Although larger trials with a more representative sample of schools are needed, the study suggests the potential for kiR as an effective approach for substance use prevention in Kenya.
A convenience ...sample of primary schools in metropolitan Nairobi was randomized into an intervention or control group. Teachers in intervention schools were trained to deliver the kiR curriculum with fidelity. Students in seventh and eighth grades in the intervention and control schools (N = 533) completed pretest and posttest questionnaires assessing substance use behaviors, attitudes, and drug resistance strategies.
Although many primary school students in Kenya report use of alcohol and other drugs, evidence-based prevention interventions for schools are generally unavailable. Globally, there are growing opportunities to conduct research that assesses whether efficacious interventions from elsewhere can be adopted for new settings and populations. This small pilot study implemented and evaluated a linguistically adapted version of the school-based keepin' it REAL (kiR) universal substance use prevention program from the United States in Kenyan primary schools to assess its effectiveness and estimate potential effect sizes.
Relative to the control group, kiR students reported several desired changes in behaviors and attitudes: less recent alcohol use and heavy (binge) alcohol drinking, and continuing or increased adherence to certain anti-drug norms. There was partial evidence that kiR helped students rely less on conflictual drug resistance strategies, such as reacting to substance offers angrily or with violence. Effect sizes for these outcomes compare favorably to those obtained in other school-based prevention interventions.
This article reports on the findings of a study of the relationship between transnational experiences in the United States (US) and the use of alcohol, tobacco, and marijuana among 7th grade students ...(
= 1418). The study was guided by a cross-national framework for research on immigrant health and assessed the accumulation of risk factors for transnational adolescents. Data came from a survey conducted in 2017 in Nogales, Mexico. In this study, the last 30-day prevalence of use of alcohol, tobacco, and marijuana among students was 21.7%, 8.3%, and 2.4%, respectively. Most students were born in Nogales (69.6%), while 10.5% were born in the US, 7.5% attended school in the US, and 3.6% engaged in health-related risk behaviors while living in or visiting the US. Students with transnational experiences, such as attending school in the US, reported the highest 30-day prevalence of tobacco (13.3%) and marijuana (9.5%) use. After adjusting for family, school, access to substances and neighborhood violence variables, students who engaged in health-related risk behavior in the US had significantly increased odds of alcohol and marijuana use while later attending school in Mexico. The article discusses the findings from a prevention science perspective and provides implications for policy, practice, and future research on the Mexico-US border region.
This article reports on effects of two earthquakes in Mexico on adolescents attending middle school. The earthquakes struck in close succession during the implementation of a school-based prevention ...program, providing an opportunity to assess emotional distress due to the earthquakes and whether the life skills taught in the program affected how students coped with the natural disaster. The objectives were to (1) evaluate the earthquakes’ impact on students’ distress; (2) assess if distress is associated with internalizing symptomology and externalizing behaviors; and (3) investigate if students receiving the original and adapted versions of the intervention coped better with the events. A Mexico-US research team culturally adapted
keepin’ it REAL
to address connections between substance use among early adolescents in Mexico and exposure to violence. A random sample of public middle schools from three cities (Mexico City, Guadalajara, and Monterrey), stratified by whether they held morning or afternoon sessions, was selected. A total of 5522 7th grade students from 36 schools participated in the study. Students answered pretest and posttest questionnaires; the latter assessed earthquake-related distress and coping strategies. Earthquake-related distress was associated with all measures of undesired internalizing symptomology and externalizing behaviors. Compared to controls, students in the adapted intervention reported less aggressive and rule-breaking externalizing behavior and less violence perpetration. However, these intervention effects were not moderated by the level of earthquake-related distress, and they were not mediated by positive or negative coping. The findings have implications for prevention intervention research and policy as natural and human-made disasters occur more often.
When testing longitudinal effects of parenting practices on adolescent adjustment, an integrated consideration of externalizing and internalizing behaviors is a gap in research. This study analyzed ...how parental support and parental knowledge directly and indirectly influence both antisocial behavior and emotional problems. The sample had 642 adolescents aged 12-15 (mean age = 12.49; 45.4% females) from Spain, who participated in a three-year long study. The results showed longitudinal bidirectional associations between parental support and parental knowledge. Only parental knowledge, however, directly predicted antisocial behavior and emotional problems. Parental support had an indirect effect on outcomes through the mediating effect of parental knowledge. This study has practical implications by indicating that increasing parental knowledge should be the target of educational-prevention programs.
