Abstract
This article presents the short-term effects of a pilot study of keepin’it REAL (Manténte REAL) conducted in central Mexico by a binational team of investigators. This middle school-based model program for preventing substance use was adapted for Mexico linguistically but not culturally. Two Guadalajara public middle schools were recruited and randomly assigned to either implement the prevention program or serve as a control site. The program was implemented in the treatment site by the students’ regular teachers, who were trained by the research team. Seventh graders in ten classrooms in the treatment and control schools (N = 432) completed a pretest and posttest survey in Spanish similar to the survey utilized in the original efficacy trial of keepin’it REAL in the US. T-tests and OLS regressions were conducted to determine the effects of the intervention on substance use outcomes. Differences between treatment and control groups in frequency of use of alcohol and tobacco, the two substances of choice in this sample, were significant and in the desired direction. Differences in amount of use were also in the preferred direction but were not significant for alcohol and only marginally significant for tobacco. When the sample was split by gender, statistically significant treatment effects remained for females but were not observed among males. Effects of the linguistically adapted version of keepin’it REAL appears to be driven by the change in female use; however, the difference in male and female outcomes was not statistically significant. Implications for cultural adaptation and prevention in Mexico are discussed from a communication competency perspective. The promising results of the pilot study suggest that the linguistic adaptation was effective, but that a comprehensive cultural adaptation of keepin’it REAL in partnership with Mexican investigators and communities may be warranted.
Similar content being viewed by others
References
Alberts, J. K., Miller-Rassulo, M. A., & Hecht, M. L. (1991). A typology of drug resistance strategies. Journal of Applied Communication Research, 19, 129–151.
Alducin, A. E., Blancarte, R. J., Castrejón, D. J., Cossío, J. R., Díaz-Guerrero, R., Flores, J. I., et al. (2004). Los valores de los Mexicanos Cambio y References permanencia. México: Tomo V Grupo Financiero Banamex.
Alonso Castillo, M. M., Esparza Almanza, S., Frederickson, K., Guzmán Facundo, F. R., & Martínez Maldonado, R. (2011). Efecto de una intervención para prevenir el consumo de alcohol y tabaco en adolescentes de escuelas secundarias de Monterrey, México. Investigación en Enfermería: Imagen y Desarrollo, 10, 79–92.
Alvarez-Gayou, J. (2007). Sexuality? Education at home or at school? Mexico: Polity Press.
Arenas-Monreal, L., Bonilla-Fernández, P., Abril-Valdez, E., Hernández Pérez, H., Cuevas-Bahena, C., & Jasso-Victoria, R. (2010). Intervención educativa con escolares para prevenir el tabaquismo. Neumologia y Cirugía de Tórax, 69, 195–199.
Arillo-Santillán, E., Fernández, E., Hernández-Ávila, M., Tapia-Uribe, M., Cruz-Valdés, A., & Lazcano-Ponce, E. C. (2002). Prevalencia de tabaquismo y bajo desempeño escolar, en estudiantes de 11 a 24 años de edad del estado de Morelos, México. Salud Pública De México, 44, S54–S66.
Consejo Nacional Contra las Adicciones. (2003). Modelos preventivos. México: Secretaría de Salud.
Díaz-Olavarrieta, C. (2010). Abortion and women’s roles in society: Opinions from Tlaxcala, Mexico. Salud Pública De México, 52, 52–60.
Félix-Ortiz, M., Velázquez, J. A. V., Medina-Mora, M. E., & Newcomb, M. D. (2001). Adolescent drug use in Mexico and among Mexican American adolescents in the United States: Environmental influences and individual characteristics. Cultural Diversity and Ethnic Minority Psychology, 7, 27–46.
Griner, D., & Smith, T. B. (2006). Culturally adapted mental health intervention: A meta-analytic review. Psychotherapy: Theory, Research, Practice, Training, 43, 531–548.
Gosin, M., Marsiglia, F. F., & Hecht, M. L. (2003). Keepin’ it REAL: a drug resistance curriculum tailored to the strengths and needs of preadolescents of the southwest. Journal of Drug Education, 33, 119–142.
Hecht, M. L., Alberts, J., & Miller-Rassulo, M. (1992). Resistance to drug offers among college students. Substance Use & Misuse, 27, 995–1017.
Hecht, M. L., Marsiglia, F. F., Elek, E., Wagstaff, D. A., Kulis, S., Dustman, P., et al. (2003). Culturally grounded substance use prevention: An evaluation of the keepin’it REAL curriculum. Prevention Science, 4, 233–248.
Hecht, M. L., & Ribeau, S. (1984). Ethnic communication: a comparative analysis of satisfying communication. International Journal of Intercultural Relations, 8, 135–151.
Instituto Nacional de Estadística y Geografía de México. (2011). Censo de Población y Vivienda 2010 [National Census of Mexico 2010]. México, México: INEGI.
