1
|
Ayers SL, Kulis SS, Marsiglia FF, Campos AP, Medina-Mora ME. Keepin' It REAL-Mantente REAL in Mexico: Longitudinal Examination of Youth Drug Resistance Strategies and Substance Use Among Early Adolescents. J Adolesc Health 2023; 73:412-420. [PMID: 37422739 PMCID: PMC10524980 DOI: 10.1016/j.jadohealth.2023.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/13/2023] [Accepted: 05/07/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE This study examined if culturally and linguistically adapted versions of a US-developed adolescent substance use prevention intervention, keepin' it REAL (kiREAL), for Mexico increases the use of drug resistance strategies and if increased use of resistance strategies subsequently leads to a reduction in the frequency of substance use (i.e., alcohol, cigarette, marijuana, and inhalants). METHODS Students (N = 5,522, 49% female, age range = 11-17) in 36 middle schools across three cities in Mexico were randomized into three conditions: (1) Mantente REAL (MREAL), the culturally adapted version, (2) kiREAL-S, the linguistically adapted version, and (3) Control. Using survey data collected at four time points, random intercept cross-lagged path analyses tested the direct and indirect effects of MREAL and kiREAL-S compared to Control. RESULTS At time 2, the number of drug resistance strategies used by students increased in both MREAL (β = 0.103, p = .001) and kiREAL-S (β = 0.064, p = .002) compared to Control. However, only MREAL lead to less frequent use of alcohol (β = -0.001, p = .038), cigarettes (β = -0.001, p = .019), marijuana (β = -0.002, p = .030), and inhalants (β = -0.001, p = .021) at time 4, mediated through increased use of drug resistance strategies. DISCUSSION This study provides evidence that MREAL and kiREAL-S are successful in spurring use of the drug resistance strategies that are the core component of the intervention. Only MREAL achieved long-term effects on substance use behaviors, the ultimate objective of these interventions. These findings provide support for the value and importance of rigorous cultural adaptation of efficacious prevention programs as a necessary condition for enhancing prevention benefits for participating youth.
Collapse
Affiliation(s)
- Stephanie L Ayers
- Global Center for Applied Health Research, School of Social Work, Arizona State University, Phoenix, Arizona; Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, Arizona.
| | - Stephen S Kulis
- Global Center for Applied Health Research, School of Social Work, Arizona State University, Phoenix, Arizona
| | - Flavio F Marsiglia
- Global Center for Applied Health Research, School of Social Work, Arizona State University, Phoenix, Arizona
| | - Ana Paola Campos
- Global Center for Applied Health Research, School of Social Work, Arizona State University, Phoenix, Arizona; Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, Arizona
| | - Maria Elena Medina-Mora
- Universidad Nacional Autónoma de México, Circuito Interior Ciudad Universitaria, Mexico City, Mexico
| |
Collapse
|
2
|
Yin R, Yang Y, Chang Y, Tang L, Hu Q, Yang J, Cheng C, Xiao L, Zhang F. Association Between Alcohol Expectancy and Drinking Behaviors in Summer Vacation and Last Year Among College Students. Int J Gen Med 2023; 16:2679-2692. [PMID: 37398513 PMCID: PMC10314789 DOI: 10.2147/ijgm.s413193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023] Open
Abstract
Background Drinking in summer vacation, as an important part of college students' drinking behavior, has rarely been studied. At present, there is no research to explore the association between alcohol expectancy and college students' drinking behavior during the summer vacation. Methods A total of 487 college students were selected from three universities in Chongqing from July 30, 2017, to August 30, 2017, by cluster sampling. The electronic questionnaires were distributed to complete the anonymous survey related to drinking. The questionnaire on drinking mainly included baseline characteristics, influencing factors related to drinking, drinking behavior in the last year and summer vacation, and alcohol expectancy. Independent sample t-test and one-way ANOVA were used for multi-factor analysis. Multi-level logistic regression analysis and ordered logistic regression analysis were used for multivariate analysis. Results The past drinking rate in the study group was 86.24%. In the past year, the drinking rate and binge drinking rate of college students were 63.24% and 23.20%. In summer drinking, these two indicators were 29.57% and 8.42%, respectively. About 92.50% of the moderate and heavy drinking groups among college students had drinking behavior during the summer vacation. The average negative expectancy among college students was 3.26 ± 0.87 while the average positive expectancy was 2.63 ± 0.66. In drinking last year, positive expectancy was a risk factor for occasional and light drinking compared with those of non-drinkers (P<0.05). In summer vacation drinking, compared with those of non-drinkers, negative expectancy was a protective factor for occasional drinking (OR: 1.847, 95% CI: 1.293-2.638), negative expectancy and positive expectancy were both influencing factors for light drinking (P<0.05). Conclusion The drinking rate in the study group was at a high level in the past. The association between alcohol expectancy and drinking behavior among college students would be different according to the period and amount of drinking.
