Elvira Elek

Culturally Grounded Substance Use Prevention: An Evaluation of the keepin' it R.E.A.L. Curriculum

This paper reports on the evaluation of a culturally grounded prevention intervention targeting substance use among urban middle-school students. The curriculum consists of 10 lessons promoting antidrug norms and teaching resistance and other social skills, reinforced by booster activities and a media campaign. Three versions were delivered: Mexican American, combined African American and European American, and Multicultural. Thirty-five middle schools were randomly assigned to 1 of the 3 versions or the control. Students completed baseline and follow-up questionnaires over a 2-year period (total 6,035 respondents). Analyses utilizing a generalized estimating equations approach assessed the overall effectiveness of cultural grounding and the cultural matching hypothesis. Support was found for the interventions overall effectiveness, with statistically significant effects on gateway drug use as well as norms, attitudes, and resistance strategies but with little support for the cultural matching hypothesis. Specific contrasts found the Mexican American and Multicultural versions impacted the most outcomes.

Influences of Personal, Injunctive, and Descriptive Norms on Early Adolescent Substance use

Social norms play an important role in adolescent substance use. Norm focus theory (Cialdini, Reno, & Kallgren, 1990) distinguishes three types of norms: injunctive, descriptive, and personal. This study examines the relative influences of these three norms, as well as the moderating effects of gender and ethnicity, on the concurrent substance use of 2,245 Mexican or Mexican-American students, 676 students of other Latino or multiethnic Latino origin, 756 non-Hispanic White students, and 353 African- American students. Personal norms appear to be the strongest significant predictor of substance use. Descriptive, parental injunctive, and friend injunctive norms also demonstrate significant, though weaker influences. Controlling for intentions reduces the predictive ability of each type of norm, especially personal norms. Gender moderates the relationship between norms and substance use with the relationships generally stronger for males. Personal norms act as stronger predictors of some types of substance use for Mexican/Mexican Americans.

The Drug Resistance Strategies Intervention: Program Effects on Substance Use

This study evaluates the Drug Resistance Strategies (DRS) project, a culturally grounded, communication-based substance use prevention program implemented in 35 middle schools in Phoenix, Arizona. The intervention consisted of 10 lessons taught by the classroom teacher that imparted the knowledge, motivation, and skills needed to resist drug offers. The evaluation used growth modeling to analyze significant differences in average postintervention substance use (alcohol, cigarettes, and marijuana) and growth of use over the course of the study. The study involved 6,298 seventh graders (65% Mexican/Mexican American) who responded to at least 1 of 4 questionnaires (1 pretest and 3 follow-up measures). When compared to a control group, the DRS intervention appeared to significantly limit the increase in the number of students reporting recent substance use, especially alcohol and marijuana use. The multicultural version of the curriculum proved most broadly effective, followed by the version targeting Mexican American youth. The development of a culturally grounded prevention curriculum for Mexican American youth expands the population being served by interventions. Moreover, the success of the multicultural curriculum version, which has the broadest application, provides particular promise, and the article demonstrates how a growth modeling approach can be used to evaluate a communication-based intervention by analyzing changes over time rather than differences between the pretest and posttest scores.

Acculturation Status and Substance Use Prevention with Mexican and Mexican-American Youth

SUMMARY This study examined whether language preference, as an indicator of acculturation, moderated the effects of a culturally grounded substance use prevention intervention for Mexican and Mexican American middle school students (N = 2,146) in Phoenix, Arizona. The main hypothesis was that levels of program effectiveness would vary based on the language preference of the students and the specific culturally grounded version of the intervention they were assigned. Findings show that matching language preference to particular versions of the intervention did not influence substance use related program outcomes, but that overall program effects (intervention versus control) did vary by language preference. English-language dominant participants, the most at risk sub-group, responded more positively to the intervention, while Spanish dominant, who had low substance use rates at baseline, and bilingual participants did not demonstrate significant differences between the intervention and control groups. Implications for school social work prevention interventions and prevention science in general, are discussed.

Ethnic Identity Development and Acculturation: A Longitudinal Analysis of Mexican-Heritage Youth in the Southwest United States:

Utilizing part of the survey data collected for a National Institute on Drug Abuse (NIDA)— funded project from 29 public elementary schools in Phoenix, Arizona (N = 1,600), this study explored the underlying structure of Mexican-heritage youths’ ethnic identity and cultural/ linguistic orientation. Latent profile and transition analyses identified four distinct orientation profiles endorsed by the early adolescents and their developmental trends across four time points. Most Mexican and Mexican American adolescents endorsed bicultural profiles with developmental trends characterized by widespread stasis and transitions toward greater ethnic identity exploration. Multinominal logistic regression analyses revealed associations between profile endorsement and adolescents’ gender, socioeconomic status, parents’ birthplace, and visits outside the United States. These findings are discussed in regard to previous findings on acculturation and ethnic identity development. Individuals’ adaptation to the immediate local environment is noted as a possible cause of prevalent biculturalism. Limitations and future directions for the research on ethnic identity development and acculturation are also discussed.

