Building a Rural, Coalition-Based Approach to Youth Substance Use Prevention: The Drug Free Dickson Coalition Model.

Youth substance use remains a critical public health issue in the United States, with rural communities experiencing disproportionate risk because of limited access to prevention resources and persistent barriers related to behavioral and mental health. Rural youth are often exposed to elevated risk factors, including geographic isolation, reduced availability of extracurricular and prosocial activities, transportation limitations, and fewer specialized prevention and treatment services. These challenges underscore the need for comprehensive, community-driven prevention approaches that are responsive to local context while grounded in evidence-based practice. This report describes the prevention framework, implementation strategies, and community context of the Drug Free Dickson Coalition (DFDC), a rural, coalition-based initiative operating in Dickson County, Tennessee. The coalition's approach highlights the importance of a long-term investment in prevention infrastructure, workforce development, and cross-sector collaboration to successfully prevent youth substance use.