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Long-Term Effects of the keepin’ it REAL Model Program in Mexico: Substance Use Trajectories of Guadalajara Middle School Students

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Abstract

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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Acknowledgments

Data collection for this study was made possible through international research support provided by Arizona State University and by the in-kind support provided by the Instituto Mexicano de Seguro Social (IMSS). Data analysis and manuscript development were supported by the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health (NIH Grant P20MD002316, to Flavio F. Marsiglia, principal investigator). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of Arizona State University, the IMMS, NIMHD or the NIH .

Conflict of interest

The authors have no conflict of interest.

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Authors and Affiliations

  1. School of Social Work, Arizona State University, Phoenix, AZ, USA

    Flavio F. Marsiglia

  2. T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA

    Stephen S. Kulis

  3. Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA

    Jaime M. Booth & Danielle E. Robbins

  4. Mexican Social Security Institute, University of Guadalajara, Guadalajara, Mexico

    Bertha L. Nuño-Gutierrez

Authors
  1. Flavio F. Marsiglia
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  2. Stephen S. Kulis
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  3. Jaime M. Booth
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  4. Bertha L. Nuño-Gutierrez
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  5. Danielle E. Robbins
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Correspondence to Stephen S. Kulis.

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Marsiglia, F.F., Kulis, S.S., Booth, J.M. et al. Long-Term Effects of the keepin’ it REAL Model Program in Mexico: Substance Use Trajectories of Guadalajara Middle School Students. J Primary Prevent 36, 93–104 (2015). https://doi.org/10.1007/s10935-014-0380-1

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