Adaptation Processes in School-based Substance Abuse Prevention
Condition: Substance Abuse Problem
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The purpose of this study is to determine if a new substance use prevention curriculum for
      rural middle schools is effective in reducing substance use and to study how prevention
      curriculum get implemented by teachers.
    

Detailed description: 
      The goals of the proposed study are to conduct an effectiveness trial of the keepin' it REAL
      (refuse, explain, avoid, leave) 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
      (Substance Abuse and Mental Health Services Administration'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, "re-grounded" in the rural culture of Pennsylvania and Ohio,
      while studying how teachers adapt both versions. This proposal responds to NIDA (National
      Institute on Drug Abuse) PA-05-118 (Program Announcement), 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, 39 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 post-tests 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, test of a mediation model, and growth modeling.
    

Intervention name(s): keepin' it REAL classic; keepin' it REAL rural; control
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): keepin' it REAL consists of 10 classroom lessons implemented in 7th grade and 4 booster sessions implemented in 8th grade by the classroom teacher following training; keepin' it REAL rural drug prevention curriculum consists for 10 lessons taught in 7th grade and 4 booster sessions taught in 8th grade.; control group continues to teach whatever prevention curriculum they were using prior to study
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: rural adolescents, substance use, prevention, adaptation