both types of activities are important parts of the larger
prevention picture, so it is important to recognize the
similarities and differences between the two. This precision
in language is particularly important when it comes to
discussing prevention support. When it comes to adopting
EBPPs, the needs, interests and motivations of professionals or service organizations are very different from the
needs of grassroots community members. Effective prevention support may also look different for those groups.
In this article, we will use the terms community to
refer to members of the general public and communitybased to refer to the prevention activities that they carry
out. The ASAP Center uses the term partner to describe
community members who have an ongoing relationship
with the ASAP Center. ASAP Center staff work with each
partner to help define his/her sphere of influence for promoting evidence-based prevention practicesthis might be
a persons workplace, neighborhood, family, or congregation. While the ASAP Center often collaborates with other
prevention professionals as it provides support to partners,

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Am J Community Psychol (2012) 50:347356

this is not the primary focus of the ASAP Centers prevention support.
Empowered People: Extending the Prevention Delivery
System
The 2011 National Prevention Strategy creates a blueprint
for improving the health of Americans by help[ing] us
understand how to weave prevention into the fabric of our
everyday lives (p. 3, National Prevention Council). The
National Prevention Strategy emphasizes the role of the
community in planning and implementing prevention policies and programs. This represents a change in thinking
about how the average community member interacts with
prevention practices, so that the community is not only the
target audience for EBPPs, but an ally in implementing
EBPPs and creating a culture of health.
Of course, the idea of community-based prevention is
nothing new. Researchers have repeatedly noted the critical
role of the community in successful prevention efforts.
While it sounds like a relatively simple concept, developing
systems that empower grassroots community members to
participate in evidence-based prevention can be quite difficult. The structure of the current substance abuse prevention system does not support activities that promote
grassroots-level development, community engagement, or
the coordination of community-based prevention. Instead,
restricted funding streams for substance abuse prevention
create a bias toward time-limited programs that are delivered by prevention professionals. If those barriers can be
addressed, there is still the question of access to information. The average community member is unlikely to know
about the National Registry of Evidence-Based Programs
and Practices (SAMHSA 2010), or to have access to professional journals or that would help determine if a program
or prevention approach is supported by research.
Coalitions play an important role in engaging some
community members in substance abuse prevention efforts
and in supporting the implementation of substance abuse
EBPPs at the community level. But not every region can
support a formal coalitionthis is a particular challenge in
rural or isolated areas. Even those areas that have strong
and active coalitions may have prevention needs that are
not addressed within the formal coalition structure. When
community members see these unmet needs, they often
choose to implement their own prevention efforts. This is
positive, as research suggests that engaging people in
health promotion and prevention programming helps to
improve health outcomes (Wallerstein 2006). However,
without systems in place to support those efforts and build
the capacity of community members to implement EBPPs,
community-wide prevention efforts will be fragmented (at
best) or ineffective (at worst).

348

In this article, we will describe the ISF as it applies to

grassroots substance abuse prevention. The article will
highlight the work of the Assistance for Substance Abuse
Prevention (ASAP) Center, a Prevention Support System
that provides community prevention supportcapacity
building and technical assistance for grassroots community
members who are interested in adopting substance abuse
EBPPs. We begin by identifying several key concepts in
community-based prevention, and examine how the ASAP
Center has conceptualized and evaluated prevention support over time. We will also present data from the ASAP
Centers program evaluation. Finally, we will discuss how
the ISF helps to clarify the systems and processes that
facilitate substance abuse prevention at the community
level.
Definitions of Community
In order to discuss how the ISF can support communitybased adoption of EBPPs, it is important to clearly define
the concept of community. In the past decade, community has become a buzzwordit is so widely used that it
almost lacks meaning. When discussing prevention, people
may use community to refer to a targeted population, a
specific prevention framework, a geographic area or
neighborhood or the general public.
The use of the term community can be even more
confusing in discussions about prevention support. In discussions about community-based prevention, there is
often a lack of distinction between prevention approaches
that are provided to the community by service providers
and prevention approaches that are provided by the community (e.g., Biglan and Hinds 2009; Julien et al. 2008).
Both types of activities are important parts of the larger
prevention picture, so it is important to recognize the
similarities and differences between the two. This precision
in language is particularly important when it comes to
discussing prevention support. When it comes to adopting
EBPPs, the needs, interests and motivations of professionals or service organizations are very different from the
needs of grassroots community members. Effective prevention support may also look different for those groups.
In this article, we will use the terms community to
refer to members of the general public and communitybased to refer to the prevention activities that they carry
out. The ASAP Center uses the term partner to describe
community members who have an ongoing relationship
with the ASAP Center. ASAP Center staff work with each
partner to help define his/her sphere of influence for promoting evidence-based prevention practicesthis might be
a persons workplace, neighborhood, family, or congregation. While the ASAP Center often collaborates with other
prevention professionals as it provides support to partners,

