Prevention Science [PREV] PP996-prev-473911 September 30, 2003 17:42 Style ﬁle version Nov. 04, 2000
Prevention Science, Vol. 4, No. 4, December 2003 (
Culturally Grounded Substance Use Prevention: An Evaluation
of the keepin’ it R.E.A.L. Curriculum
Michael L. Hecht,
Flavio Francisco Marsiglia,
David A. Wagstaff,
and Michelle Miller-Day
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 intervention’s
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
KEY WORDS: substance use; middle-school students; prevention programs; cultural grounding.
Over the past decade, the percentage of U.S. ado-
lescents reporting any substance use has increased
(Johnston et al., 2000). This increase reﬂected the use
of both “gateway” and “hard” drugs, and occurred
despite the implementation of stand-alone programs,
integrated approaches, and “blueprint” messages de-
signed to reduce substance use and abuse among pre-
Department of Communication, Arts and Sciences,, The Pennsyl-
vania State University, University Park, Pennsylvania.
School of Social Work, Arizona State University, Tempe, Arizona.
The Methodology Center, The Pennsylvania State University, Uni-
versity Park, Pennsylvania.
Department of Sociology, Arizona State University, Tempe,
Drug Resistance Strategies Project, Arizona State University,
Correspondence should be directed to Michael L. Hecht, PhD,
Department of Communication, Arts and Sciences, 234 Sparks,
The Pennsylvania State University, University Park, Pennsylvania
16802; e-mail: email@example.com.
teens and teens (Johnston et al., 2000). In particular,
the sharp spike in use as students move from mid-
dle school to high school grades remains a particular
concern (Johnston et al., 2000; Wilson et al., 2002).
Ethnic, racial, and cultural inﬂuences play a role
in the prevalence of substance use and abuse, in de-
velopmentally related increases in use, and in the
effectiveness of substance use prevention. For ex-
ample, African American adolescents demonstrate
substantially lower rates of alcohol, tobacco, and mar-
ijuana use than do non-Hispanic Whites, whereas
Latino students generally report rates of use in be-
tween the other two groups (Centers for Disease Con-
trol and Prevention, 1998). However, in some regions
of the country and for some substances such as al-
cohol, Latino eighth-grade students exhibit the high-
est prevalence of use (Marsiglia et al., 2001). Even
if rates of substance use did not differ among eth-
nic/racial groups, prevention researchers would still
need to consider that culture can play a crucial role in
prevention program effectiveness (Castro et al., 1999).
2003 Society for Prevention Research