The Drug Resistance Strategies (DRS) Project, funded by the National Institute on Drug Abuse (NIDA), was one of the first programs to examine how adolescents refused drug offers.
The research, which originally began in 1989, grew out of the need to understand the adolescent perspective on drugs and drug offers as well as how they assess risks and make good decisions.
Applying a narrative prevention approach developed by Michelle Miller-Day and Michael Hecht, stories from thousands of youth were collected and transformed into a multimedia, multicultural prevention program keepin’ it REAL. The curriculum provides teens with effective ways to stay away from drugs—straight from other teens.
The acronym REAL stands for the four ways the adolescents resist drug offers - Refuse, Explain, Avoid, and Leave - and represent the central message of the curriculum. These easy to remember resistance strategies help kids stay away from alcohol, tobacco and other drugs by preparing them to act decisively and comfortably in difficult situations. Students also learn how to assess risk, value their perceptions and feelings, and communicate effectively.
DRS implemented the curriculum in seventh grade classrooms in Phoenix, Arizona, where students receiving keepin’ it REAL reported lower alcohol, marijuana, and cigarette use than students who did not receive the program. The effectiveness of the curriculum resulted in the selection of keepin’ it REAL as one of SAMHSA’s model programs and its listing on the National Registry of Effective Programs.
Chronology
The Drug Resistance Strategies project has been conducted in a series of phases, each funded by the National Institute of Drug Abuse (NIDA). These grants, DRS 1-4, as well as the current project DRS Rural are described below:
The High School Study 1988-1991 - DRS 1
Two high schools in Mesa and Tempe, Arizona participated in these studies which identified the four resistance strategies (Refuse, Avoid, Explain, and Leave) that became REAL, the core of the DRS Project. [Read More...]
DRS1 was the first large-scale research project to examine how youth are offered and resist drugs. The goals of the 1988 Arizona high school study were to: (1) begin to identify adolescents' perceptions of drug resistance strategies, (2) design a training program for teaching resistance skills and (3) conduct a pilot study of its effectiveness.
These strategies became known by their acronym, REAL, and were later found to be used by college and middle school students as well. The youth narratives collected in this research were used to develop live and videotaped performances, entitled Killing Time (produced and directed by Joe Rassulo). These performances proved successful in reducing youth drug use in a pilot study, creating the model for our keepin’ it REAL prevention curriculum.
The studies from this phase of the Drug Resistance Strategies Project produced a set of resistance strategies and specified some of the situations under which these strategies were effective and ineffective. In addition, these studies suggested differences in resistance to alcohol and other drugs, the importance of resistance beyond the initial refusal, the role of implicit and explicit peer pressure, the utility of language analysis, and the significance of initial skill level.
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The Middle School Studies 1993-2001 - DRS 2 & 3
Having discovered that drug involvement begins before high school, DRS researchers targeted middle-school students in their next phase of prevention testing and research. Michael Hecht, Principle Investigator, obtained funding from NIDA for the Drug Resistance Strategies Minority Project (DRS2). Working in collaboration with Melanie Trost, DRS2 extended research to middle school-aged youth and was the first series of studies to examine ethnicity and adolescent drug resistance. [Read More...]
Funding was then obtained from NIDA (Michael Hecht, PI) to develop, implement, and evaluate a curriculum based on the narrative and performance framework originally developed by Michelle Miller-Day and Michael Hecht in DRS1. Project researchers developed the keepin’ it REAL prevention curricula using research from the high school pilot study and middle school interviews that identified drug resistance strategies used by adolescents as well as prototypical narratives. The project team led by Dr. Sarah Amira de la Garza and Michael Hecht then worked with students at South Mountain High School who created 5 videos teaching the refusal skills that were incorporated into 10 lessons created by Dr. Sarah Amira de la Garza, Monika Gosin, and Amy Drapeau. The lessons teach critical thinking (i.e., risk assessment, decision making), communication skills (refusal/REAL, conflict), and social support. to be implemented by teachers in the classroom.
