Medicine and Health Sciences Commons^™

Sufferance For Snuff Puffs: The Acceptability And Behavior Of Smoking Marijuana And Tobacco Inside The House, Eusabeia Silfanus, Oliver Lopez, Vincent Berardi

Student Scholar Symposium Abstracts and Posters

Secondhand smoke (SHS) released from indoor smoking contributes to household air pollution, releasing large quantities of fine particulate matter which can pose negative health outcomes, especially for developing children who spend most of their time at home. The increased legalization of marijuana increases its recreational and medicinal use along with its acceptability. With tobacco use remaining prevalent, the use of marijuana and/or tobacco remains common and may occur inside the home. Project Fresh Air conducted in San Diego County studies the air quality in households (n = 298) with at least one adult smoking tobacco and/or marijuana living with at …

Real-World Dispensing Of Buprenorphine In California During Prepandemic And Pandemic Periods, Yun Wang, Alexandre Chan, Richard Beuttler, Marc L. Fleming, Todd Schneberk, Michael Nichol, Haibing Lu

Pharmacy Faculty Articles and Research

Introduction: The opioid overdose crisis in the United States has become a significant national emergency. Buprenorphine, a primary medication for individuals coping with opioid use disorder (OUD), presents promising pharmacokinetic properties for use in primary care settings, and is often delivered as a take-home therapy. The COVID-19 pandemic exacerbated the scarcity of access to buprenorphine, leading to dire consequences for those with OUD. Most existing studies, primarily focused on the immediate aftermath of the COVID-19 outbreak, highlight the challenges in accessing medications for opioid use disorder (MOUDs), particularly buprenorphine. However, these studies only cover a relatively short timeframe. Methods: To …

Addressing The Crisis: Leveraging The United Nations Sustainable Development Goals To Prepare Student Leaders To Tackle The Opioid Epidemic, Sharon Xavioer, Laressa Bethishou, Madeline Dintzner, Reza Taheri, Jelena Lewis

Pharmacy Faculty Articles and Research

The United States faces several ongoing public health issues including the opioid epidemic. This article describes a new model aimed at providing a framework that incorporates the United Nations (UN) Sustainable Development Goals (SDGs) to develop pharmacy student leaders through education, experiences, and development of critical skills. This holistic approach can serve as an example methodology to equip future leaders across public health domains to tackle many of the critical problems we face today.

Selection Homophily And Peer Influence For Adolescents’ Smoking And Vaping Norms And Outcomes In High And Middle-Income Settings, Jennifer M. Murray, Sharon Sánchez-Franco, Olga L. Sarmiento, Erik O. Kimbrough, Christopher Tate, Shannon C. Montgomery, Rajnish Kumar, Laura Dunne, Abhijit Ramalingam, Erin L. Krupka, Felipe Montes, Huiyu Zhou, Laurence Moore, Linda Bauld, Blanca Llorente, Frank Kee, Ruth F. Hunter

Economics Faculty Articles and Research

The MECHANISMS study investigates how social norms for adolescent smoking and vaping are transmitted through school friendship networks, and is the first study to use behavioral economics methodology to assess smoking-related social norms. Here, we investigate the effects of selection homophily (the tendency to form friendships with similar peers) and peer influence (a social process whereby an individual’s behavior or attitudes are affected by peers acting as reference points for the individual) on experimentally measured smoking and vaping norms, and other smoking outcomes, in adolescents from high and middle-income settings. Full school year groups in six secondary schools in Northern …

Α7 Nicotinic Acetylcholine Receptor Interaction With G Proteins In Breast Cancer Cell Proliferation, Motility, And Calcium Signaling, Murat Oz, Justin R. King, Keun-Hang Susan Yang, Sarah Khushaish, Yulia Tchugunova, Maitham A. Khajah, Yunus A. Luqmani, Nadine Kabbani

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Chronic smoking is a primary risk factor for breast cancer due to the presence of various toxins and carcinogens within tobacco products. Nicotine is the primary addictive component of tobacco products and has been shown to promote breast cancer cell proliferation and metastases. Nicotine activates nicotinic acetylcholine receptors (nAChRs) that are expressed in cancer cell lines. Here, we examine the role of the α7 nAChR in coupling to heterotrimeric G proteins within breast cancer MCF-7 cells. Pharmacological activation of the α7 nAChR using choline or nicotine was found to increase proliferation, motility, and calcium signaling in MCF-7 cells. This effect …

Geospatial Analysis Of Opioid Dispensing Patterns In California: A 2021 Real-World Study, Hongxia Lu, Jianwei Zheng, Yun Wang

Pharmacy Faculty Articles and Research

The misuse and abuse of opioids has become a serious public health threat in the United States. The state of California has been hit particularly hard by the opioid epidemic, with a noticeable increase in opioid-related fatalities and hospitalizations. This brief report paper aims to contribute to the growing literature by conducting a geospatial analysis of opioid dispensing patterns in California in 2021. The primary objective was to identify areas characterized by high-risk opioid dispending patterns and explore possible contributing factors. This retrospective study analyzed data from over 7 million records of opioid and benzodiazepine prescriptions dispensed by outpatient pharmacies …

Alcohol As A Modifiable Risk Factor For Alzheimer’S Disease—Evidence From Experimental Studies, Devaraj V. Chandrashekar, Ross A. Steinberg, Derick Han, Rachita K. Sumbria