123

Am J Community Psychol (2012) 50:347356

this is not the primary focus of the ASAP Centers prevention support.
Empowered People: Extending the Prevention Delivery
System
The 2011 National Prevention Strategy creates a blueprint
for improving the health of Americans by help[ing] us
understand how to weave prevention into the fabric of our
everyday lives (p. 3, National Prevention Council). The
National Prevention Strategy emphasizes the role of the
community in planning and implementing prevention policies and programs. This represents a change in thinking
about how the average community member interacts with
prevention practices, so that the community is not only the
target audience for EBPPs, but an ally in implementing
EBPPs and creating a culture of health.
Of course, the idea of community-based prevention is
nothing new. Researchers have repeatedly noted the critical
role of the community in successful prevention efforts.
While it sounds like a relatively simple concept, developing
systems that empower grassroots community members to
participate in evidence-based prevention can be quite difficult. The structure of the current substance abuse prevention system does not support activities that promote
grassroots-level development, community engagement, or
the coordination of community-based prevention. Instead,
restricted funding streams for substance abuse prevention
create a bias toward time-limited programs that are delivered by prevention professionals. If those barriers can be
addressed, there is still the question of access to information. The average community member is unlikely to know
about the National Registry of Evidence-Based Programs
and Practices (SAMHSA 2010), or to have access to professional journals or that would help determine if a program
or prevention approach is supported by research.
Coalitions play an important role in engaging some
community members in substance abuse prevention efforts
and in supporting the implementation of substance abuse
EBPPs at the community level. But not every region can
support a formal coalitionthis is a particular challenge in
rural or isolated areas. Even those areas that have strong
and active coalitions may have prevention needs that are
not addressed within the formal coalition structure. When
community members see these unmet needs, they often
choose to implement their own prevention efforts. This is
positive, as research suggests that engaging people in
health promotion and prevention programming helps to
improve health outcomes (Wallerstein 2006). However,
without systems in place to support those efforts and build
the capacity of community members to implement EBPPs,
community-wide prevention efforts will be fragmented (at
best) or ineffective (at worst).

Am J Community Psychol (2012) 50:347356

The ASAP Center Approach to Prevention Support

The ASAP Center builds the capacity of community
members so that they can adopt evidence-based substance
abuse prevention. There are already a number of professionals implementing evidence-based programs that
address substance use in the Greater Cincinnati area. There
are also strong and active coalitions that implement evidence-based programs and education strategies. The ASAP
Center does not duplicate that work. Instead, the ASAP
Center complements the existing substance abuse prevention infrastructure by helping community groups adopt
prevention messages that are based in evidence and consistent with the formal prevention efforts in their area. This
fills gaps and creates a coordinated network of messages
about healthy drug and alcohol use.
There is no average ASAP partner. The ASAP Center
provides prevention support to individuals, organizations
and communities. This means the ASAP Center works with
volunteers (individuals), neighborhood groups (communities), and small social service organizationsany community member or organization who has an interest in
preventing substance abuse. Each community member has
different needs, and each sets his/her own goals for the
prevention efforts. To meet the diverse needs of the community, the ASAP Center supports broader research-based
frameworks as well as specific evidence-based programs so
that partners can find the best ways to make prevention work
for them (see Table 1). Evidence-based prevention looks
different for each partner: some ASAP partners implement
evidence-based prevention programs (e.g., a summer camp
that implements the All Stars curriculum as part of its
evening programming), while it may make more sense for
others to adopt a research-based prevention framework and
incorporate evidence-based kernels into their existing
work (e.g., a congregation that begins to emphasize the 40
Developmental Assets in volunteer training for youth leaders) (Embry and Biglan 2008; Search Institute 2009; Tanglewood Research Incorporated 2011). Ideally, partners will
do both. Successful prevention support is based on long-term
relationships that build partners general capacity and
Table 1 Evidence-based frameworks and programs
Evidence-based frameworks

