Long-term effects of the keepin’ it REAL model program in Mexico: substance use trajectories of Guadalajara middle school students
Open accessAbstract
In the face of rising rates of substance use among Mexican youth and rapidly narrowing gender differences in use, substance use prevention is an increasingly urgent priority for Mexico. Prevention interventions have been implemented in Mexico but few have been rigorously evaluated for effectiveness. This article presents the long term effects of a Mexico-based pilot study to test the feasibility of a linguistically specific (Mexican Spanish) adapted version of keepin' it REAL, a school-based substance abuse prevention model program. University affiliated researchers from Mexico and the US collaborated on the study design, program implementation, data collection, and analysis. Students and their teachers from two middle schools (secundarias) in Guadalajara participated in this field trial of Mantente REAL (translated to Spanish). The schools were randomly assigned to treatment and control conditions. The sample of 431 students reported last 30 day substance use at three times (one pretest and two posttests). Changes in substance use behaviors over time were examined using growth curve models. Long term desired intervention effects were found for alcohol and marijuana use but not for cigarettes. The intervention effects were greater for girls than for boys in slowing the typical developmental increase over time in alcohol use. Marijuana effects were based on small numbers of users and indicate a need for larger scale studies. These findings suggest that keepin' it REAL is a promising foundation for cultural program adaptation efforts to create efficacious school-based universal prevention interventions for middle school students in Mexico.
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Of the health promotion and education RCTs, 2 were based in the workplace, 5 in the community, 6 in schools, and 7 in clinics, of which 1 focused on women sex workers.
“Of these, 2 were based in the workplace [26,38], 5 in the community [23,37,43,84], 6 in schools [33,40,65,85,86], and 7 in clinics [39,55–57], of which 1 was focused on women sex workers [95].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [65]
About half (8 of 17) of the health promotion and education interventions were found to have positive results.
“About half (8 of 17) of the health promotion and education interventions were found to have positive results [25,26,38,39,54,56,57,65,66,84].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [65]
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- Marsiglia FF Hecht ML 2005 Keepin’ it REAL: An evidence-based program Santa Cruz ETR Associates PMC3043619 21359122
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- Authors
- Marsiglia, F. F., Kulis, S. S., Booth, J. M., Nuño-Gutierrez, B. L., & Robbins, D. E.
- Affiliations
- Arizona State University (US)
- Corresponding author
- Kulis, Stephen S.
- Venue
- The Journal of Primary Prevention
- Published
- 2014-11-22
- Volume
- 36
- Issue
- 2
- Pages
- 93-104
- ISSN
- 0278-095X (ISSN-L)
- 1573-6547
- PMC
- PMC4503325
- OpenAlex
- W2001147879
- Cited by
- 36
- References
- 29
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 10 · 2021: 5 · 2020: 3 · 2019: 5 · 2018: 2 · 2017: 1 · 2016: 1
- FWCI
- 0.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- The Journal of Primary Prevention (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Arizona State University Library Digital Repository (Arizona State University) (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA038657)
- National Institute on Minority Health and Health Disparities (P20MD002316)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Demography › Youth, Drugs, and Violence
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- keepin' it REAL, adolescent substance use, alcohol consumption, cannabis use, cigarette smoking, gender differences in substance use, program adaptation, Mexican Spanish, universal prevention, junior high school students, Guadalajara, long-term intervention effects
- MeSH terms
- Smoking Prevention, Adolescent, Alcohol Drinking, Feasibility Studies, Female, Humans, Male, Marijuana Smoking, Mexico, Pilot Projects, School Health Services, Smoking, Students, Time, Program Evaluation, Sex Distribution
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