Collapse
Affiliation(s)
- Ruoyun Yin
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yuan Yang
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yujiao Chang
- Department of Infection, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lei Tang
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qian Hu
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jian Yang
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Chong Cheng
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lei Xiao
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Fan Zhang
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| |
Collapse
|
3
|
Cutrín O, Avalos MRA, Corona MD, Nuño-Gutiérrez BL, Medina-Mora ME, Real T, Mendoza-Meléndez MÁ, Lara-Valencia F, Ayers SL, Kulis SS, Marsiglia FF. Use of Violence as a Strategy of Early Adolescents for Rejecting Drug Offers in Mexican Cities. REVISTA MEXICANA DE PSICOLOGIA 2022; 39:18-30. [PMID: 36108313 PMCID: PMC9450683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Drug use and violence are two interconnected problems in violent urban contexts, leading to coercive drug offers. In this study, relationships between drug use, use of violence as a strategy for rejecting drug offers, and exposure to neighborhood violence were analyzed in Mexican students. Data were obtained through a self-report survey and focus groups with lower secondary students in three Mexican metropolitan areas. Both quantitative and qualitative results indicated that students who had used or would use violence as a strategy for rejecting drug offers presented a more problematic psychosocial profile, with exposure to neighborhood violence as the main predictor. These results suggest that Mexican students in violent cities may resort to violence as a strategy for rejecting drug offers.
Collapse
Affiliation(s)
- Olalla Cutrín
- Facultade de Psicoloxía, Universidade de Santiago de Compostela, España
| | - Marvyn R Arévalo Avalos
- Latinx Center of Excellence in Behavioral Health, University of California, Berkeley, Estados Unidos
| | - M Dolores Corona
- Facultad de Enfermería, Universidad Autónoma de Nuevo León, México
| | | | | | - Tania Real
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México
| | | | | | - Stephanie L Ayers
- Global Center for Applied Health Research, Arizona State University, Estados Unidos
| | - Stephen S Kulis
- Global Center for Applied Health Research, Arizona State University, Estados Unidos
| | - Flavio F Marsiglia
- Global Center for Applied Health Research, Arizona State University, Estados Unidos
| |
Collapse
|
4
|
Kulis SS, Marsiglia FF, Medina-Mora ME, Nuño-Gutiérrez BL, Corona MD, Ayers SL. Keepin' It REAL-Mantente REAL in Mexico: a Cluster Randomized Controlled Trial of a Culturally Adapted Substance Use Prevention Curriculum for Early Adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:645-657. [PMID: 33772435 DOI: 10.1007/s11121-021-01217-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 11/30/2022]
Abstract
This study assesses the efficacy of a version of the keepin' it REAL (kiREAL) substance use prevention curriculum for middle school students that was culturally adapted for Mexico, renamed Mantente REAL (MREAL), and tested in a cluster randomized controlled trial in Mexico's three largest cities. Student participants were in 7th grade in public middle schools (N = 5523, 49% female, mean age = 11.9). A representative sample of 12 schools from each city, stratified by whether they held morning or afternoon sessions, was randomized to three conditions: culturally adapted MREAL, original kiREAL translated into Spanish, or a treatment-as-usual control group. Regular classroom teachers were trained to deliver the adapted MREAL or the kiREAL manualized curricula. Students with active parental consent completed pretest and post-test questionnaires, 7-8 months apart, at the beginning and end of the 2017-2018 academic year. We assessed the MREAL intervention, relative to kiREAL and controls, with general linear models adjusted for baseline, attrition (24%), non-normal distributions, stratification by city, and school-level clustering. Among students already using the substance more often at pretest, MREAL students had relatively more desirable outcomes, compared to kiREAL and/or to controls, in recent use of alcohol, cigarettes, "hard drugs," heavy episodic drinking, and intoxication. MREAL students reported relatively less violence victimization and perpetration of bullying and relatively more use of three of the intervention's REAL drug resistance strategies (Explain, Avoid, Leave). The adapted version of kiREAL for Mexico showed numerous desired outcomes in areas deliberately targeted in the cultural adaptation. Full protocol can be accessed through Clinical Trials.gov. ID: NCT03233386, "'Keepin' It REAL in Mexico: An adaptation and multisite RCT".