Evidence-based programs

40 Developmental assets

Life skills training

Communities that care

Second step

Strategic prevention framework

PRIME for life

Shoulder to shoulder
Strengthening families
Walking the talk
All stars

349

support the transfer of skills and knowledge necessary for the

implementation of evidence-based practices.
While the ASAP Center uses a repertoire of common
tools to build capacity for EBPPs (see Table 2), there is no
standard approach to prevention support. Instead, the
capacity building menu is offered a` la carte so that
partners can get the type(s) of support they need. While
some of the ASAP Centers community partners pick and
choose their own combination of supports, many partners
need support to help them identify their needs. These
partners rely on the ASAP Center staff for guidance. Partners often describe the ASAP Center staff as coaches or
mentors, and both are apt descriptors for the type of
interactions that make up the ASAP Centers approach to
prevention support. Generally, ASAP staff uses a community-centered model of capacity building so that partners
identify and implement the evidence-based approaches that
match their communities needs and goals (Flaspohler et al.
2008). At the same time, the ASAP Center works strategically to promote substance abuse prevention, facilitate
the adoption of EBPPs, and align resources and efforts
throughout the region when it is feasible. So while ASAP
staff supports partners unique needs using a communitycentered approach, the ASAP approach to community
prevention support adopts a decidedly more research-topractice philosophy at the strategic level. The ASAP Center
is always working toward the specific goal of engaging
partners in substance abuse EBPPs, with expert staff guiding community members to adopt specific interventions and
approaches that tie into larger community efforts.
The ASAP Centers Theory of Change
Community-based prevention is entirely voluntary. Unlike
the professional system, there are no financial incentives
that encourage (or require) community members to
implement substance abuse EBPPs. This means that the
ASAP Center must create incentives that get partners in
the door by building the capacity and willingness of
community members to engage in substance abuse prevention. Since this is the case, most of the ASAP Centers
attention has gone to understanding how and why community members adopt EBPPs.
The ASAP Center uses a theory of change to conceptualize how community members move toward the adoption of
EBPPs, which was built on knowledge translation theory
(including Estabrooks, et al. 2006; Rogers 1995) and adapted
with experience. Community members generally move
through four stages as they develop capacity to adopt EBPPs
(See Fig. 1). First, they develop their knowledge about
substance abuse EBPPs. Next, they become more aware of
the resources that are available to support substance abuse
EBPPs (including resources within professional delivery

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Am J Community Psychol (2012) 50:347356

Table 2 The ASAP centers capacity building menu

Approach

Explanation

Consultations

The ASAP Center offers individual and organizational consultation to help partners build general capacity to
participate in substance abuse prevention efforts. ASAP staff also provides coaching to build the EBPP-specific
capacity of partners. These consultations might involve:
General information about substance abuse
Strategic planning advice
Developing a sustainability plan for prevention work
Evaluation consultation
Leadership coaching
Troubleshooting or crisis management

Training and
workshops

The ASAP Center holds free or reduced-cost workshops to train community members on specific evidence-based
practices. Depending on the topic, workshops will be presented by ASAP staff, consultants, or outside experts. The
ASAP Center also provides support to help community partners attend national conferences or events. Examples of
past workshops and educational events include:
PRIME for Life Facilitator Training
Asset Building Workshop with Dr. Peter Benson
The Search Institutes Healthy Communities*healthy Youth Conference

Library

The ASAP Center has a library that provides prevention materials to community members at no charge. The ASAP
library features a collection of just under 600 prevention tools, curricula and resources. Partners can borrow and
review materials before purchasing an evidence-based curriculum

Resource center

The ASAP Center offers more than 100 different prevention-related materials through the community resource center.
Community members can pick up brochures, booklets, surveys, assessments and other prevention tools free of charge

Networking and
convening

The ASAP Center establishes collaborative workgroups and community meetings to help bring like-minded community
members together to address problems related to substance use

