Substance Use Clinical Trial
Official title:
Adaptation Processes in School-Based Substance Abuse Programs
The goals of this study are to develop a middle school substance use prevention curriculum
for underserved rural youth and evaluate its efficacy compared to the existing,
multicultural curriculum. In addition, we are studying how the curricula get taught by the
teachers.
Hypothesis 1: When compared to students in the control condition, students in the treatment
conditions will report less substance use, more conservative norms, less positive
expectations about substance use outcomes, and better life and communication skills.
Hypothesis 2: When compared to students in the control condition, students in the researcher
adaptation condition will report less substance use, more conservative norms, less positive
expectations, and better life and communication skills.
Hypothesis 3: When compared to students in the control condition, students in the teacher
adaptation condition will report less substance use, more conservative norms, less positive
expectations, and better life and communication skills.
Hypothesis 4: Researcher adaptation will have a greater impact on substance use, norms, and
expectations than teacher adaptation.
The goals of the proposed study are to conduct an effectiveness trial of the keepin' it REAL
middle school substance use prevention curriculum among a new target audience in rural
Pennsylvania and Ohio, describe how teachers adapt the curriculum when they present it, and
develop, implement, and evaluate a Pennsylvania/Ohio-version of the curriculum to test
whether an evidence-based universal curriculum can be improved by adapting it to local
cultures. keepin' it REAL is recognized as a "model program" by SAMHSA's National Registry
of Effective programs and is one of the few that are multicultural. The study will evaluate
the effectiveness of the original curriculum, grounded in the cultures of the southwest and
compare that to a new version, "regrounded" in the rural culture of Pennsylvania and Ohio,
while studying how teachers adapt both versions. This proposal responds to NIDA PA-05-118,
Drug Abuse Prevention Intervention Research that calls for investigations addressing, "1)
the development of novel drug abuse prevention approaches; 2) the efficacy and effectiveness
of newly developed and/or modified prevention programs; 3) the processes associated with the
selection, adoption, adaptation, implementation, sustainability, and financing of
empirically validated interventions." This proposal addresses all three points.
A randomized control trial will be conducted in middle schools to accomplish these goals.
First, formative research will be conducted to develop a rural Pennsylvania/Ohio-version of
the curriculum. Second, 42 rural schools will be randomly assigned to one of three
conditions: teacher adaptation in which the original keepin' it REAL curriculum is
implemented; researcher adaptation in which a new Pennsylvania-version of the curriculum is
implemented, and a control group. We hypothesized the participation in either form of the
curriculum will reduce drug use and that the researcher adaptation will produce better
outcomes and less teacher adaptation than the teacher adaptation. A pretest will be
administered followed by posttests in 7-9th grades. Adaptation and fidelity will be measured
in 3 ways: teachers completing a Program Quality and Adaptation online measure after each
lesson, videotaped lessons, and attendance. The major hypothesis tests will be conducted
using variants of the general linear model, taking into account the multilevel structure of
the data (e.g., multilevel multiple regression), test of a mediation model, and growth
modeling.
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