OVERALL EFFECTIVENESS

7,304 students in 35 middle schools were surveyed as part of the keepin' it REAL outcome study. The schools were randomly assigned to the keepin' it REAL curriculum or to the control group. Students completed a baseline and three follow-up questionnaires over a 2-year period. Analyses utilizing a generalized estimating equations approach assessed the overall effectiveness of cultural grounding and cultural matching. Support was found for the intervention's overall effectiveness, with statistically significant effects on gateway drug use, drug norms and attitudes, and resistance strategies.  Changes in the desired direction -- relative decreases in undesirable outcomes and increases in desirable outcomes -- resulted with the curriculum, across all three follow-up periods (T2, T3, and T4), controlling for baseline drug use and other variables and using multiple imputation techniques to account for missing data.  Students in the program reduced their alcohol use at a 72 percent higher rate and they discontinued use by 66 percent over a two year period. 

LATINO EFFECTIVENESS

Strong evidence found that KIR was particularly effective for more acculturated Latinos rather than their less acculturated counterparts who appear less at risk of substance use.  [Marsiglia, F.F., Kulis, S., Wagstaff, D.A., Elek, E. & Dran, D. (2005). Acculturation status and substance use prevention with Mexican and Mexican American youth.  Journal of Social Work Practice in the Addictions, 5(1/2), 85-111.  Reprinted in Mario de la Rosa, Lori Holleran, & S. Lala Ashenberg Straussner, (eds.), Substance abusing Latinos: Current research on epidemiology, prevention and treatment. Haworth Press, 2005.]

 GENDER EFFECTIVENESS

Results for the total sample of youths showed no gender differences in program effects on recent substance use, but the program was more effective in fostering boys' than girls' anti-drug norms.  Subgroup analyses demonstrated several more beneficial program effects for boys than girls (less alcohol and cigarette use and stronger anti-drug norms), but only among less acculturated Latinos.  There were no gender differences in program effects among more acculturated Latinos, nor among non-Latino whites. [Kulis, S., Yabikku, S., Marsiglia, F.F., Nieri, T., & Crossman, A.(2007). Differences by gender, ethnicity and acculturation in the efficacy of the keepin' it REAL model prevention program.  Journal of Drug Education, 37(2), 23-144.]

REPORTED SUBSTANCE USERS EFFECTIVENESS

The effectiveness of KIR was examined among youth reporting substance use at baseline.  Discrete-time event history methods modeled the rates of reduced and recently discontinued use across four waves of data.  Each substance was modeled separately.  Beginning at wave 2, participants who reported use at wave 1 were considered at risk of reducing or discontinuing use.  Results indicated that prevention program participation influenced the rates of reduced and recently discontinued use only for alcohol, controlling for baseline use severity, age, grades, socioeconomic status, ethnicity and gender.  Among youth who reported use of alcohol in wave 1 (N=1,028), the rate of reducing use for program participants was 72% higher than the rate for control students.  The rate of discontinuing use was 66% higher than the rate for control students.  Among youth who reported use of one or more of the three substances in wave 1 (N=1,364), the rate of discontinuing all use was 61% higher for program participants than for control students. [Kulis, S., Nieri, T., Yabiku, S., Stromwall, L., & Marsiglia, F.F. (2007).  Promoting reduced and discontinued substance use among adolescent substance users: Effectiveness of a universal prevention program. Prevention Science, 8(1), 35-49.]

MEXICAN/MEXICAN AMERICAN ADOLESCENTS EFFECTIVENESS

A randomized trial tested the eficacy of three curriculum versions teaching drug resistance strategies, one modeled on Mexican American culture; another modeled on European American and African American culture and a multicultural version.  Students in the multicultural version reported less alcohol, marijuana and overall substance use. [Kulis, S., Marsiglia, F.F., Elek, E., Dustman, P., Wagstaff, D., & Hecht, M. (2005). Mexican/Mexican American adolescents and keepin' it REAL: An evidence-based substance use prevention program. Children and Schools, 27(3), 133-145.]