Background: This article reports on a test of a youth substance use prevention program conducted in Nogales-Sonora, a Mexican city on the US border. Objective: The study tested the efficacy of a ...version of the keepin' it REAL curriculum for middle school students that was culturally adapted for Mexico and renamed Mantente REAL. Methods: Students in 7th grade classrooms in four public schools participated in the study (N = 1,418, 49% female, mean age = 11.9). Using a clustered randomized design, two schools received the intervention and two served as a treatment-as-usual control group. Regular classroom teachers were trained to deliver the twelve-lesson Mantente REAL manualized curriculum. Parents provided active consent and students gave written assent to collect pretest and posttest questionnaire data, 7 months apart, at the beginning and end of the 2017-2018 academic year. We assessed the Mantente REAL intervention with general linear models adjusted for baseline, attrition, non-linear distributions, and school-level clustering. Results: Students who participated in Mantente REAL reported relatively less frequent use of alcohol and illicit drugs other than marijuana, compared to students in control schools. Males alone reported desirable intervention effects for marijuana use. These desirable effects were especially strong among students who reported higher initial levels of involvement in risky behaviors. Among students more at risk, both females and males receiving the program reported relative reductions in the frequency of use of alcohol and illicit drugs. Conclusions: These promising results within the Mexico-US border context support a further dissemination of the intervention and additional youth prevention research in the region.
This study assesses the efficacy of a version of the
keepin’ it REAL
(
kiREAL
) substance use prevention curriculum for middle school students that was culturally adapted for Mexico, renamed
Mantente ...REAL
(
MREAL
), and tested in a cluster randomized controlled trial in Mexico’s three largest cities. Student participants were in 7th grade in public middle schools (
N
= 5523, 49% female, mean age = 11.9). A representative sample of 12 schools from each city, stratified by whether they held morning or afternoon sessions, was randomized to three conditions: culturally adapted
MREAL
, original
kiREAL
translated into Spanish, or a treatment-as-usual control group. Regular classroom teachers were trained to deliver the adapted
MREAL
or the
kiREAL
manualized curricula. Students with active parental consent completed pretest and post-test questionnaires, 7–8 months apart, at the beginning and end of the 2017–2018 academic year. We assessed the
MREAL
intervention, relative to
kiREAL
and controls, with general linear models adjusted for baseline, attrition (24%), non-normal distributions, stratification by city, and school-level clustering. Among students already using the substance more often at pretest,
MREAL
students had relatively more desirable outcomes, compared to
kiREAL
and/or to controls, in recent use of alcohol, cigarettes, “hard drugs,” heavy episodic drinking, and intoxication.
MREAL
students reported relatively less violence victimization and perpetration of bullying and relatively more use of three of the intervention’s REAL drug resistance strategies (Explain, Avoid, Leave). The adapted version of
kiREAL
for Mexico showed numerous desired outcomes in areas deliberately targeted in the cultural adaptation. Full protocol can be accessed through Clinical Trials.gov. ID: NCT03233386, “‘Keepin’ It REAL in Mexico: An adaptation and multisite RCT”
This article describes a test in Guatemala City of
Mantente REAL
, a linguistically adapted version of the
keepin’ it REAL
universal substance use prevention curriculum for early adolescents that ...teaches culturally grounded drug resistance, risk assessment, and decision making skills. Academic researchers collaborated with a local non-profit to recruit and randomize 12 elementary schools in Guatemala City to intervention and comparison conditions. Regular classroom teachers were trained to deliver the ten-lesson
Mantente REAL
(MR) manualized curriculum to sixth-grade students. Parents provided passive consent and students gave active assent for data collection, which occurred between February 2013 and September 2014. Two academic year cohorts of students participated (
n
= 676; 53% male; M age = 12.2). All students completed a pretest questionnaire before the curriculum lessons began in intervention schools and a posttest (87% matched) 4 months later, 1 month after the final lesson. We assessed the
MR
intervention with paired
t
tests, effect sizes (Cohen’s
d
), and general linear models adjusted for baseline, attrition, non-linear distributions, and school-level clustering. Results indicated that
MR
can be an effective school-based prevention approach in Guatemala. The
MR
participants reported pretest-to-posttest changes in desirable directions on substance use behaviors, attitudinal antecedents of substance use, and acquisition of drug resistance skills. The comparison group generally changed in undesirable directions. In linear models, the MR participants, relative to the comparison group, reported less cigarette and marijuana use, less positive drug use expectancies, and greater use of drug resistance skills. Intervention effect sizes were between .2 and .3.
This article explores the interconnected spiritual, religious, and cultural worlds of the majority of American Indian (AI) youth who live in urban areas: their patterns of involvement in religion and ...Native spirituality and associated well-being. Latent class analysis of data from 205 AI middle school students identified five distinctive classes using survey measures of religious affiliation, attendance at services, adherence to Christian and traditional spiritual beliefs, Native spirituality, and Native cultural practices. Two classes were Christian groups: one attending Christian churches and following Christian beliefs but uninvolved with Native beliefs, spirituality, or cultural practices; and a nominal Christian group affiliated with but not attending church and unattached to belief systems. Two groups followed Native beliefs and spiritual practices, one affiliated with the Native American Church and another unaffiliated with any church. The fifth, nonreligious group, had no religious affiliation, followed neither Christian nor traditional beliefs, and was uninvolved in Native spirituality and cultural practices. The two groups embracing AI spirituality reported better academic performance, more reservation contact, higher AI enculturation, and stronger bicultural orientations.
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