Research Projects

keepin' it REAL /Mantente REAL: Adaptation and Pilot Test in Uruguay

Target Population:
Adolescents aged 11-15 years in the Uruguayan capital city, Montevideo
Project Team:

Flavio F. Marsiglia, PhD; Stephen S. Kulis, PhD; Carlos Libbisch, MA; Paul Ruiz, PhD

Project Status: Active

In collaboration with the Pablo de Tarso Foundation, the Uruguayan National Board on Drug Use, Uruguayan educational authorities, and the American embassy in Montevideo, GCAHR conducted a pilot study to test the feasibility of implementing keepin' it REAL in Montevideo-Uruguay, determine if this middle school-based curriculum would need adaptation to the Uruguayan population, and revised the curriculum including the creation of new accompanying videos. There were two pilot tests of the curriculum: an initial one in middle schools with 7th-grade students, and a subsequent test among 6th-grade students in their last year of primary school.

Substance use behaviors, attitudes, and exposure; use of effective drug resistance skills

In the first pilot test, four middle schools, half public and half private, in the poorest neighborhood in the capital city of Montevideo, were randomized into two treatment (implementation) or control/comparison conditions. In the second test, six public primary schools were randomized to implementation or control conditions. Regular teachers were trained to implement the Spanish-translated version of keepin' it REAL (Mantente REAL). The first pilot test included 388 adolescents aged 12-15 years who completed pretest and post-test questionnaires; the second test in primary schools had 233 students aged 11-14 who also completed pretests and post-tests.

In the middle school test, the Mantente REAL intervention group reported desired changes in four of six last 30-day substance use outcomes: relatively smaller increases or actual reductions in the frequency of alcohol and marijuana use and in amounts of cigarette and marijuana use.  In the primary school test, Mantente REAL students--compared to controls-- reported relative decreases in alcohol use,  intentions to use substances, positive expectancies about substance use, and violence victimization, as well as increases in the use of effective drug resistance strategies.

Marsiglia, F. F., Kulis, S. S., Kiehne, E., Ayers, S. L., Libisch, C. A., & Barros, L. (2018). Adolescent substance use prevention and legalization of marijuana in Uruguay: A feasibility trial of the keepin’ it REAL prevention program. Journal of Substance Use, 23(5), 457-465. doi: 10.1080/14659891.2017.1358308

Marsiglia, F. F., Alarcón, D., Kiehne, E., Ayers, S. L., & Kulis, S. S. (2019). School connectedness, educational aspirations, academic performance, and alcohol use In Uruguay. Health Behavior and Policy Review, 6(3), 276-285. doi:10.14485/HBPR.6.3.7


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The referenced media source is missing and needs to be re-embedded.