Cited by 383Substance Abuse Treatment and OutcomesYouth, Drugs, and ViolenceCrime Patterns and Interventions

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Culturally Grounded Substance Use Prevention: An Evaluation of the keepin' it R.E.A.L. Curriculum

Hecht, Michael L., Marsiglia, Flavio Francisco, Elek, Elvira, Wagstaff, David A., Kulis, Stephen, Dustman, Patricia, Miller-Day, Michelle·2003·Prevention Science

DOI 10.1023/a:1026016131401

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Abstract

This paper reports on the evaluation of a culturally grounded prevention intervention targeting substance use among urban middle-school students. The curriculum consists of 10 lessons promoting antidrug norms and teaching resistance and other social skills, reinforced by booster activities and a media campaign. Three versions were delivered: Mexican American, combined African American and European American, and Multicultural. Thirty-five middle schools were randomly assigned to 1 of the 3 versions or the control. Students completed baseline and follow-up questionnaires over a 2-year period (total 6,035 respondents). Analyses utilizing a generalized estimating equations approach assessed the overall effectiveness of cultural grounding and the cultural matching hypothesis. Support was found for the intervention's overall effectiveness, with statistically significant effects on gateway drug use as well as norms, attitudes, and resistance strategies but with little support for the cultural matching hypothesis. Specific contrasts found the Mexican American and Multicultural versions impacted the most outcomes.

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Foreword
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Preface
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Impaired Physicians
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Alcohol Use Disorders
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Health and social services for drug users
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Supply control
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Index
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Summary and conclusions
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Substance Abuse
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Preventing illicit drug use by young people
Babor, T. F., Caulkins, J. P., Edwards, G., Fischer, B., Foxcroft, D., Humphreys, K. N., Obot, I. S., Rehm, J. T., Reuter, P., Room, R., et al. (2009) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199557127.003.008
Author Preface
(2009) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199557127.002.0005
Preface
(2009) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199557127.002.0004
Contributors
(2009) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199557127.002.0007
Appendix
(2009) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199557127.005.01
Copyright Page
(2009) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199557127.002.0003
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“It has a strong evidence base for strengthening anti-substance norms and delaying onset of use (Hecht et al., 2003). ki R is based on communication theory and the original intervention is grounded in the Mexican-American culture of the Southwest U.S. (Gosin et al., 2003).”
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“A central goal of HP is to teach students resistance skills to respond to drug offers in a way that is relevant to their community and cultural background [17].”
A Systematic Review and Narrative Synthesis of Barriers and Facilitators for the Implementation of School-based Substance Misuse Prevention Programmes
Fitzgerald, A., James, P. D., Hollywood, E., Comiskey, C. M., Reilly, R., Annunziata, K. N., & Kelly, P. (2026) · Global Implementation Research and Applications · doi:10.1007/s43477-026-00235-4
Discrimination and early substance use among racial-ethnically minoritized youth: Self-reports and hair samples
Wang, Y., Zhang, Y., Yan, J., Huang, Q., Jelsma, E. B., Zhao, Z., Zhao, J., Cham, H., Alegria, M. M., & Yip, T. (2026) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2026.113372

Authors: Hecht, M. L., Marsiglia, F. F., Elek, E., Wagstaff, D. A., Kulis, S., Dustman, P., & Miller-Day, M.
Affiliations: Pennsylvania State University (US)
Arizona State University (US)
Corresponding author: Hecht, Michael L.
ORCID: Hecht, Michael L.
Marsiglia, Flavio Francisco
Elek, Elvira
Kulis, Stephen
Miller-Day, Michelle
Venue: Prevention Science
Publisher: Springer Science and Business Media LLC
Published: 2003-12
Volume: 4
Issue: 4
Pages: 233-248
ISSN: 1389-4986 (ISSN-L)
1573-6695
DOI: 10.1023/a:1026016131401
OpenAlex: W1577230560
Cited by: 383
References: 69
Citations by year: 2026: 6 · 2025: 5 · 2024: 7 · 2023: 11 · 2022: 17 · 2021: 7 · 2020: 48 · 2019: 16 · 2018: 16 · 2017: 16 · 2016: 22 · 2015: 14 · 2014: 15 · 2013: 26 · 2012: 20
FWCI: 5.85
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Prevention Science (publishedVersion)
PubMed (publishedVersion)
Funders: Centers for Disease Control and Prevention
National Institute on Drug Abuse (R01 DA 05629, R01DA005629)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Youth, Drugs, and Violence
Social Sciences › Sociology and Political Science › Crime Patterns and Interventions
Keywords: substance use prevention, cultural grounding, Mexican American students, African American students, European American students, junior high school students, resistance strategies, social skills, media campaigns, multicultural curriculum
MeSH terms: Adolescent, Culture, Curriculum, Ethnicity, Health Education, Humans, Surveys and Questionnaires, School Health Services, United States, Program Evaluation, Substance-Related Disorders, Self Efficacy

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Culturally Grounded Substance Use Prevention: An Evaluation of the keepin' it R.E.A.L. Curriculum

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