Coalitions as Prevention Infrastructure for Youth Substance Use: Coordinated, Local Relevance, and Sustainability

Abstract

CONTEXT: Youth substance use remains a preventable public health issue, yet substantial proportions of US adolescents continue to report substance use. Despite advances in prevention, the substance use landscape continues to evolve, and disparities persist, underscoring the need for strategies that address the social, environmental, and structural factors influencing youth substance use. OBJECTIVE: To outline the conceptual rationale for community partnerships in youth substance use prevention, summarize evidence supporting coalition- and partnership-based prevention systems, and demonstrate, through real-world examples, how partnerships strengthen prevention efforts. DESIGN: This article synthesizes prevention science literature and national evaluation findings through a social-ecological lens and presents illustrative case studies demonstrating how coalition-based prevention systems operate in real-world settings. INTERVENTION: Coalition- and partnership-based prevention systems, including Communities That Care, PROSPER, and the Drug-Free Communities Support Program. RESULTS: Partnerships and coalitions strengthen youth substance use prevention through cross-sector coordination, local relevance, and long-term sustainability. The case studies illustrate how partnership-based prevention systems enhance community prevention capacity by coordinating efforts across schools, public health agencies, health care systems, and community organizations. Coalitions implemented prevention strategies responsive to local priorities by engaging trusted partners, tailoring interventions to community needs, and integrating prevention into existing institutions. They also adapted to policy changes, workforce and funding constraints, and evolving community needs. National evaluations demonstrate that communities with sustained coalition infrastructure experience reductions in alcohol, tobacco, and cannabis use, along with improvements in youth risk and protective factors. These benefits increase as coalitions mature. CONCLUSIONS: Partnerships and coalitions serve as essential prevention infrastructure for youth substance use prevention. Public health practices that strengthen coalition capacity, cross-sector coordination, local relevance, and long-term sustainability are critical to achieving sustained reductions in youth substance use at the community level.

The authors' abstract, as published at the source. Journal of Public Health Management and Practice, 2026 · DOI ↗