Assessing coalition capacity: Keys to success in local policy change

CDC's recommendations for state and community interventions in tobacco control focus on promoting changes in social norms through policy. Indiana's tobacco control program has an extensive infrastructure of local coalitions conducting tobacco control interventions. Since 2004, Indiana, without a statewide law, has seen a high level of activity in local smoke free air.

This study examined characteristics of coalitions and coordinators associated with passing local smoke free air laws. Evaluations of community-level efforts frequently find mixed support for their effectiveness, attributable to the difficulty of measuring community context and well-documented gaps in community-level measures.

To address these challenges we developed a survey based on review of available community measures, augmented by interviews with key ITPC staff and exemplary coalition coordinators. 76 (of 93) county- and minority-based coalition coordinators representing 85 Indiana counties completed a web-based survey. Local policies were rated on a scale from 0 (no ordinance ever introduced, no community education) to 4 (comprehensive smoke free law). Multi-item scales were developed for community readiness for change, coordinator tobacco control skills, and coordinator tobacco control knowledge. All scales had Cronbach's alpha > .88. Preliminary analyses show community readiness for change and level of coalition coordinator tobacco control-relevant knowledge are significantly correlated with comprehensive smoke free air policies.

Community readiness for change is significantly associated with higher levels of interagency relationships, and coalition coordinator characteristics (years of experience and tobacco-related skills). These factors demonstrate community coalition efforts are important to achieving policy changes in states without a statewide law.