Using a research design developed by Michael Hecht and John Graham of Penn State University, keepin' it REAL was implemented by trained classroom teachers in 35 middle schools by Flavio Marsiglia and Dee Spencer. The project proved successful in limiting increases in alcohol, tobacco, and marijuana use between 7th and 8th grades and keepin' it REAL was selected as a Evidence-based Program by the National Registry of Evidence-based Programs and Practices (NREPP) at the Substance Abuse and Mental Health Services Administration. keepin' it REAL was among the first culturally grounded prevention programs and the most effective version was multicultural.
Additional research advanced our understanding of how the program works, how ethnicity and gender are related to adolescent drug use, the role of social norms, and identified acculturation status as an important aspect of drug decisions.
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DRS4
Starting in 2003, the DRS team began work to determine the best grade level to introduce the prevention program (5th vs. 7th grade), including elementary school implementation in addition to middle school. In addition, work on DRS4 has continued examining the relationships among acculturation, decision-making, different types of norms, identity, family structure, parent-child communication, and drug use. [Read More...]
During the first year, the multicultural version of the keepin' it REAL curriculum was adapted for fifth grades by Nancy Gonzalez, Leslie Reeves, Patricia Dustman, and Mary Harthun. In addition, an acculturation enhancement was developed by this team and a group support component was developed . During year two, curriculum materials were developed by Leslie Reeves, teachers from 29 elementary schools were trained by Mary Harthun and the curriculum was implemented under the leadership of Patricia Dustman. During 2007-08, the multicultural version of keepin’ it REAL was implemented in 27 middle schools in Phoenix, Arizona. Evaluation research, under the leadership of Michael Hecht, Elvira Elek, David Wagstaff, Stephen Kulis, and Tanya Nieri, wa s being conducted to measure the program's impact.
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DRS Rural
In 2008 the DRS team was awarded a NIDA grant to evaluate the effectiveness of the original curriculum, which was grounded in the cultures of the southwest and compare that to a new version, “regrounded” in the rural culture of Pennsylvania and Ohio. Additionally, the DRS team will also study how teachers adapt both versions to their classroom. Click here to visit the kiR Rural website. [Read More...]
The development of an effective school-based substance use prevention programs has given rise to a recent focus on implementation issues. The current study will help us understand how to implement programs beyond their original target audience, as well as how to guide teachers when they adapt curriculum to their classes.
A randomized control trial will be conducted in middle schools to accomplish these goals. First, we will conduct formative research to develop the rural version of the curriculum. Second, 42 schools will be randomly assigned to one of these three conditions:
- teacher adaptation in implementing the original keepin’ it REAL curriculum
- researcher adaptation in implementing the new rural version of the curriculum
- a control group
We hypothesized that participation in either form of the curriculum will reduce substance use and that researcher adaptation will produce better outcomes than teacher adaptation.
A pretest will be administered followed by posttests in 7th-9th grades. Three measures will assess adaptation and quality/fidelity: a Program Quality and Adaptation online measure completed by teachers after each lesson, observation of two lessons, and audio recording of two lessons.
The major hypothesis tests utilize variants of the general linear model, taking into account the multilevel structure of the data (e.g., multilevel multiple regression), tests of a mediation model, and growth modeling.
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Collaboration with D.A.R.E. America
D.A.R.E. America licensed keepin’ it REAL from Penn State University for national and international distribution starting September 2009. A D.A.R.E. version of the curriculum was developed cooperatively, including three sets of new, national videos for rural, suburban and urban schools. The curriculum was pilot tested by Michelle Miller-Day, Magi Colby, and Michael Hecht of Penn State and then revised in cooperation with Anita Bryan, BJ McConnell, Bobby Robinson, and Scott Gilliam of D.A.R.E. The collaboration was launched at D.A.R.E.’s national and international meeting in Orlando, Florida in July 2009. This collaboration makes keepin’ it REAL the most widely disseminated middle school program in the world.
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