Short-Term Effects on Substance Use of the Keepin’ It REAL Pilot Prevention Program: Linguistically Adapted for Youth in Jalisco, Mexico

Abstract

This article presents the short-term effects of a pilot study of keepin' it REAL(Manténte REAL) conducted in central Mexico by a bi-national 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 post-test 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.

Binge drinking by gender and race/ethnicity among California adults, 2007/2009

“…Although not directly related to binge drinking, a ''Keepin'it REAL'' intervention to prevent substance abuse was translated and tested in Mexican public schools. Researchers found modest, but statistically significant, effects for females and a conclusion was that comprehensive cultural adaptation may be needed in addition to linguistic translation to achieve full effectiveness (37). Finally, it seems reasonable to recommend, too, that efforts to curtail binge drinking be coordinated with initiatives to reduce overall alcohol consumption; the majority of binge drinkers, in fact, may be considered moderate drinkers (e.g.…”

The Association between Engaging in Romantic Relationships and Mexican Adolescent Substance Use Offers: Exploring Gender Differences

“…A more dramatic increase in 30-day use was observed for females (2.7%-11.6%) when compared to males (11.5%-17.4%) (Medina-Mora Address correspondence to Jaime M. Booth, Arizona State University, Phoenix, AZ, USA; E-mail: jmbooth2@asu.edu et al, 2012). In Jalisco, Mexico, gender gaps in substance use have been consistent with the national averages in the past decade (Medina-Mora, Borges, Muñiz, Benjet, & Jaimes, 2003;Ortiz, Soriano, Meza, Martinez, & Galván, 2006); however, emerging evidence suggests that adolescent Mexican females are using substances at the same (Villatoro et al, 2009) or at higher rates than their male counterparts (Marsiglia et al, 2012). These trends may be a function of substance offers and availability.…”

The Impact of a Substance Use Prevention Program on the Health Literacy of Youth in Guatemala City

“…; 0 = almost never have enough money, 3 = almost always have enough money), grades (0 = mostly D's or lower, to 3 = mostly A's), and educational attainment of the most highly educated parent (0 = did not finish elementary, to 4 = college degree). Each of these variables has been shown to be correlated with HL, and has been used in previous studies with Spanish speaking youth populations (Marsiglia et al, 2014;Trout, Hoffman, Epstein, & Nelson, 2014). T-tests were used to compare participants in the treatment and control groups, and Cohen's d effect sizes were computed for each item.…”

“…While culturally-tailored interventions specifically targeting HL are not likely to appear in Guatemala for some time given the country's need to attend to more pressing challenges, there are educational intervention programs currently being implemented that do focus on some aspects of health. One such program that is being used and has been implemented throughout the world is the Keepin' it REAL (KiR) substance use prevention program (Marsiglia et al, 2014). KiR is recognized as a model program on the National Registry of Effective Programs and Practices in the US, and has been culturally-tailored and adapted for use in countries throughout the world, including Spanish speaking countries such as Mexico (Marsiglia et al, 2014).…”

“…One such program that is being used and has been implemented throughout the world is the Keepin' it REAL (KiR) substance use prevention program (Marsiglia et al, 2014). KiR is recognized as a model program on the National Registry of Effective Programs and Practices in the US, and has been culturally-tailored and adapted for use in countries throughout the world, including Spanish speaking countries such as Mexico (Marsiglia et al, 2014). The KiR program emphasizes four resistance strategiesrefuse, explain, avoid, and leave (REAL).…”