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Randomized Controlled Trial
. 2021;56(2):245-257.
doi: 10.1080/10826084.2020.1858103. Epub 2020 Dec 21.

Testing a Culturally Adapted Youth Substance Use Prevention Program in a Mexican Border City: Mantente REAL

Stephen S Kulis  1   2 , Hilda Garcia-Perez  3 , Flavio F Marsiglia  1   4 , Stephanie L Ayers  1
Affiliations
Randomized Controlled Trial

Testing a Culturally Adapted Youth Substance Use Prevention Program in a Mexican Border City: Mantente REAL

Stephen S Kulis et al. Subst Use Misuse. 2021.

Abstract

Background: This article reports on a test of a youth substance use prevention program conducted in Nogales-Sonora, a Mexican city on the US border. Objective: The study tested the efficacy of a version of the keepin' it REAL curriculum for middle school students that was culturally adapted for Mexico and renamed Mantente REAL. Methods: Students in 7th grade classrooms in four public schools participated in the study (N = 1,418, 49% female, mean age = 11.9). Using a clustered randomized design, two schools received the intervention and two served as a treatment-as-usual control group. Regular classroom teachers were trained to deliver the twelve-lesson Mantente REAL manualized curriculum. Parents provided active consent and students gave written assent to collect pretest and posttest questionnaire data, 7 months apart, at the beginning and end of the 2017-2018 academic year. We assessed the Mantente REAL intervention with general linear models adjusted for baseline, attrition, non-linear distributions, and school-level clustering. Results: Students who participated in Mantente REAL reported relatively less frequent use of alcohol and illicit drugs other than marijuana, compared to students in control schools. Males alone reported desirable intervention effects for marijuana use. These desirable effects were especially strong among students who reported higher initial levels of involvement in risky behaviors. Among students more at risk, both females and males receiving the program reported relative reductions in the frequency of use of alcohol and illicit drugs. Conclusions: These promising results within the Mexico-US border context support a further dissemination of the intervention and additional youth prevention research in the region.

Keywords: Border; Mexico; Substance use; cultural adaptation; prevention; youth.

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Conflict of interest statement

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Figures

Figure 1.
Figure 1.
Participants in the Mantente REAL efficacy trial in Nogales, Mexico.
Figure 2.
Figure 2.
Posttest alcohol frequency by risk behavior score at pretest, intervention condition, and gender*. *Predicted last 30 day alcohol frequency at post-test; risk level at pretest provided at 1 SD intervals.
See this image and copyright information in PMC

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