Patricia Dustman

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.

Ties That Protect: An Ecological Perspective on Latino/a Urban Pre-Adolescent Drug Use.

SUMMARY An ecological risk and resiliency framework was applied to explore how social contexts, especially the role of families and schools, are affecting Latino/a pre-adolescent substance use in the urban Southwest. A mixed research design, using both quantitative and qualitative methodologies, guided the study. Quantitative data were collected through surveys administered as part of a school-based prevention intervention experiment (N = 2,125). Individual interviews conducted with a randomly selected number of matched students (N = 60) provided the qualitative data. The main theme emerging throughout both data sets was a strong resilience against drug use of the participating 7th grade urban youth. The vast majority of students did not use hard drugs, and agreed that alcohol use was inappropriate at their age. A high degree of attachment and strong ties to their parents and their school environment emerged as a shared protective factor. Recommendations include social work interventions that support the resiliency characteristics of urban Latino/a youth in different social contexts such as communities, schools, and families. Limitations of the study are reviewed and suggestions for future research are offered.

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.

Creating Culturally Grounded Videos for Substance Abuse Prevention

ABSTRACT This article describes and critiques the pilot phase of a project in which an ethnically diverse group of students from a large southwestern urban high school created culturally based substance abuse prevention videos for urban middle school students. The rationale evolved from research that suggested that a peer-created, culturally-specific approach to drug abuse prevention would be more effective than would programming created by adults operating from a “so-called” culturally-neutral” perspective. The dual perspective of this article includes both the field experiment per se and the data collected, using a case study perspective. Overarching themes of culture and power are discussed, as are the elements of age and gender. Implications extending beyond the pilot offer insights for researchers and practitioners.

A Continuum of Approaches Toward Developing Culturally Focused Prevention Interventions: From Adaptation to Grounding

The purpose of this article is to describe a conceptual model of methods used to develop culturally focused interventions. We describe a continuum of approaches ranging from non-adapted/surface-structure adapted programs to culturally grounded programs, and present recent examples of interventions resulting from the application of each of these approaches. The model has implications for categorizing culturally focused prevention efforts more accurately, and for gauging the time, resources, and level of community engagement necessary to develop programs using each of the different methods. The model also has implications for funding decisions related to the development and evaluation of programs, and for planning of participatory research approaches with community members.

Implementing a Prevention Curriculum An Effective Researcher-Teacher Partnership

Researchers from social work, education, and communications worked with practicing teachers to create and implement a curriculum around four culturally grounded prevention strategies in urban southwestern schools. The project proposed to test the effectiveness of various degrees of ethnic sensitivity in school-based drug prevention curricula developed around three different models, including a Latino, a non-Latino (Euro-American), and a multicultural (Latino, Euro-American, and African American) model, based on the cultural norms of these dominant populations. Collaboration with schools to implement the curriculum and to administer pretest and posttest surveys to students was accomplished by developing a strong partnership with teachers. Significant trends in urban drug prevention education and at least four essential conclusions about conducting effective school-based research surfaced from the implementation of this study.

The Implications of Ecologically Based Assessment for Primary Prevention with Indigenous Youth Populations

This paper describes a five-stage approach toward conducting an ecologically based assessment with Indigenous youth populations, and the implications of this approach for the development and implementation of culturally grounded prevention interventions. A description of a pilot study funded by the National Institutes of Health/National Institute on Drug Abuse (NIH/NIDA) focused on drug use and American Indian youth is presented as one model for operationalizing ecologically based assessment with Indigenous youth populations, and issues related to translating the pilot study into a prevention intervention are discussed. This paper suggests that ecologically based assessment can serve as a foundation for culturally grounded prevention interventions, promoting the social and ecological validity of those interventions. Editors’ Strategic Implications: By basing the intervention components on assessments of population needs and abilities, the authors demonstrate how programs may be responsive to participants embedded in specific cultural contexts. This type of forward engineering changes the focus of adaptation to program development and should serve as a model for all those developing interventions as well as those working to adapt effective programs to meet the needs of specific populations.

Who Is Offering and How Often? Gender Differences in Drug Offers Among American Indian Adolescents of the Southwest:

This exploratory study examined gender differences in the patterns of drug offers among a sample of 71 American Indian middle school students. Participants responded to an inventory of drug-related problem situations specific to the cultural contexts of Southwestern American Indian youth. They were asked to consider the frequency of drug offers from specific groups in their social networks and the difficulty associated with refusing drugs from various offerers. The results indicated that female and male American Indian youth differ in the degree of exposure to drug offers and the degree of perceived difficulty in handling such offers. Even after controlling for differences in age, grade level, socioeconomic status, family structure, and residence on a reservation, girls reported significantly more drug offers from friends, cousins, and other peers than did boys. Compared to boys, girls also reported a significantly higher sense of difficulty in dealing with drug offers from all sources.

American Indian Cultures: How CBPR Illuminated Intertribal Cultural Elements Fundamental to an Adaptation Effort

The ever-increasing numbers of ethnic minority populations in the USA seeking social services suggest that a “multicultural paradigm shift” is underway and gaining speed. This shift will increasingly demand that prevention programs and interventions be more culturally responsive. Interventions that are not aligned with prospective participants’ world views and experiences are only minimally effective. Existing models for conducting culturally grounded program adaptations emphasize identifying distinct levels of cultural influences while preserving core elements of the original intervention. An effective adaptation requires competent language translation as well as trained translations of program concepts and principles that will be meaningful to the targeted group, without compromising program fidelity. This article describes how a university research team and curriculum developers worked with American Indian youth and adults in a large southwestern city using a CBPR process to identify cultural elements that became foundational to the adaptation of a prevention curriculum that is a national model program, with the objective of increasing its applicability for urban native youth.

Strategies to resist drug offers among urban American Indian youth of the southwest: An enumeration, classification, and analysis by substance and offeror

This study explores the drug resistance strategies of urban American Indian adolescents when they encounter people offering them alcohol, cigarettes, and marijuana. Data were collected in 2005 from 11 female and 9 male adolescents who self-identified as American Indian and attended two urban middle schools in the southwestern United States. In two focus groups—one at each school site—the youth described their reactions to 25 hypothetical substance offer scenarios drawn from real-life narratives of similar youth. Qualitative analysis of their 552 responses to the scenarios generated 14 categories. Half of the responses were strategies reported most often by nonnative youth (refuse, explain, leave, and avoid). Using ecodevelopmental theory, the responses were analyzed for indications of culturally specific ways of resisting substance offers, such as variation by specific substance and relationship to the person offering. Study limitations are noted along with suggestive implications for future research on culturally appropriate prevention approaches for urban American Indian youth.