Primary author: Kristin Post
Community Coalition Action Theory-Revision
Butterfoss and Kegler (2002) developed the Community Coalition Action Theory (CCAT) which is a form of the Interorganizational Relations (IOR) Theory. A community coalition is a structured arrangement where all members can work together on a common goal and objective. The community coalition is represented by individuals and organizations which come together long term, even after a goal has been achieved. The theory focuses on fourteen constructs; of which a few are coalition development, coalition functioning, development of coalition synergy, and creation of organizational and community change (Butterfoss, 2002). The CCAT is a continuous cycle of formation, maintenance and institutionalization as new issues arise which is the construct of stages of development (Butterfoss, 2002). The use of CCAT is to increase a community’s capacity and improve health and social outcomes (Butterfoss, 2002). There are many issues with the CCAT, but one main issue with CCAT is it is difficult to test its effectiveness because of the complexity of the constructs.
The CCAT community context construct is the characteristics of the community that impact the coalition function and development (Butterfoss, 2002). The coalition has a lead agency/convener group which agrees to support financially and to also manage the coalition. However, according to Butterfoss (2002), success of the coalition can be seen when the lead agency enrolls members of the community to help develop trust throughout the community. The coalition comes together with the coalition membership, which are members of the community, organizations, and institutions that come together to resolve the health or social issue (Butterfoss, 2002). The next construct is the operations and processes encourage member participation via communications and decision making (Butterfoss, 2002). The operations and processes are facilitated through leadership and staffing that keep the coalition functioning. The structures construct is the formal makeup of the coalition which includes the missions and goals (Butterfoss, 2002).
The last seven constructs of the CCAT are related to the interventions and the outcomes. The pooled member and external resources construct pools the members and community resources to be used for a successful outcome (Butterfoss, 2002). CCAT involves member engagement to have the members more fully involved in the work (Butterfoss, 2002). The assessment and planning are conducted before the implementation takes place for a successful coalition (Butterfoss, 2002). The implementation of strategies targets multiple levels in order for the actions to create change in the community (Butterfoss, 2002). The community change outcomes construct changes the community strategies that improves the health and social outcomes (Butterfoss, 2002). The health and social outcomes are the indicators that the coalition was successful (Butterfoss, 2002). The last construct is the community capacity, which is the communities’ ability to change other social and health outcomes from the involvement in the successful coalition (Butterfoss, 2002).
The CCAT was used to develop a cancer coalition. In Pennsylvania and New York between 2002 and 2004 there were eleven Appalachian cancer coalitions. The coalitions used the CCAT to provide framework for the development activities and interventions (Kluhaman, 2006). The development activities were used to educate, equip, or enlarge the coalition membership. These activities are necessary for long-term sustainability of coalitions. Community intervention is one area where the coalition fulfilled its goal of cancer control among these communities versus the control groups without a coalition (Kluhaman, 2006). This study emphasizes the continuous cycle of formation, maintenance and institutionalization by the use of the development activities to keep the coalition running.
A study conducted by Kegler (2010) looked at how community context influenced coalition formation aspect of the CCAT in eight communities participating in a healthy community’s initiative. During this study five contextual domains were examined including history of collaboration, community politics and history, community norms and values, community demographics and economy conditions, and geography. “History of collaboration influenced the broadest range of coalition factors” (Kegler, 2010). According to Kegler (2010), the coalition membership was influenced by the demographic and economic makeup of the community along with the community politics, history, norms and values. The history of the collaboration influenced the selection of the lead agency and the overall coalition structure (Kegler, 2010). The formation of the coalition was affected by the geography of the community (Kegler, 2010). The organizers of a coalition need to be aware of the influences of these five contextual domains when they are developing the structure of the coalition. Therefore, these domains can be addressed during the development of the coalition, instead of finding out the impacts during the implementation of the strategies. Thus, all five of the contextual domains impact the formation of a community coalition and should be taken into consideration when a coalition is developed.
The CCAT is formed by a lead agency that brings together organizations and diverse individuals, which come together to make changes in a community on dealing with health or social issues. As new issues emerge the CCAT may need to restructure starting the formation, maintenance and implementation process over to achieve the outcomes of the new issue (Butterfoss, 2002). As the study conducted by Kegler showed, there are five contextual domains that impact the formation of a community coalition. At the start of the formation of the community coalition’s history of collaboration should be evaluated to allow the most success of the coalition.

Butterfoss, F.D. & Kegler, M.C. (2002). Toward a Comprehensive Understanding of Community Coalitions Moving from Practice to Theory. In R. J. DiClemente, R.A. Crosby, MC Kegler, Emerging Theories in Health Promotion Practice and Research Strategies for Improving Public Health (pp. 157-193). San Francisco: Jossey-Bass.
Kegler, M.C., Rigler, J., & Honeycutt, S. (2010). How does community context influence coalitions in the formation stage? a mutiple case study based on the Community Coalition Action Theory. BMC Public Health , 1-11.
Kluhaman, B.C., Bencivenga, J., Ward, A.J., Lehman, E., & Lengerich, E.J. (2006). Initiatives of 11 Rural Appalachian Cancer Coalitions in Pennsylvania and New York. Preventing Chronic Disease , 1-10.