Collapse
Affiliation(s)
- Stephen S Kulis
- Global, Center for Applied Health Research, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ, 85004-0693, USA. .,School of Social and Family Dynamics, Arizona State University, P.O. Box 873701, Tempe, AZ, 85287, USA.
| | - Flavio F Marsiglia
- Global, Center for Applied Health Research, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ, 85004-0693, USA.,School of Social Work, Arizona State University, 411 N. Central Avenue, Suite 800, Phoenix, AZ, 85004, USA
| | - Maria Elena Medina-Mora
- Facultad de Psicología, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Circuito Ciudad Universitaria, Coyoacán, CP 04510, Ciudad de Mexico, Mexico
| | - Bertha L Nuño-Gutiérrez
- Centro de Estudios e Investigaciones, Universidad de Guadalajara, Francisco de Quevedo, #180 Col. Arcos Vallarta, 44130, Guadalajara, Mexico
| | - Maria Dolores Corona
- Departamento de Enfermerías, Universidad Autónoma de Nuevo León, San Nicolas de la Garza, Mexico
| | - Stephanie L Ayers
- Global, Center for Applied Health Research, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ, 85004-0693, USA.,School of Social Work, Arizona State University, 411 N. Central Avenue, Suite 800, Phoenix, AZ, 85004, USA
| |
Collapse
|
5
|
Kulis SS, Garcia-Perez H, Marsiglia FF, Ayers SL. Testing a Culturally Adapted Youth Substance Use Prevention Program in a Mexican Border City: Mantente REAL. Subst Use Misuse 2021; 56:245-257. [PMID: 33345674 PMCID: PMC9446903 DOI: 10.1080/10826084.2020.1858103] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: This article reports on a test of a youth substance use prevention program conducted in Nogales-Sonora, a Mexican city on the US border. Objective: The study tested the efficacy of a version of the keepin' it REAL curriculum for middle school students that was culturally adapted for Mexico and renamed Mantente REAL. Methods: Students in 7th grade classrooms in four public schools participated in the study (N = 1,418, 49% female, mean age = 11.9). Using a clustered randomized design, two schools received the intervention and two served as a treatment-as-usual control group. Regular classroom teachers were trained to deliver the twelve-lesson Mantente REAL manualized curriculum. Parents provided active consent and students gave written assent to collect pretest and posttest questionnaire data, 7 months apart, at the beginning and end of the 2017-2018 academic year. We assessed the Mantente REAL intervention with general linear models adjusted for baseline, attrition, non-linear distributions, and school-level clustering. Results: Students who participated in Mantente REAL reported relatively less frequent use of alcohol and illicit drugs other than marijuana, compared to students in control schools. Males alone reported desirable intervention effects for marijuana use. These desirable effects were especially strong among students who reported higher initial levels of involvement in risky behaviors. Among students more at risk, both females and males receiving the program reported relative reductions in the frequency of use of alcohol and illicit drugs. Conclusions: These promising results within the Mexico-US border context support a further dissemination of the intervention and additional youth prevention research in the region.
