keepin’ it REAL Adaptation Trial

Drug Resistance Strategies IV

Principal Investigator: Flavio Marsiglia (Arizona component)

Funding: National Institutes of Health/ National Institute on Drug Abuse, award R01 DA005629 (2003-2008)

This study developed and tested new or enhanced versions of the successful, multicultural keepin' it REAL intervention, originally designed for 7th grade middle school students.  The enhanced version of the curriculum targeted Mexican heritage youth and added content relevant to acculturation stress, language transition, parental monitoring, and bi-culturalism. The study also evaluated the optimal age for implementing school based universal substance use prevention programs by adapting the original 7th grade version of keepin' it REAL to make it developmentally appropriate for the 5th grade, simplifying the language, making the presentation of concepts more concrete, and providing age appropriate examples. The study compared outcomes for students who received interventions at 5th grade only, 7th grade only, and both 5th and 7th grades. Finally, the study examined the role of acculturation and gender as moderators of the intervention’s impact on substance use. Students in 29 schools (n= 1,670) were tracked over 4 years, from the beginning of 5th to the end of 8th grade. The findings provide no evidence that intervening only in elementary school (5th grade) was effective in altering substance use trajectories from 5th to 8th grade. Implementing keepin’ it REAL in middle school alone (7th grade) altered the trajectories of use of alcohol, cigarettes, marijuana and inhalants in desired directions. A double dose of prevention, in elementary and middle school, proved to be equally as effective as intervening in 7th grade only.

Ayers, S. L., Kulis, S., & Marsiglia, F. F. (2013). The impact of ethnoracial appearance on substance use in Mexican heritage adolescents. Hispanic Journal of the Behavioral Sciences, 3, 227-240. doi: 10.117710739986312467940

Harthun, M. L., Dustman, P. A., Reeves, L. J., Hecht, M. L., & Marsiglia, F. F. (2009). Using community-based participatory research to adapt keepin’ it REAL: Creating a socially, developmentally, and academically appropriate prevention curriculum for 5th graders. Journal of Alcohol and Drug Education, 53, 12-38.  Read full article PMCID: PMC2971695

Harthun, M. L., Dustman, P. A., Reeves, L. J., Hecht, M. L., & Marsiglia, F. F. (2008). Culture in the classroom: Developing teacher proficiency in delivering a culturally-grounded prevention curriculum. Journal of Primary Prevention, 43, 435-454. doi: 10.1007/s10935-008-0150-z. Read full article PMCID: PMC2615230

Hecht, M. L., Elek, E., Wagstaff, D. A., Kam, J. A., Marsiglia, F. F., Dustman, P. A., Reeves, L. J., & Harthun, M. L. (2008). Immediate and short-term effects of the 5th grade version of the keepin' it REAL substance use prevention intervention. Journal of Drug Education, 38, 225-251. doi: 10.2190/DE.38.3.c. Read full article PMCID: PMC2892822

Hodge, D. R., Marsiglia, F. F., & Nieri, T. A. (2011). Religion and substance use among youth of Mexican heritage: A social capital perspective. Social Work Research, 35, 3, 137-146.  Read full article PMCID: PMC3229215

Kulis, S., Marsiglia, F. F., Kopak, A. M., Olmsted, M. E., & Crossman, A. (2012). Ethnic identity and substance use among Mexican-heritage preadolescents: Moderator effects of gender and time in the US. Journal of Early Adolescence, 32, 2, 165-199. doi:10.1177/0272431610384484  Read full article PMCID:PMC3392121

Kulis, S., Marsiglia, F. F., & Nagoshi, J. L. (2012). Gender roles and substance use among Mexican American adolescents: A relationship moderated by acculturation? Substance Use and Misuse, 47, 214-229. doi:10.3109/10826084.2011.630438.  Read full article PMCID: PMC3402241

Kulis, S., Marsiglia, F. F., & Nieri, T. A. (2009). Perceived discrimination versus acculturation stress: Influences on substance use among Latino youth in the Southwest. Journal of Health and Social Behavior, 50, 443-459.  Read full article PMCID: PMC2821707

Marsiglia, F. F. (2010). A culturally grounded approach to drug prevention with Latino children and youth. In Fortune, A. E., McCallion, P., & Briar-Lawson, K. (Eds.). Social work practice research for the 21st century (pp. 138-153). New York: Columbia University Press.