Grantmaking

The ASAP Center provides mini-grants of up to $5,000 to help partners begin or expand substance abuse prevention
activities in the community

Knowledge of
Prevention
Approaches

Awareness of
Prevention
Resources

Connection to
Prevention
Resources

Integrate
EBPPs

Fig. 1 The ASAP centers theory of change for community prevention support

system and other community members who are using

EBPPs). After learning about available resources, they
begin to connect to them to get more information about
prevention. These connections are often (but not always)
facilitated by the ASAP Center through workshops, networking meetings, or introductions. Once they have gained
these connections and resources, community members can
begin to integrate EBPPs into their own organizations or
spheres of influence. Partners may go through these stages
several times as they experiment with different EBPPs to
find the right fit for their environment.
The ASAP Centers staff uses this model to talk to
partners about how their capacity is growing and to coordinate prevention support among ASAP Center staff and
consultants. At each step, ASAP Center staff tailors
capacity building to the partner and his/her unique sphere
of influence. This model also became the foundation of the
ASAP Centers program evaluation, since the ASAP

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Center was initially most interested in knowing whether or

not partners adopt EBPPs.

Evaluating Community-Based Prevention Support

The ASAP Center evaluates its work so that staff can
monitor partners progress toward adopting EBPPs and
identify ways to improve their capacity building offerings.
Data that support The ASAP Centers program evaluation
are collected from a variety of sources, including contact
logs, regional surveys, and regular partner surveys. While
all of these are useful in their own right, this article focuses
on the results of the ASAP Centers Partner Survey, which
is described in more detail below. The survey is not a
research tool, nor were these data collected as part of an
empirical study.
The Partner Survey
The ASAP Centers Partner Survey was initially developed
and administered in 2002, with the help of evaluation staff
at The Health Foundation of Greater Cincinnati (the ASAP
Centers funder and parent organization). The Partner

Am J Community Psychol (2012) 50:347356

Survey was administered annually by ASAP Center staff

between 2002 and 2006, and has been administered biannually since that time, for a total of 6 iterations. The 2010
Partner Survey data were still being collected at the time
this article was written and are not included in this analysis.
Since the Partner Survey primarily informs the work of the
ASAP Center, each iteration of the survey is slightly different; however, ASAP Center staff recognized the need to
collect data that would allow for rough comparisons over
time. Four anchor items have remained constant across
all iterations of the survey. These four items are based on
the stages in the ASAP Centers theory of change for
community-based prevention capacity:
1.
2.
3.
4.

Knowledge: Rate your knowledge of current prevention approaches (1 = none, 5 = significant)

Awareness of Resources: Rate your awareness of local
prevention resources (1 = none, 5 = significant)
Connection to Resources: Rate your use of local
prevention resources (1 = none, 5 = significant)
Adopting EBPPs: How likely are you to adopt
prevention evidence-based practices (0 = definitely
will not, 4 = currently use)

The surveys are designed to collect retrospective selfreport data from respondents. This is a common approach
to data collection in program evaluation, and is preferred
by evaluators for its tendency to reduce shift biases that
often occur in self-reported ratings. In each iteration of the
survey, respondents are asked to provide ratings for their
pre-ASAP and post-ASAP knowledge, awareness of
resources, and connection to resources. They also report
whether they are currently using EBPPs and, if not, how
likely they are to begin using EBPPs.
In order to obtain candid, useful data, ASAP Center staff
administer the Partner Survey anonymously. Before each
survey, ASAP Center staff creates a list of active partners
(community members who have had contact with the ASAP
Center since the previous survey). Early iterations of the
survey were mailed to potential respondents with instructions and a self-addressed, stamped envelope to allow for
anonymous responses. Since 2006, the Partner Survey has
been administered using a combination of online software
and direct mailing for partners who did not have access to
the internet. Because the survey is anonymous, and there is
no requirement that respondents participate, an individuals
completion of the survey is considered informed consent.
The ASAP Center provides prevention support to both
individuals and organizations. Sometimes, it is difficult to
identify the unit of intervention in community prevention
support (individual versus organization); the partner survey is
administered and analyzed assuming the individual as the
primary unit of analysis. An individual community member
may have several points of influence where he/she can

