Adaptation Processes in School-Based Substance Abuse Programs
Condition: Substance Use
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The goals of this study are to develop a middle school substance use prevention curriculum
      for underserved rural youth and evaluate its efficacy compared to the existing, multicultural
      curriculum. In addition, we are studying how the curricula get taught by the teachers.

      Hypothesis 1: When compared to students in the control condition, students in the treatment
      conditions will report less substance use, more conservative norms, less positive
      expectations about substance use outcomes, and better life and communication skills.

      Hypothesis 2: When compared to students in the control condition, students in the researcher
      adaptation condition will report less substance use, more conservative norms, less positive
      expectations, and better life and communication skills.

      Hypothesis 3: When compared to students in the control condition, students in the teacher
      adaptation condition will report less substance use, more conservative norms, less positive
      expectations, and better life and communication skills.

      Hypothesis 4: Researcher adaptation will have a greater impact on substance use, norms, and
      expectations than teacher adaptation.
    

Detailed description: 
      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. keepin' 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, "regrounded" 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.
    

Intervention name(s): Rural curriculum; Classic curriculum
Intervention type(s): Other; Other
Intervention description(s): Students in schools randomly assigned to this condition receive the rural version of the curriculum.; Students in schools randomly assigned to this condition receive the classic version of the curriculum.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: adolescent substance use; rural substance use; middle school prevention; implementation processes; implementation quality; adaptation of prevention curricula; dissemination