Marsiglia, F. F., Ayers, S., Gance-Cleveland, B., Mentler, K., & Booth, J. M. (2012). Beyond primary prevention of alcohol use: A culturally specific secondary prevention program for Mexican heritage adolescents. Prevention Science, 13, 241-251. PMCID: PMC3401063 Read full article PMCID: PMC3401063

Marsiglia, F. F., Kulis, S., Yabiku, S. T., Nieri, T. A., & Coleman, E. (2011). When to intervene: elementary school, middle school or both? Effects of keepin' it REAL on substance use trajectories of Mexican heritage youth. Prevention Science, 12, 48-62. doi: 10.1007/s11121-010-0189-y  Read full article PMCID: PMC3042028

Marsiglia, F. F., Peña, V., Nieri, T. A., & Nagoshi, J. L. (2010). REAL Groups: The design and immediate effects of a prevention intervention for Latino children. Social Work with Groups, 33, 103-121. doi: 10.1080/01609510903366202.  Read full article PMCID: PMC2904465

Marsiglia, F. F., Yabiku, S. T., Kulis, S., Nieri, T. A., Parsai, M. B., & Becerra, D. (2011). The influence of linguistic acculturation and gender on the initiation of substance use among Mexican heritage preadolescents in the borderlands. Journal of Early Adolescence, 31, 271-299. doi:10.1177/0272431610363157.  Read full article PMCID: PMC3108799

Nieri, T. (2012). School context and individual acculturation: How school composition affects Latino students’ acculturation. Sociological Inquiry, 82, 460–484. doi: 10.1111/j.1475-682X.2012.00423.x.  Read full article PMCID: PMC3519394

Nieri, T. A., Apkarian, J., Kulis, S., & Marsiglia, F. F. (2015). Effects of a youth substance use prevention program on stealing, fighting, and weapon use. The Journal of Primary Prevention, 36(1), 41-49. doi: 10.1007/s10935-014-0373-0  PMCID:PMC4289019

Nieri, T. A., Lee, C., Kulis, S., & Marsiglia, F. F. (2011). Acculturation among Mexican-heritage preadolescents: A latent class analysis. Social Science Research, 40, 1236-1248. doi:10.1016/j.ssresearch.2011.02.005  Read full article PMCID: PMC3139995

Sangalang, C. C., Tran, A.G.T.T., Ayers, S. L., & Marsiglia, F.F. (2016). Bullying among urban Mexican- heritage adolescents: Exploring risk for substance use by status as a bully, victim, and bully-victim. Children & Youth Services Review, 61, 216-221.

Wagstaff, D. A., Elek, E., Kulis, S., & Marsiglia, F. F. (2009). Using a nonparametric bootstrap to obtain a confidence interval for Pearson's r with cluster randomized data: A case study. Journal of Primary Prevention, 30, 497-512. doi: 10.1007/s10935-009-0191-y. Read full article PMCID: PMC2792874

Wagstaff, D. A., Kulis, S., & Elek, E. (2009). A six-wave study of the consistency of Mexican/Mexican American preadolescents’ lifetime substance use reports. Journal of Drug Education, 39, 361-384. Read full article PMCID: PMC2892828

Yabiku, S. T., Marsiglia, F. F., Kulis, S., Parsai, M. B., Becerra, D., & Del-Colle, M. (2010). Parental monitoring and changes in substance use among Latino/a and non-Latino/a preadolescents in the Southwest. Substance Use and Misuse, 45, 2524-2550. doi: 10.3109/10826081003728256.  Read full article PMCID: PMC3108798