351

introduce evidence-based prevention messages. ASAP Center

staff encourages partners to think about how they can integrate EBPPs in multiple settings and connect others to evidence-based approaches. Many community members do
integrate evidence-based prevention messages across settings
(e.g., in their congregations, neighborhoods and workplaces),
making the individual the more meaningful unit of analysis.
Using individual, anonymous surveys to collect data has
distinct advantages and disadvantages. One advantage is that
surveys place fewer time and financial demands on ASAP
Center staff when compared to other methods of data collection. This approach also allows community members who
work closely with ASAP Center staff to provide candid
feedback about their work and their interactions with the
ASAP Center. Unfortunately, the surveys have not been
constructed to allow the ASAP Center to match an individuals responses so that they can monitor partners progress over an extended period of time (e.g., 35 years) or
conduct a longitudinal evaluation of their work. This also
means that it is impossible to identify the number of partners
who completed surveys in more than 1 year, since there is no
way to know which of the invited participants actually
responded to each survey. As a result, partners who are
involved over the course of several years and have participated in several iterations of the Partner Survey (those who
have become the highest-capacity ASAP partners) may skew
statistical results when the data from all iterations are combined as part of a cross-sectional evaluation design. In the
future, the ASAP Center may consider altering its data collection strategy to compensate for these disadvantages.
Data Analysis
Across all six iterations of the Partner Survey, the ASAP
Center has received 426 survey responses. Response rates for
individual Partner Surveys ranged from a low of 27% in 2002
to a high of 79% in 2005 (Table 3). ASAP partners work in
three states: Indiana, Kentucky and Ohio. Ohio ASAP partners
make up just over half of the respondents (54%), while Kentucky (11%) and Indiana (6%) partners constitute a smaller
proportion of the responses. This is roughly representative of
the distribution of the population in the region. Approximately
2% of ASAP partners reported that they provide prevention
activities in more than one state. Not all participants responded
to this item, so totals do not equal 100%.
Partners Implementing EBPPs
Across all iterations of the survey, 95% of ASAP Partners
indicated that they had already adopted EBPPs or that they
probably/definitely would adopt EBPPs as a result of their
involvement with the ASAP Center. This is a very high
percentage; however, without data from non-partners, we

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Knowledge

No. of
respondents

Survey response rate

(%)

% of total
sample

2002

36

27

8.5

2003

78

76

18.3

2004

143

62

33.6

2005

35

79

8.2

2006

109

57

25.6

2008
Total

25
426

70
58

5.9
100

2002

2003

2004

2005

2006

0
Before Prevention Support

Mean Ratings

Year

Mean Ratings

Table 3 Partner survey responses by year

Awareness

70%

Currently Using EBPPs

60%

Probably will/Definitely will

use EBPPs
Probably will not use EBPPs

50%
40%
30%

Mean Ratings

80%

2002
2003

2004

2005

2006

90%

2008

Before Prevention Support

100%

After Prevention Support

After Prevention Support

Resource Connections

2008
2002

2003

2004

2005

2006
2008

0
Before Prevention Support

After Prevention Support

Definitely will not use EBPPs

Fig. 3 Self-reported changes in prevention capacity

20%
10%
0%
2002 2003 2004 2005 2006 2008

Fig. 2 Survey respondents intention to adopt EBPPs

do not have basis for comparison. The percent of respondents who reported that they are using EBPPs has increased
over time, while the percent of respondents who reported
that they probably/definitely will use EBPPs has decreased
over time. This seems to suggest that ASAPs long-term
partners do eventually move from considering using EBPPs
to actually implementing EBPPs (See Fig. 2).
Interestingly, the percentage of respondents who report
that they do not intend to implement EBPPs has remained
relatively consistent since 2002 (with the one exception
being the 2004 survey respondents). We assume that this is
because most community members who engage with the
ASAP Center probably already have some interest in
implementing substance abuse prevention; those who do
not would not be motivated to maintain a partnership. The
ASAP Center staff continually evaluates the status of
partner relationships, and generally knows why partners
reject prevention support (a lack of time, infrastructure and
leadership are typical reasons). However, at the time of this
article, the ASAP Center has not made attempts to conduct
formal surveys of former ASAP partners.
Exploring the ASAP Centers Theory of Change
for Community-Based Prevention Capacity
In addition to partners adoption of EBPPs, the ASAP
Center also monitors changes in partners self-reported

