keepin’ it REAL: Contextual Moderators of Program Effects

Drug Resistance Strategies: The Next Generation 

Principal Investigators: Flavio Marsiglia & Stephen Kulis

Funding: National Institutes of Health/ National Institute on Drug Abuse, award R01 DA14825 (2001-2003)

Utilizing data from the original randomized trial of keepin’ it REAL (kiR), this study examined contextual and moderator effects on the efficacy of that SAMHSA Model Program for substance use prevention in middle schools. The study sought to identify the subgroups and social conditions where the intervention was most successful as well as the mechanisms for success. Following an ecological risk and resiliency perspective the study analyzed several types of contextual factors that influence youth risk of substance use and their responsiveness to the keepin' it REAL: characteristics of the client (student), implementer (teacher), school, and neighborhood. For example:

• Do students benefit more from kiR if they receive a version of the curriculum that is specifically targeted toward their ethnic background?
• Does the program work by both delaying the students’ initiation of substance use as well as by reducing the level of use of those students who have already started to experiment with use?
• Are program outcomes better when teacher/implementers are of the same ethnicity as most of their students, and when the teachers deliver a version of the curriculum that matches their own background ethnically?
• Do the ethnic composition and acculturation status of the school’s students influence the effectiveness of different culturally grounded versions of the program?
• Does the ethnic, immigrant and socioeconomic composition of the neighborhood affect program outcomes?

The study yielded numerous insights into the social contexts that shape the effectiveness of school-based prevention programs.

Dixon, A. L., Yabiku, S. T., Okamoto, S. K., Tann, S. S., Marsiglia, F. F., Kulis, S., & Burke, A.M. (2007). The efficacy of a multicultural prevention intervention among urban American Indian youth in the Southwest U.S. Journal of Primary Prevention, 28, 547-568. doi: 10.1007/s10935-007-0114-8.  Read full article PMCID: PMC3042736

Holley, L.C., Moya Salas, L., Marsiglia, F. F., Yabiku, S. T., Fitzharris, B., & Jackson, K.F. (2009). Youth of Mexican descent of the Southwest: Exploring differences in ethnic labels. Children and Schools, 31, 15-26.  Read full article PMCID: PMC2758796

Elek, E., Miller-Day, M., & Hecht, M. (2006). Influences of personal, injunctive, and descriptive norms on early adolescent substance use. Journal of Drug Issues, 36, 147-171.

Kulis, S., Marsiglia, F. F., Elek, E., Dustman, P. A., Wagstaff, D. A., & Hecht, M. L. (2005). Mexican/Mexican American adolescents and keepin’ it REAL: An evidence-based substance use prevention program. Children and Schools, 27, 133-145. Read full article PMCID: PMC3043619

Kulis, S., Marsiglia, F. F., Nieri, T. A., Sicotte, D., & Hohmann-Marriott, B. (2004). Majority rules? The effects of school ethnic composition on substance use by Mexican heritage adolescents. Sociological Focus, 37, 373-393. Read full article PMCID: PMC3113510.

Kulis, S., Marsiglia, F. F., Sicotte, D.M., & Nieri, T. A. (2007). Neighborhood effects on youth substance use in a southwestern city. Sociological Perspectives, 50, 273-301.  Read full article PMCID: PMC3040571

Kulis, S., Nieri, T. A., Yabiku, S. T, Stromwall, L., & Marsiglia, F. F. (2007). Promoting reduced and discontinued substance use among adolescent substance users: Effectiveness of a universal prevention program. Prevention Science, 8, 35-49. Read full article PMCID: PMC3055561

Kulis, S., Yabiku, S. T., Marsiglia, F. F., Nieri, T. A., & Crossman, A. (2007). Differences by gender, ethnicity and acculturation in the efficacy of the keepin’ it REAL model prevention program. Journal of Drug Education 37, 123-144.

Marsiglia, F. F., Kulis, S., Wagstaff, D. A., Elek, E., & Dran, D. (2005). Acculturation status and substance use prevention with Mexican and Mexican American youth. Journal of Social Work Practice in the Addictions, 5, 85-111. doi: 10.1300/J160v5n01_05. Reprinted in M. De la Rosa, L. Holleran, & L.A. Straussner (Eds.), Substance abusing Latinos: Current research on epidemiology, prevention and treatment. NY: Haworth, 2005. Read full article PMCID: PMC3110070

Marsiglia, F. F., Yabiku, S. T., Kulis, S., Nieri, T. A., & Lewin, B. (2010). Influences of school Latino composition and linguistic acculturation on a prevention program for youths. Social Work Research, 34, 6-19.  Read full article PMCID: PMC2922772

Yabiku, S. T., Kulis, S., Marsiglia, F. F., Lewin, B., Nieri, T. A., & Hussaini, S. (2007). Neighborhood effects on the efficacy of a program to prevent youth alcohol use. Substance Use and Misuse, 42, 65-87. doi: 10.1080/10826080601094264. Read full article PMCID: PMC3046879

Yabiku, S. T., Rayle, A. D., Okamoto, S. K., Marsiglia, F. F., & Kulis, S. (2007). The effect of neighborhood context on the drug use of American Indian youth of the Southwest. Journal of Ethnicity in Substance Abuse, 6, 181-204. Reprinted in P.L. Myers (Ed.), 21st century research on drugs and ethnicity: Studies supported by the National Institute on Drug Abuse, NY: Haworth, 2007. doi: 10.1300/J233v06n02-11. Read full article PMCID: PMC3045036