Bertha Lidia Nuño-Gutiérrez

Short-Term Effects on Substance Use of the Keepin' It REAL Pilot Prevention Program: Linguistically Adapted for Youth in Jalisco, Mexico

This article presents the short-term effects of a pilot study of keepin’it REAL (Manténte REAL) conducted in central Mexico by a binational team of investigators. This middle school-based model program for preventing substance use was adapted for Mexico linguistically but not culturally. Two Guadalajara public middle schools were recruited and randomly assigned to either implement the prevention program or serve as a control site. The program was implemented in the treatment site by the students’ regular teachers, who were trained by the research team. Seventh graders in ten classrooms in the treatment and control schools (N = 432) completed a pretest and posttest survey in Spanish similar to the survey utilized in the original efficacy trial of keepin’it REAL in the US. T-tests and OLS regressions were conducted to determine the effects of the intervention on substance use outcomes. Differences between treatment and control groups in frequency of use of alcohol and tobacco, the two substances of choice in this sample, were significant and in the desired direction. Differences in amount of use were also in the preferred direction but were not significant for alcohol and only marginally significant for tobacco. When the sample was split by gender, statistically significant treatment effects remained for females but were not observed among males. Effects of the linguistically adapted version of keepin’it REAL appears to be driven by the change in female use; however, the difference in male and female outcomes was not statistically significant. Implications for cultural adaptation and prevention in Mexico are discussed from a communication competency perspective. The promising results of the pilot study suggest that the linguistic adaptation was effective, but that a comprehensive cultural adaptation of keepin’it REAL in partnership with Mexican investigators and communities may be warranted.

Gender Differences in Drug Resistance Skills of Youth in Guanajuato, Mexico

Research is limited or absent on Mexican adolescents’ exposure to substance offers, ways of dealing with these offers, and possible gender differences in responses to offers. Extending U.S.-based research, this study examines how youth living in the Mexican state of Guanajuato employ the four drug resistance strategies—refuse, explain, avoid, and leave—that are part of the Keepin’ It REAL evidence-based drug prevention intervention. The analysis uses cross-sectional survey data from 702 students enrolled in eight alternative secondary education sites in 2007. Participants reported the drug resistance behaviors they used to deal with offers of alcohol, cigarettes, and marijuana. Using multivariate regression, findings indicate most youth had developed repertoires of drug resistance strategies that involved multiple REAL strategies and some other strategy as well. For those receiving offers, the most common strategy was to refuse the offer with a simple “no.” However, males used all the strategies significantly more often than females for situations involving cigarettes and marijuana as well as when using refuse and non-REAL strategies for alcohol. Possible reasons for the gender difference in use of strategies are discussed. The findings can help inform effective prevention programs based on teaching culturally appropriate drug resistance and communication skills.

La representación social que orienta las decisiones paternas al afrontar el consumo de drogas de sus hijos

Objective. To identify the social representation guiding decisions of parents of teenage drug users to face consumption of their children. Material and Methods. A qualitative study using free lists, characterization questionnaires, and in-depth interviews was performed among 60 systematically selected parents of young drug users who were receiving treatment in Centros de Integracion Juvenil. Data analysis included correlations and interpretive analysis. Results.stages were identified: 1) discovery of the addiction, characterized by parental disappointment; 2) permanence: The highest in duration, resource investment, and losses; and 3) withdrawal: Featured by seeking health services. Conclusions. The representation that guided parental decisions was “the offer of a better world”, which stemmed from the social, cultural, and family context that revolves around consumption and that was sustained by two beliefs: “Learning from mistakes” and “where there is a will there is a way”. The English version of this paper is available at: http://www.insp.mx/salud/index.html

Traditional gender roles and substance-use behaviors, attitudes, exposure, and resistance among early adolescents in large cities of Mexico

ABSTRACT This study investigated the associations between traditional gender roles (TGRs) and substance use among early adolescents in Mexico’s largest cities. The sample of seventh grade students (n = 4,932) attended 26 public schools in Mexico City, Guadalajara, or Monterrey in 2014. Outcomes included recent alcohol, binge drinking, cigarette and marijuana use, and lifetime poly-substance use; substance-use intentions, norms, attitudes, and expectancies; and substance-use exposure (peer use, offers) and resistance (refusal confidence, refusal skills, and decision-making skills). A TGR scale assessed endorsement of a polarized gender division of family labor and power. As hypothesized, among males, TGRs were consistently associated with poorer outcomes, and this association was usually stronger for males than for females. In contrast, among females there was no evidence that TGRs were associated with desirable outcomes. Contrary to expectations, TGRs predicted poorer outcomes for both females and males, and to equivalent degrees, for binge drinking, cigarette use, positive substance-use expectancies, and friends’ approval of substance use, and they predicted poorer outcomes for females but not for males on parental disapproval of substance use and drug-resistance skills. Interpretations highlight the persisting aspects of TGRs in the family and conflicting messages for females as Mexico undergoes changes in its gender order.