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knowledge, awareness and connection to resources. These

data help staff to make decisions about the types of
capacity building and technical assistance that are necessary to continue to move community members toward the
adoption of EBPPs. Generally, the ASAP Center uses
simple line graphs of these data to depict trends in these
three indicators. These line graphs suggest that ASAP
partners capacity to implement EBPPs (as measured by
these three indicators) is increasing (Fig. 3). Organizing
the data in this way provides staff with some (albeit rough)
insight into how partners prevention capacity changes
over time, because they can see how respondents selfratings change from pre- to post-intervention as well as
across iterations of the survey. Given the structure of the
datawhich do not allow us to identify long-term ASAP
partners and remove duplicate responses when aggregating datawe believe this is the most accurate way to
look for changes in these variables. By examining the data
by survey iteration, we can be assured that each partner is
represented one time in each analysis, assuming that their
responses and biases remain consistent from year to year.
We conducted a series of paired samples t tests to
examine the data more closely. We used a cross-sectional
design for this analysis, and examined the pre- and postimplementation ratings from each iteration of the Partner
Survey separately. The results of the analyses are presented
in Tables 4, 5 and 6. Since these analyses require a total of
18 paired-sample t tests (six survey iterations each for
knowledge, awareness and use), we used a Bonferroniadjusted p value of .003 to determine statistical significance. Even with the more stringent p value, the results

Am J Community Psychol (2012) 50:347356

353

Table 4 Knowledge of prevention approaches

Year

Before ASAP involvement

After ASAP involvement

Mean

SD

Mean

df

g2

SD

2002

2.69

1.18

3.94

.80

-6.49

34

.000*

.55

2003

2.93

.87

3.81

.64

-9.60

69

.000*

.57

2004

2.56

1.05

3.72

.862

-15.17

130

.000*

.64
.72

2005

2.57

.85

3.77

.60

-9.35

35

.000*

2006

2.87

1.08

3.95

.73

-13.63

108

.000*

.63

2008

2.81

.68

4.38

.67

-8.88

20

.000*

.80

g2

* Bonferroni adjusted p = .003

Table 5 Awareness of prevention resources

Year

Before ASAP involvement

After ASAP involvement

Mean

Mean

SD

df

SD

2002

2.60

1.12

4.06

.54

-8.08

34

.000*

.66

2003

2.91

1.05

3.94

.68

-9.73

69

.000*

.58

2004

2.48

1.05

3.84

.86

-16.58

128

.000*

.68

2005

2.66

.59

4.03

.57

-12.57

37

.000*

.82

2006

2.64

1.10

3.93

.76

-13.63

106

.000*

.67

2008

2.50

.66

4.25

.61

-12.69

23

.000*

.88

g2

.000*

.47

* Bonferroni adjusted p = .003

Table 6 Connections to Prevention Resources
Year

2002

Before ASAP involvement

After ASAP involvement

Mean

SD

Mean

SD

2.47

1.26

3.50

1.05

df

-5.39

33

2003

2.97

1.15

3.71

.96

-8.08

69

.000*

.49

2004

2.46

1.25

3.22

1.27

-9.07

127

.000*

.39
.64

2005

2.54

.85

3.71

.75

-7.78

34

.000*

2006

2.53

1.16

3.47

1.00

-11.18

108

.000*

.54

2008

2.32

.69

4.12

.67

-9.40

24

.000*

.79

* Bonferroni adjusted p = .003

indicate that there are significant increases in respondents

knowledge, awareness of, and connection to prevention
resources across every iteration of the survey, indicating
that community members report having more capacity to
implement EBPPs as a result of their interactions with the
ASAP Center. The effect sizes for the analyses were relatively large, ranging from a low of .39 (2003 ratings of use)
to a high of .88 (2008 ratings of awareness).

