treatment and thereby assure "institutional learning" at the community level. This requires an infrastructure among a set of relevant organizations. The CCOP provides this infrastructure, permitting NCI, cancer centers, cooperative groups, and community-based physicians to achieve strategic objectives that were not possible for any single organization.


The National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA) have long traditions of supporting demonstrations to develop and evaluate treatment and prevention interventions. The institutes used a variety of funding and management mechanisms to promote prevention programs, develop services for homeless men and women, and test strategies to reduce the risk of HIV infection among drug users. Three sets of demonstration initiatives are examined to identify lessons for research-practice collaborations in community-based drug treatment.

Prevention Demonstrations

NIAAA and NIDA prevention initiatives began in the 1970s. State Prevention Coordinators were supported to facilitate state planning, provide prevention training, manage state prevention contracts, and serve as liaisons with the federal Institutes (Williams and Vejnoska, 1981). NIAAA funded the development of prevention curriculum for children, adolescents, and college students. After the models were implemented, NIAAA used a demonstration replication program to test the generalizability of the three prevention models. Eight local communities and State Alcoholism Authorities were funded to replicate and evaluate one of the prevention programs. The replication highlighted the need for systematic documentation and illustrated the variations encountered as communities deviated from model frameworks (NIAAA, 1981). The two formal school-based curricula (Here's Looking at You and CASPAR) have evolved during more than 20 years of use and remain cornerstones of prevention activities in many school systems. The university-based model, however, faded as neither the original campus nor the replication campuses maintained the initiative for long after the termination of federal funding.

Based on these experiences, NIAAA designed subsequent prevention projects to be "conceptually tighter, more skeptical, and careful in statements of objectives and intentions, more modest in whom they mean to reach and what they mean to do with people, and more deliberate in how they plan to go about it" (NIAAA, 1981). There was more emphasis on theory, and projects were more likely to be funded in public health depart-

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