Communicating Prevention: The Effects of the keepin’ it REAL Classroom Videotapes and Televised PSAs on Middle-School Students’ Substance Use

This study sought to determine if exposure to two communication-oriented activities, videotapes and public service announcements, accounts for changes in substance use among adolescents participating in the Drug Resistance Strategies Projects keepin’ it REAL adolescent substance use prevention curriculum. Middle-school students (4,734, 72% Latino) responded to questionnaires related to these analyses. An analysis of covariance (ANCOVA) model was fit separately to six substance use outcomes. The results suggested that intervention students who saw four or five videos engaged in less substance use in the past month than did students who saw fewer videos. Having seen the PSAs one or more times did not predict the reported change in substance use.

Results of a 3-Year Study of Two Methods of Delivery of Life Skills Training

Model programs and standards for substance abuse prevention have been identified by a number of federal agencies. The study reported here assessed two methods of delivery of one such program, Life Skills Training (LST), implemented in nine rural disadvantaged school districts. The results indicate that neither standard LST nor an infused LST delivery method was found effective for the entire sample, although some encouraging results were foundforthe females in the study. This study, conductedbyresearchersindependentof the LST program, is useful for school decision makers in determining what programs are most effective with which groups. It includedall studentswith parentalpermission,controllingforprioruse levels, unlike some previous LST studies. The results of the program, as implemented by regular classroom teachers, reflect many issues relevant to recruitment, training, implementation, adaptation, and institutionalization of prevention programming.

A Review of Elementary School-Based Substance Use Prevention Programs: Identifying Program Attributes:

This article takes a systematic approach to reviewing substance use prevention programs introduced in elementary school (K-6th grade). Previous studies evaluating such programs among elementary school students showed mixed effects on subsequent substance use and related psychosocial factors. Thirty published evaluation studies of 24 elementary school-based substance use prevention programs were reviewed. The study selection criteria included searching for program evaluations from 1980 to 2008. Among 27 evaluation studies that examined program effects on substance use, 56% (n = 15) found significant decreases. In addition, programs most often demonstrated effects on increasing negative substance use attitudes, increasing knowledge, decreasing perceptions of prevalence rates (i.e., descriptive norms), and improving resistance skills. These results have implications for the appropriateness and value of introducing substance use prevention programs to youth in elementary school.

“Drinking Won't Get You Thinking”: A Content Analysis of Adolescent-Created Print Alcohol Counter-advertisements

Involvement in creating antialcohol advertisements generates enthusiasm among adolescents; however, little is known about the messages adolescents develop for these activities. In this article, we present a content analysis of 72 print alcohol counteradvertisements created by high school (age 14–17 years old) and college (18–25 years old) students. The posters were content analyzed for poster message content, persuasion strategies, and production components, and we compared high school and college student posters. All of the posters used a slogan to highlight the main point/message of the ad and counterarguments/consequences to support the slogans. The most frequently depicted consequences were negative consequences of alcohol use, followed by negative–positive consequence comparison. Persuasion strategies were sparingly used in advertisements and included having fun/one of the gang, humor/unexpected, glamour/sex appeal, and endorsement. Finally, posters displayed a number of production techniques including depicting people, clear setting, multiple colors, different font sizes, and object placement. College and high school student-constructed posters were similar on many features (e.g., posters displayed similar frequency of utilization of slogans, negative consequences, and positive–negative consequence comparisons), but were different on the use of positive consequences of not using alcohol and before–after comparisons. Implications for teaching media literacy and involving adolescents and youth in developing alcohol prevention messages are discussed.

Substance use, resistance skills, decision making, and refusal efficacy among Mexican and Mexican American preadolescents.

This article examines the relationships among resistance skills, refusal efficacy, decision-making skills, and substance use for a sample of Mexican and Mexican American 5th grade students who were attending public schools in Phoenix, Arizona. An analysis of self-report questionnaire data indicated that the likelihood that male students reported ever having used one or more substances increased as they reported a greater willingness to use passive decision-making (e.g., going along) and decreased as they reported greater refusal efficacy and a greater willingness to utilize active decision making (e.g., thoughtful processing). No significant relationships emerged between the 4 predictors and lifetime substance use among the girls. These findings support the role of social skills in substance use prevention, shed light on an understudied group, and suggest the importance of continuing to examine gender differences in skills-based interventions.