The goals of the proposed study are to conduct an effectiveness trial of the keepin'it REAL middle school substance use prevention curriculum among a new target audience in rural Pennsylvania and Ohio, describe how teachers adapt the curriculum when they present it, and develop, implement, and evaluate a Pennsylvania/Ohio-version of the curriculum to test whether an evidence-based universal curriculum can be improved by adapting it to local cultures. keeping'it REAL is recognized as a model program by SAMHSA's National Registry of Effective programs and is one of the few that are multicultural. The study will evaluate the effectiveness of the original curriculum, grounded in the cultures of the southwest and compare that to a new version, reground in the rural culture of Pennsylvania and Ohio, while studying how teachers adapt both versions. This proposal responds to NIDA PA-05-118, Drug Abuse Prevention Intervention Research that calls for investigations addressing, 1) the development of novel drug abuse prevention approaches;2) the efficacy and effectiveness of newly developed and/or modified prevention programs;3) the processes associated with the selection, adoption, adaptation, implementation, sustainability, and financing of empirically validated interventions. This proposal addresses all three points. A randomized control trial will be conducted in middle schools to accomplish these goals. First, formative research will be conducted to develop a rural Pennsylvania/Ohio-version of the curriculum. Second, 42 rural schools will be randomly assigned to one of three conditions: teacher adaptation in which the original keepin'it REAL curriculum is implemented;researcher adaptation in which a new Pennsylvania-version of the curriculum is implemented, and a control group. We hypothesized the participation in either form of the curriculum will reduce drug use and that the researcher adaptation will produce better outcomes and less teacher adaptation than the teacher adaptation. A pretest will be administered followed by posttests in 7-9th grades. Adaptation and fidelity will be measured in 3 ways: teachers completing a Program Quality and Adaptation online measure after each lesson, videotaped lessons, and attendance. The major hypothesis tests will be conducted using variants of the general linear model, taking into account the multilevel structure of the data (e.g., multilevel multiple regression), test of a mediation model, and growth modeling. The development of effective school-based substance use prevention programs has given rise to a recent focus on implementation issues. This study will help us understand how to implement programs beyond their original target audience as well as how to guide teachers when they adapt curriculum to their classes.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-HOP-X (04))
Program Officer
Sims, Belinda E
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Pennsylvania State University
Other Health Professions
Schools of Arts and Sciences
University Park
United States
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Miller-Day, Michelle; Hecht, Michael L; Krieger, Janice L et al. (2015) Teacher Narratives and Student Engagement: Testing Narrative Engagement Theory in Drug Prevention Education. J Lang Soc Psychol 34:604-620
Pettigrew, Jonathan; Graham, John W; Miller-Day, Michelle et al. (2015) Adherence and delivery: implementation quality and program outcomes for the seventh-grade keepin' it REAL program. Prev Sci 16:90-9
Ebersole, Diana S; Miller-Day, Michelle; Raup-Krieger, Janice (2014) Do Actions Speak Louder Than Words?: Adolescent Interpretations of Parental Substance Use. J Fam Commun 14:328-351
Choi, Hye Jeong; Krieger, Janice L; Hecht, Michael L (2013) Reconceptualizing efficacy in substance use prevention research: refusal response efficacy and drug resistance self-efficacy in adolescent substance use. Health Commun 28:40-52
Pettigrew, Jonathan; Miller-Day, Michelle; Shin, Youngju et al. (2013) Describing teacher-student interactions: a qualitative assessment of teacher implementation of the 7th grade keepin' it REAL substance use intervention. Am J Community Psychol 51:43-56
Colby, Margaret; Hecht, Michael L; Miller-Day, Michelle et al. (2013) Adapting school-based substance use prevention curriculum through cultural grounding: a review and exemplar of adaptation processes for rural schools. Am J Community Psychol 51:190-205
Moreland, Jennifer J; Raup-Krieger, Janice L; Hecht, Michael L et al. (2013) The conceptualization and communication of risk among rural appalachian adolescents. J Health Commun 18:668-85
Choi, Hye Jeong; Smith, Rachel A (2013) Members, isolates, and liaisons: meta-analysis of adolescents' network positions and their smoking behavior. Subst Use Misuse 48:612-22
Greene, Kathryn; Hecht, Michael L (2013) Introduction for symposium on engaging youth in prevention message creation: the theory and practice of active involvement interventions. Health Commun 28:641-3
Krieger, Janice L; Coveleski, Samantha; Hecht, Michael L et al. (2013) From kids, through kids, to kids: examining the social influence strategies used by adolescents to promote prevention among peers. Health Commun 28:683-95

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