Collapse
Affiliation(s)
- Stephen S Kulis
- Global Center for Applied Health Research, Arizona State University, Phoenix, AZ, USA.,School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Hilda Garcia-Perez
- El Colegio de la Frontera Norte, Population Studies Department, Nogales, Sonora, México
| | - Flavio F Marsiglia
- Global Center for Applied Health Research, Arizona State University, Phoenix, AZ, USA.,School of Social Work, Arizona State University, Phoenix, AZ, USA
| | - Stephanie L Ayers
- Global Center for Applied Health Research, Arizona State University, Phoenix, AZ, USA
| |
Collapse
|
6
|
Hershow RB, Reyes HLM, Ha TV, Chander G, Mai NVT, Sripaipan T, Frangakis C, Dowdy DW, Latkin C, Hutton HE, Pettifor A, Maman S, Go VF. Longitudinal analysis of alcohol use and intimate partner violence perpetration among men with HIV in northern Vietnam. Drug Alcohol Depend 2020; 213:108098. [PMID: 32563847 PMCID: PMC7372834 DOI: 10.1016/j.drugalcdep.2020.108098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/30/2020] [Accepted: 06/01/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Alcohol use is a known risk factor for male-perpetrated intimate partner violence (IPV), although few studies have been conducted globally and among men with HIV (MWH). We estimated the longitudinal effects of alcohol use on IPV perpetration among MWH. METHODS This study is a secondary analysis of randomized controlled trial data among male and female antiretroviral treatment patients with hazardous alcohol use in Thai Nguyen, Vietnam. Analyses were restricted to male participants who were married/cohabitating (N = 313). Alcohol use was assessed as proportion days alcohol abstinent, heavy drinking, and alcohol use disorder (AUD) using the Timeline Followback and Mini International Neuropsychiatric Interview questionnaire. Multilevel modeling was used to estimate the effects of higher versus lower average alcohol use on IPV perpetration (between-person effects) and the effects of time-specific deviations in alcohol use on IPV perpetration (within-person effects). RESULTS Participants with higher average proportion days alcohol abstinent had decreased odds of IPV perpetration (adjusted Odds Ratio [aOR] = 0.43, p = 0.03) and those with higher average heavy drinking and AUD had increased odds of IPV perpetration (Heavy drinking: aOR = 1.05, p = 0.002; AUD: aOR = 4.74, p < 0.0001). Time-specific increases in proportion days alcohol abstinent were associated with decreased odds of IPV perpetration (aOR = 0.39, p = 0.02) and time-specific increases in AUD were associated with increased odds of IPV perpetration (aOR = 2.95, p = 0.001). Within-person effects for heavy drinking were non-significant. CONCLUSIONS Alcohol use is associated with IPV perpetration among Vietnamese men with HIV. In this context, AUD and frequent drinking are stronger correlates of IPV perpetration as compared to heavy drinking.
Collapse
Affiliation(s)
- Rebecca B Hershow
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Drive, 302 Rosenau Hall, Chapel Hill, NC, 27599, USA.
| | - H Luz McNaughton Reyes
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Drive, 302 Rosenau Hall, Chapel Hill, NC, 27599, USA
| | - Tran Viet Ha
- UNC Project Vietnam, Yen Hoa Health Clinic, Lot E2, Duong Dinh Nghe Street, Hanoi, Viet Nam
| | - Geetanjali Chander
- Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA; Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Nguyen Vu Tuyet Mai
- UNC Project Vietnam, Yen Hoa Health Clinic, Lot E2, Duong Dinh Nghe Street, Hanoi, Viet Nam
| | - Teerada Sripaipan
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Drive, 302 Rosenau Hall, Chapel Hill, NC, 27599, USA
| | - Constantine Frangakis
- Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA; Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - David W Dowdy
- Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA; Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Carl Latkin
- Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA; Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Heidi E Hutton
- Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Audrey Pettifor
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Drive, 302 Rosenau Hall, Chapel Hill, NC, 27599, USA
| | - Suzanne Maman
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Drive, 302 Rosenau Hall, Chapel Hill, NC, 27599, USA
| | - Vivian F Go
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Drive, 302 Rosenau Hall, Chapel Hill, NC, 27599, USA
| |
Collapse
|