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)
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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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Hecht, Michael L; Shin, YoungJu; Pettigrew, Jonathan et al. (2018) Designed Cultural Adaptation and Delivery Quality in Rural Substance Use Prevention: an Effectiveness Trial for the Keepin' it REAL Curriculum. Prev Sci 19:1008-1018
Shin, YoungJu; Pettigrew, Jonathan; Miller-Day, Michelle et al. (2018) Trends of Parent-Adolescent Drug Talk Styles in Early Adolescence. Health Commun :1-10
Shin, YoungJu; Miller-Day, Michelle; Hecht, Michael L (2018) Differential Effects of Parental ""drug talk"" Styles and Family Communication Environments on Adolescent Substance Use. Health Commun :1-9
Shin, YoungJu; Miller-Day, Michelle; Hecht, Michael L et al. (2018) Entertainment-Education Videos as a Persuasive Tool in the Substance Use Prevention Intervention ""keepin' it REAL"". Health Commun 33:896-906
Pettigrew, Jonathan; Miller-Day, Michelle; Shin, YoungJu et al. (2018) Parental Messages about Substance Use in Early Adolescence: Extending a Model of Drug-Talk Styles. Health Commun 33:349-358
Choi, Hye Jeong; Miller-Day, Michelle; Shin, YoungJu et al. (2017) Parent Prevention Communication Profiles and Adolescent Substance Use: A Latent Profile Analysis and Growth Curve Model. J Fam Commun 17:15-32
Choi, Hye Jeong; Hecht, Michael; Smith, Rachel A (2017) Investigating the Potential Impact of Social Talk on Prevention Through Social Networks: the Relationships Between Social Talk and Refusal Self-Efficacy and Norms. Prev Sci 18:459-468
Shin, YoungJu; Miller-Day, Michelle (2017) A Longitudinal Study of Parental Anti-Substance-Use Socialization for Early Adolescents' Substance-Use Behaviors. Commun Monogr 84:277-297
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

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