Discussion
We hope that readers will view these data in the spirit of
the ISFas a Prevention Support System, it is part of the

ASAP Centers role to provide feedback to the Prevention Research and Translation System on how practices
and theories are implemented in real world settings. The
approach and survey data presented in this article suggest
that the ISF can be used to facilitate the adoption of EBPPs
at the grassroots, community level. This type of prevention
support seems to be successful in increasing grassroots
community members capacity to adopt EBPPs.
As mentioned previously, there are a number of limitations that should be considered when interpreting these
data. For the purposes of this article, we used the ASAP
Centers program evaluation datanot research datato
explore the impact of prevention support on community
members adoption of EBPPs. Although the results

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presented here are promising, we can only make assumptions about the true impact of the ASAP Centers prevention support because we do not have the comparative data
and a longitudinal sample that are necessary to support
stronger statements.
To date, the ASAP Center has primarily focused on
facilitating community adoption of EBPPs, and evaluation
efforts have emphasized partners progress toward this
goal. Although the ASAP Center has a number of longterm partners, ASAP Center staff has not identified a costand resource-effective way to quantify partners ongoing
growth and capacity building. The ASAP Center collects
qualitative data that lead staff to believe that partners
continue to build capacity after adopting EBPPs. The
authors would like to have more objective data to support
this belief. At this time, the ASAP Center staff is considering making changes to the ASAP Centers program
evaluation to collect more data about high-capacity partners continued growth over time.
The other limitation of these program evaluation data is
that the ASAP Center has not fully examined partners
fidelity to EBPPs or the impact of partners EBPPs on
substance use. While there is anecdotal evidence that suggests that many partners prevention efforts have been
sustained with positive impact, the ASAP Centers ability to
measure fidelity and impact is limited by partners lack of
resources to support ongoing assessment. While the ASAP
Center has explored several different mechanisms to overcome these barriers (including implementing Efforts to
Outcomes, hiring external consultants, and offering partners
the opportunity to attend evaluation workshops), a thorough
assessment of these questions will take considerably more
resources than the ASAP Center has traditionally dedicated
to evaluation. As the ASAP Centers work and partnerships
in the community expand and deepen, it may become
important to consider making an investment in a more
robust approach to measurement and/or fidelity assessment.
Even with their limitations, we believe that these data
are important because they demonstrate that the PSS conceptualized in the ISF can play a valuable role in facilitating community-level adoption of EBPPs. The majority
of ASAP partners report that they are using or intend to use
EBPPs in their work. When one considers that these are
grassroots community membersnot professionalsthis
is an impressive outcome. Ultimately, we hope that this
exchange of ideas will lead to more research that helps the
ASAP Center better understand and support the adoption of
EBPPs at the community level. The ASAP Centers next
step is to improve its own data collection methodsthe
authors are particularly interested in developing tools that
help identify markers of success in capacity building and
community-based prevention. We believe this is where the
ASAP Center can make the greatest contribution to

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partners overall success and inform the continued development of prevention support.
The Utility of the Interactive Systems Framework
in Community-Based Prevention
The ISF has been useful in the ASAP Centers work
because it has provided language and concepts that help
frame the ASAP Centers work in the community. One of
the ASAP Centers biggest challenges has been describing
its work. In the past, discussions of the work have been
very focused on activities (such as workshops, consultations, or grants), rather than the role that the ASAP Center
plays in the community. While these activities are important, they do not tell the whole story. The vocabulary of the
ISF has allowed ASAP Center staff to bring stakeholders
attention to the larger goal of prevention support
strengthening the Prevention Delivery System by engaging
community members in evidence-based substance abuse
prevention. Certainly, the ISF makes a strong case for the
role of prevention support in the larger prevention system.
Although there are philosophies, approaches, and concepts that are compatible across prevention disciplines, the
topic-specific, siloed nature of current prevention systems
makes it difficult to identify these approaches and apply them
in meaningful ways. For example, a high school might offer
prevention programs that address several different issues
(reproductive health, an anti-drug curriculum, and an antiviolence program) without making connections between
them. As a framework, the ISF helps prevention professionals
disseminate information to inform practices across disciplines and fields so that community members can address
some of the general risk and protective factors that underlie
many problems. We expect that the ISF will be particularly
useful as the model of health and prevention begins to shift
toward more holistic approaches that address the whole
person.
Defining the Communitys Role in the ISF
While the ASAP Center has found much value in the ISF, the
authors largest criticism of the model is that the role of the
community in the Prevention Delivery System is implied but
not clearly defined. Applications of the ISF do not clearly
identify how (or even that) professionals and community
members can work together to form a holistic Prevention
Delivery System (e.g., Chinman et al. 2005; Community
Anti-Drug Coalitions of America 2009; Livet et al. 2008).
Perhaps this is because there is little existing research on
community capacity for prevention (Flaspohler et al. 2008).
Certainly, as the field calls for more community engagement
in prevention and health promotion (e.g., National Research
Council and Institute of Medicine 2009; National Prevention

