Influencers and connectors in community prevention of drug abuse: balance between multi-site consistency and local community fit in program implementation

Abstract

The simultaneous implementation of a program in multiple sites poses a challenge for the adequate coordination and internal consistency of an intervention. The operation of the network of program facilitators can be critical for effectiveness and community adjustment of such interventions. In this paper, we conducted a case study of a community prevention program for drug addiction applied in a large group of cities in Andalusia, in southern Spain. The aim was to explore how integrated planning and local adaptation are combined in community prevention, through the collaboration network between program facilitators. For this aim, we analyze and describe two types of relevant roles of local facilitators: those that have a central coordinating role, versus peripheral “connectors”, which have a bridge role between different geographical areas. The network of the “Cities against Drugs” program in the province of Seville (n = 45) showed a core-periphery structure, with coordination patterns clearly influenced by the geographical location of facilitators. The capital and its metropolitan area not only have greater geographic centrality but also a central role in the social network. On the other hand, the role of “connectors” seems to be functional to avoid the fragmentation of the remotest regional nuclei. Finally, we discuss the tension between central coordination of the program and the adaptation to peculiarities of each local context.