Supporting community-based prevention and health promotion initiatives: Developing effective technical assistance systems

As research evidence for the effectiveness of community-based prevention has mounted, so has recognition of the gap between research and community practice. As a result, state and local governments are taking a more active role in building the capacity of community-based organizations to deliver evidence-based prevention interventions. Innovations are taking place in the establishment of technical assistance or support systems to influence the prevention and health education activities of community-based organizations. Several challenges for technical assistance systems are described: (1) setting prevention priorities and allocating limited technical assistance resources, (2) balancing capacity-building versus program dissemination efforts, (3) collaborating across categorical problem areas, (4) designing technical assistance initiatives with enough “dose strength ” to have an effect, (5) balancing fidelity versus adaptation in program implementation, (6) building organizational cultures that support innovation, and (7) building local evaluative capacity versus generalizable evaluation findings. As research evidence for the effectiveness of community-based substance abuse pre-vention has mounted,1-3 so has recognition of the gap between research and community practice.4-8 Community-based initiatives appear compelling to funding sources and com-munity activists alike because broad-based community partnerships have the potential t