'keepin' It REAL in Mexico: An Adaptation and Multisite RCT

在墨西哥“保持”真实：适应和多站点随机对照试验

• 批准号: 9142311
• 负责人: Flavio Francisco Marsiglia
• 金额: $ 63.21万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-15 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9142311
• 关键词: Address; Adherence; Adolescent; Affect; Alcohol consumption; Alcohol or Other Drugs use; Area; Attitude; Behavior; Beryllium; Characteristics; Cities; Communication; Country; Drug resistance; Drug usage; Educational Curriculum; Educational process of instructing; Elements; Ensure; Feasibility Studies; Feedback; Female; Future Teacher; Gender; Gender Role; Goals; Government; Health; Healthy People 2020; Intervention; Intervention Studies; Knowledge; Latino; Left; Life; Life Experience; Light; Mexican; Mexican Americans; Mexico; Middle School Student; Minority Groups; Modeling; Morbidity - disease rate; Outcome; Participant; Pharmaceutical Preparations; Phase; Pilot Projects; Play; Prevention; Prevention approach; Prevention program; Preventive Intervention; Process; Prodrugs; Public Health; Randomized; Randomized Controlled Trials; Registries; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Role; Sampling; Schools; Science; Self-Administered; Series; Side; Site; Students; Subgroup; Surface; Surveys; Testing; Time; Tobacco use; Translational Research; Translations; Victimization; Violence; Work; Youth; adolescent substance use; base; cost effective; design; efficacy testing; ethnic minority population; evidence base; experience; gender difference; improved; junior high school; male; marijuana use; metropolitan; mortality; perpetrators; phase 1 study; prevent; programs; racial minority; reduced substance use; seventh grade; skills; substance abuse prevention; substance use prevention; success; successful intervention; teacher; underage drinking; universal prevention

 DESCRIPTION (provided by applicant): Sharp increases in substance use rates among youth in Mexico are a major concern, both in Mexico and the US. Although the Mexican government has elevated substance abuse prevention as a national priority, there are few school-based universal prevention programs to choose from that are culturally grounded, empirically tested, and shown to be efficacious. This study aims to address this gap by adapting, implementing, and testing the keepin' it REAL (kiR) prevention intervention in Mexico's three largest cities: Mexico City, Guadalajara, and Monterrey. kiR is a model program for middle school students on the US National Registry of Effective Programs and Practices, shown to be efficacious and cost-effective in reducing substance use among large multi-ethnic and Mexican American samples in the US. The proposed study will leverage the bi-national research team's expertise in developing and adapting kiR and build upon a series of feasibility studies across Mexico which showed that kiR's core elements are applicable there. However, evidence also suggested that further adaptation is needed to enhance the intervention's cultural fit. During the proposed study's Phase 1, students and teacher-implementers in three schools-one from each of the cities-will provide feedback about the original curriculum and identify culturally and contextually relevant scenarios and examples. The bi-national research team-including original kiR curriculum designers-will collaborate to ensure cultural applicability in Mexico and fidelity to core elements of kiR. In Phase 2, the efficacy of the culturally adapted Mexican version of kiR, relative to the original version of kiR and to a control condition, will be tested through an inten-to-treat analysis in a randomized controlled trial with 4,050 7th grade students in 27 middle schools, 9 from each city. The study will investigate and incorporate into the curriculum gender specific experiences with drug offers and appropriate drug resistance strategies in the Mexican context that may impact the youths' risk of substance use and their responsiveness to prevention programs. In light of rising violence in Mexico, a secondary aim of the study is to investigate how youths' perpetration, victimization, and witnessing of violence may moderate the efficacy of kiR in Mexico. The study will create knowledge relevant to efficacious prevention approaches for Mexican-heritage youth on both sides of the US-Mexico border. Prevention science will be advanced by understanding how culturally influenced gender role norms affect substance use offers, attitudes, and behaviors, as well as the success of universal prevention programs. In addition, the study will add to knowledge on how to execute collaborative, cross-national, translational prevention intervention research.

 描述（由适用提供）：在墨西哥和美国，墨西哥青年的物质使用率的急剧提高是一个主要问题。尽管墨西哥政府将预防药物滥用作为国家优先事项，但以学校为基础的普遍预防计划是在文化上扎根，经过经验测试和有效效率的。这项研究旨在通过适应，实施和测试墨西哥三个最大城市的预防干预（KIR）预防干预：墨西哥城，瓜达拉哈拉和蒙特雷，来解决这一差距。 KIR是一项模型计划，适用于美国国家有效计划和实践注册处的中学生，在美国大型多种族和墨西哥裔美国人样本中降低药物使用方面具有效率和成本效益。拟议的研究将利用双国研究团队在开发和适应KIR方面的专业知识，并以墨西哥的一系列可行性研究为基础，这表明KIR的核心要素适用于那里。但是，有证据表明，需要进一步适应以增强干预措施的文化契合度。在拟议的研究的第1阶段，在每个城市中的三所学校中的学生和教师实践者都会提供有关原始课程的反馈，并在文化和上下文上识别 相关方案和示例。两国研究团队包括原始的KIR课程设计师，将合作，以确保墨西哥的文化适用性以及对KIR核心元素的忠诚。在第2阶段，相对于KIR的原始版本和控制条件，文化适应的墨西哥版KIR的有效性将在一项随机对照试验中通过Inten-to-Treat分析进行测试，其中27名中学的4,050个7年级学生，来自每个城市的9个。该研究将调查并纳入墨西哥背景下的药物优惠和适当耐药策略的课程性别特定经验，这可能会影响年轻人的药物使用风险及其对预防计划的反应。鉴于墨西哥的暴力行为不断上升，该研究的次要目的是调查年轻人的犯罪，胜利和目击暴力的持续性可能会使墨西哥的基尔效率调节。这项研究将创造与美墨边境双方墨西哥裔青年有效预防方法相关的知识。预防科学将通过了解受文化影响的性别角色规范如何影响物质使用报价，参与者和行为以及通用预防计划的成功。此外，该研究将增加有关如何执行协作，跨国，转化预防干预研究的知识。