Keepin’ It REAL—Mantente REAL in Mexico: a Cluster Randomized Controlled Trial of a Culturally Adapted Substance Use Prevention Curriculum for Early Adolescents

A systematic review of the effect of the school-based drug prevention program Keepin’ it REAL: translated and implemented in Brazil by PROERD

“…kiR-Plus (developed to deal with the transition period that adolescents go through) and kiR Acculturation Enhanced -kiR-AE (developed especially for Hispanic students in the process of acculturation in the USA) were also developed for both 5 th -and 7 th -grade students 8,21 . In addition, four more versions were created for 7 th -grade students: a version to be applied in rural areas 22 ; a version for American indigenous peoples (Living in 2 Worlds) 23 ; a version culturally adapted for Mexicans (Mantente Real Mexico) [24][25][26][27] , and another version culturally adapted for the Spanish people (Mantente Real España). There is also Mantente Real version that was only translated into the Spanish language and not adapted, which was applied to 6 th -grade students in Guatemala 28 .…”

“…Two articles reported short and longterm results of another RCT carried out in the city of Guadalajara, Mexico, to evaluate the MR version already culturally adapted for 7 th -and 8 th -grade Mexican students 24,25 . The Mexican MR also had two other RCTs conducted more recently (2017-2018) with 7 th -grade students, with two different samples 26,27 . Finally, a recent pilot study (2021), conducted in two cities in Spain, evaluated the effect of the MR version adapted for the Spanish students 33 .…”

“…The results of the two RCTs that evaluated the kiR version directed at 5th-grade students showed that the program does not seem to be effective in reducing drug use by students 8,10,20 . On the other hand, except for the Brazilian study (PROERD/Caindo na Real), the results of other RCTs (n=8) that evaluated the curriculum for 7 th -8 th -grade students, in the different versions (Mexican/Mexican American, Black/White, multicultural, kiR-Plus, kiR-AE, Mantente Real, Living in 2 Worlds, and kiR for rural areas) showed a positive effect on reducing episodes of alcohol intoxication 33 , use of alcohol 25,26,28,29,31,33 , cigarettes [22][23][24]28,31 , marijuana 22,25,26,28,29 , and other illicit drugs in the last 30 days 26,27 . Positive results of the 7th-grade curriculum were also evidenced among those young people who, before starting the intervention, already reported using alcohol and/or other drugs 27,32,33 , as well as among those who presented risky behaviors 26 .…”

“…Of the three studies that evaluated the kiR effect on violence outcomes 23,28 , the only version that showed positive results was MR, which proved to be effective in reducing bullying episodes 27 .…”

“…The studies that carried out comparisons between the adapted versions and the originals showed that using the adapted version is always more effective 22,23,27 .…”