Instituto Nacional de Salud Pública. (2008). Encuesta Nacional de Adicciones 2008 [National Survey of Addictions, 2008]. México: Instituto Nacional de Salud Pública INSP, Consejo Nacional contra las Adicciones CONADIC, Instituto Nacional de Psiquiatría Ramón de la Fuente, Fundación González Río Arronte IAP.
Kulis, S., Marsiglia, F. F., Ayers, S. L., Booth, J., & Nuño-Gutiérrez, B. L. (2012). Drug resistance and substance use among male and female adolescents in alternative secondary schools in Guanajuato, Mexico. Journal of Studies on Alcohol and Drugs, 73, 111–119.
Kulis, S., Marsiglia, F. F., Ayers, S. L., Calderón-Tena, C. O., & Nuño-Gutiérrez, B. L. (2011). Gender differences in drug resistance skills in youth in Guanajuato, Mexico. Journal of Primary Prevention, 32, 113–127.
Kulis, S., Marsiglia, F. F., Elek, E., Dustman, P., 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.
Kulis, S., Marsiglia, F. F., Lingard, E. C., Nieri, T., & Nagoshi, J. (2008). Gender identity and substance use among students in two high schools in Monterrey, Mexico. Drug and Alcohol Dependence, 95, 258–268.
Latimer, W., Floyd, L. J., Kariis, T., Novotna, G., Exnerova, P., & O’Brien, M. (2004). Peer and sibling substance use: predictors of substance use among adolescents in Mexico. Revista Panamericana De Salud Pública, 15, 225–232.
Marsiglia, F. F., & Hecht, M. L. (2005). Keepin’ it REAL: an evidence-based program. Santa Cruz, CA: ETR Associates.
Marsiglia, F. F., & Booth, J. (2013). Empirical status of culturally competent practices. In M. G. Vaughn & B. E. Perron (Eds.), Social Work Practice in the Addictions (pp. 165–181). New York, NY: Springer.
Medina-Mora, M. E., & Rojas Guiot, E. (2003). Mujer, probeza, y adicciones. Perinatolgia y Reproducción Humana, 17, 230–244.
Mendoza Flores, M. E., Sánchez Jiménez, B., García Cardona, M., & Ávila Rosas, H. (2002). Morbilidad percibida y control prenatal. Estudio de campo. Perinatología y Reproducción Humana, 16, 26–34.
Nuño-Gutiérrez, B. L., Álvarez-Nemegye, J., & Madrigal-de León, E. A. (2008). Efecto de una intervención anti-tabaco en estudiantes de enseñanza media superior en Guadalajara México. Salud Mental, 31, 181–188.
OECD (2011). Health at a Glance 2011: OECD Indicators, OECD Publishing, http://dx.doi.org/10.1787/health_glance-2011-en.
Rogler, L. H. (1989). The meaning of culturally sensitive research. The American Journal of Psychiatry, 146, 296–303.
Spitzberg, B. H., & Cupach, W. R. (1984). Interpersonal communication competence. Beverly Hills, CA: Sage Publications.
Tobler, N. S., Roona, M. R., Ochshorn, P., Marshall, D. G., Streke, A. V., & Stackpole, K. M. (2000). School-based adolescent drug prevention programs: 1998 meta-analysis. The Journal of Primary Prevention, 20, 275–336.
Tobler, N. S., & Stratton, H. H. (1997). Effectiveness of school-based drug prevention programs: a meta-analysis of the research. The Journal of Primary Prevention, 18, 71–128.
Zorrilla Fierro, M. (2008). Final Report of Evaluation of the National Program Safe School (PNES). Retrieved from http://www.coneval.gob.mx/Informes/Evaluacion/Diseno/Diseno_2008/SEP/EDS_08_SEP_ADICCIONES.pdf.
World Health Organization. (2009). Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: World Health Organization.
World Health Organization (2011). Global Status Report on Alcohol and Health 2011. Retrieved from http://www.who.int/substance_abuse/publications/global_alcohol_report/profiles/mex.pd.
Wright, A. J., Nichols, T. R., Graber, J. A., Brooks-Gunn, J., & Botvin, G. J. (2004). It’s not what you say, it’s how many different ways you can say it: Links between divergent peer resistance skills and delinquency a year later. Journal of Adolescent Health, 35, 380–391.
Acknowledgments
Data collection for this study was made possible through the Global Health Initiative of the Southwest Interdisciplinary Research Center (SIRC) funded by Arizona State University. Data analysis and manuscript development were supported by the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health (Grant P20MD002316-05, to Flavio F. Marsiglia, principal investigator). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of Arizona State University, the NIMHD or the National Institutes of Health.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Marsiglia, F.F., Booth, J.M., Ayers, S.L. et al. Short-Term Effects on Substance Use of the Keepin’ It REAL Pilot Prevention Program: Linguistically Adapted for Youth in Jalisco, Mexico. Prev Sci 15, 694–704 (2014). https://doi.org/10.1007/s11121-013-0421-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11121-013-0421-7