New Study Demonstrates Effectiveness of Mantente REAL in Montevideo Elementary Schools

A new peer-reviewed study published by researchers at the Arizona State University Global Center for Applied Health Research (GCAHR) and the Universidad de la República in Montevideo, Uruguay highlights encouraging results for the substance use prevention program Mantente REAL (MREAL). The research, conducted by a binational team of scholars, evaluated how well the program helps sixth-grade students build skills to resist substance use and navigate peer pressure.

MREAL is the Spanish-language version of the internationally recognized keepin' it REAL curriculum. The program focuses on four core resistance strategies that help young people respond to risky situations with confidence: Refuse, Explain, Avoid, and Leave. For this study, the GCAHR team worked closely with local educators to ensure the curriculum reflected the cultural context, communication styles, and lived realities of Uruguayan youth.

Researchers partnered with six public schools and trained teachers to deliver the MREAL lessons during the regular school day. A total of 223 sixth-grade students participated in the randomized controlled trial and completed surveys before and after the program. These surveys assessed behaviors and experiences such as substance use, peer drug offers, and decision-making skills.

Key Findings

Students who participated in MREAL demonstrated meaningful positive outcomes, including:

• Reduced use of alcohol, cigarettes, and other drugs
• Lower permissive personal norms towards substance use
• Lower perception that most or all peers in school are using substances
• Fewer drug offers from peers

Students in the control group, who continued with standard classroom instruction, did not show the same improvements.

Why These Results Matter

Students in low-income communities often face environmental and social factors that increase their exposure to drugs and risky situations. The findings from this study show that a culturally grounded, skills-focused curriculum like MREAL can strengthen young people's ability to resist peer pressure and make healthier choices. MREAL also aligns with broader public health goals by supporting early prevention and promoting protective decision-making during a formative developmental stage.

Looking Ahead

The study underscores the promise of MREAL as an effective and scalable intervention for elementary schools in Uruguay. The research also highlights the value of culturally responsive prevention strategies that are co-created with local educators and grounded in the strengths of the communities they serve. Our center remains committed to advancing evidence-based prevention programming and supporting sustainable implementation of MREAL across similar school settings.

To access the full article, please see below:

Marsiglia, F. F., Libisch, C., Kulis, S. S., & Ruiz, P. (2025, online). Drug use prevention in low-income neighborhoods of Montevideo-Uruguay: The effectiveness of Mantente REAL in public elementary schools. Journal of Prevention. https://doi.org/10.1007/s10935-025-00886-3