Am J Community Psychol (2012) 50:347356

355

Fig. 4 Community prevention support in the ISF framework

Council 2011), this will be an important application of the

ISF. We suggest that a simple change in the description of the
PDS could explicitly identify the community as part of the
broader PDS (see Fig. 4). We do not believe that this constitutes a material change to the spirit of the ISF; however, it
is an important clarification. Quite simply, if community
members do not see themselves in the ISF, they will not think
of themselves as a part of it. The same is likely true for future
researchers and prevention practitioners. Including the
community in the definition of the PDS would make the ISF
more useful for communicating about the role of grassroots
community members in prevention, and help generate support for community-based prevention activities among
funders, policymakers and professionals. It would also make
the ISF a meaningful framework that orients members of
the general public to the systems and processes that are
necessary to support evidence-based prevention.
Community-Based Prevention Support
We initially conceptualized the work of the communitybased prevention support as an additional layer in the

ISFa Community Prevention Support System (CPSS)

that connected the Professional Prevention Delivery System to the community at large. However, after reflection,
we have come to believe it is most helpful to consider the
CPSS as a role that operates parallel to and in collaboration
with the Professional Prevention Support System (PPSS)
within the broader PSS (Fig. 4). This demonstrates the
collaborative functions of the CPSS and PPSS, and also
helps reinforce the community as part of the PDS.
We consider the community prevention support as a
distinct function within the ISF, separate from the Prevention Support Systems that primarily target professionals. While the roles of the two Prevention Support Systems
are similar (both provide general and EBPP-specific
capacity building), the approaches necessary to serve their
respective audiences require the CPSS and PPSS to operate
in fundamentally different waysa CPSS has different
capacities than a PPSS. It is worth noting that an effective
CPSS can not be completely separate from a PPSS. In order
to create coordinated prevention efforts, the two must be
strategically aligned and in close communication. There
may be some circumstances where one PSS could meet the

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needs of both community members and prevention

professionals. However, experience tells us that practical
considerations (including funding streams, competing
interests, and the skills and interests of staff) would make
this an unlikely scenario. Unfortunately, when the community and professionals are combined, the interests and
needs of the community tend to get overlooked.
Areas for Future Research
In light of the recent emphasis on engaging the community
in prevention, we would like to see more research investigating the factors that facilitate community adoption of
EBPPs, as well as barriers to the adoption of EBPPs at the
grassroots, community level. This research would be beneficial from a practical standpoint, because it would allow
for discussions of the ways that community prevention
support differs from professional prevention support. This
information could also be used to advocate for systems,
payment structures, and policy approaches that would
support more effective, holistic approaches to prevention.
Similarly, the Prevention Support System could be
strengthened with more information about how the various
systems within the ISF interact with one another. Specifically, it would be useful to know what qualities or factors
facilitate the exchange of information among systems. For
example, are there skills, actions, or approaches that make
the Prevention Support System particularly effective as it
interacts with the Prevention Delivery and the Prevention
Synthesis and Translation System? What conditions
enhance collaboration among various players in the system? What barriers exist within the current structure? Is it
possible to measure the strength of collaboration within
a system?
The ISF has the potential to transform the conditions of
our communities because it allows individuals working in
different capacities to understand and appreciate the
unique role of each member of the prevention system.
This new perspective can be used to facilitate the adoption
of the public health approach in substance abuse prevention by highlighting needs and opportunities in communities and in the entire system. Ideally, researchers,
funders, professionals, and community partners would all
consider the ISF as they develop and implement new
approaches to preventing problem behaviors. Otherwise,
caring and well-intentioned people operate in isolation
without adequate support to guide their contributions.
When we expand our perception of how these separate
systems can work together, we can begin to recognize
that, truly, everyone has a role to play in preventing
substance use disorders.

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