Pharmacy Faculty Articles and Research

Alzheimer’s disease (AD) is a progressive neurodegenerative disease characterized by cognitive impairment and memory loss. Epidemiological evidence suggests that heavy alcohol consumption aggravates AD pathology, whereas low alcohol intake may be protective. However, these observations have been inconsistent, and because of methodological discrepancies, the findings remain controversial. Alcohol-feeding studies in AD mice support the notion that high alcohol intake promotes AD, while also hinting that low alcohol doses may be protective against AD. Chronic alcohol feeding to AD mice that delivers alcohol doses sufficient to cause liver injury largely promotes and accelerates AD pathology. The mechanisms by which alcohol can …

Factors Affecting Initiation And Retention Of Medication-Assisted Recovery (Mar) Within A Pilot Pharmacist-Involved Practice Model At A Federally Qualified Healthcare Center (Fqhc) During The Covid-19 Pandemic, Tiffany Nguyen, Thomas Craig Cheetham, Souhiela Fawaz, Richard Beuttler, Sharon Xavioer

Pharmacy Faculty Articles and Research

Background: During the COVID-19 pandemic, opioid-related overdose deaths increased. Although Medication-Assisted Treatment or Recovery (MAT or MAR) is available, initiation and retention rates vary. The goal of this study was to evaluate clinical, demographic, and Social Determinant of Health factors affecting MAR initiation, on-time initiation of medications, and successful retention in the program. The secondary goal was to evaluate the impact of a novel interprofessional practice model incorporating pharmacists. Methods: A retrospective analysis was conducted using electronic health record data from a pilot MAR Program initiated within a California Federally Qualified Healthcare Center. Results: From September 2019 to August 2020, …

Computational Design And Molecular Modeling Of Morphine Derivatives For Preferential Binding In Inflamed Tissue, Makena Augenstein, Nayiri Alexander, Matthew Gartner

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

The opioid epidemic has impacted over 10 million Americans in 2019. Opioids, like morphine, bind non-selectively in both peripheral tissue, leading to effective pain relief, and central tissue, resulting in dangerous side effects and addiction. The inflamed conditions of injured tissues have a lower pH (pH = 6–6.5) environment than healthy tissue (pH = 7.4). We aim to design a morphine derivative that binds selectively within inflamed tissue using molecular extension and dissection techniques. Morphine binds to the μ-opioid receptor (MOR) when the biochemically active amine group is protonated. Fluorination of a β-carbon from the tertiary amine group led to …

Adolescent Use And Co-Use Of Tobacco And Cannabis In California: The Roles Of Local Policy And Density Of Tobacco, Vape, And Cannabis Retailers Around Schools, Georgiana Bostean, Anton M. Palma, Alison A. Padon, Erik Linstead, Joni Ricks-Oddie, Jason A. Douglas, Jennifer B. Unger

Sociology Faculty Articles and Research

Adolescent tobacco use (particularly vaping) and co-use of cannabis and tobacco have increased, leading some jurisdictions to implement policies intended to reduce youth access to these products; however, their impacts remain unclear. We examine associations between local policy, density of tobacco, vape, and cannabis retailers around schools, and adolescent use and co-use of tobacco/vape and cannabis.

We combined 2018 statewide California (US) data on: (a) jurisdiction-level policies related to tobacco and cannabis retail environments, (b) jurisdiction-level sociodemographic composition, (c) retailer locations (tobacco, vape, and cannabis shops), and (d) survey data on 534,176 middle and high school students (California Healthy Kids …

The Student Athlete Wellness Portal: Translating Student Athletes’ Prescription Opioid Use Narratives Into A Targeted Public Health Intervention, Anne E. Pezalla, Hyejeong Choi, Francis Mckee, Michelle Miller-Day, Michael L. Hecht

Communication Faculty Articles and Research

Background and Objectives: The opioid epidemic has permeated all strata of society over the last two decades, especially within the adolescent student athletic environment, a group particularly at risk and presenting their own challenges for science and practice. This paper (a) describes the development of a web-based intervention called the Student Athlete Wellness Portal that models effective opioid misuse resistance strategies and (b) details the findings of a single-group design to test its effectiveness. Materials and Methods: Formative research included 35 student athletes residing in the United States, ages 14 to 21, who had been injured in their …

Pharmacists’ Response To The Opioid Crisis: A California Naloxone Survey, Jerika T. Lam, Moom Roosan, Mary A. Gutierrez, Enrique Seoane-Vazquez

Pharmacy Faculty Articles and Research

This study aimed to assess pharmacists’ response to the current opioid crisis in California, particularly regarding the prevalence of naloxone furnishing (or dispensing without a prescription) and prescriptions for medication-assisted treatment (MAT) drugs for opioid use disorder (OUD) to patients and consumers.

Modulation Of Hepatic Amyloid Precursor Protein And Lipoprotein Receptor-Related Protein 1 By Chronic Alcohol Intake: Potential Link Between Liver Steatosis And Amyloid-Β, Jerome Garcia, Rudy Chang, Ross A. Steinberg, Aldo Arce, Joshua Yang, Peter Van Der Eb, Tamara Abdullah, Devaraj V. Chandrashekar, Syndey M. Eck, Pablo Meza, Zhang-Xu Liu, Enrique Cadenas, David H. Cribbs, Neil Kaplowitz, Rachita K. Sumbria, Derick Han

Pharmacy Faculty Articles and Research

Heavy alcohol consumption is a known risk factor for various forms of dementia and the development of Alzheimer’s disease (AD). In this work, we investigated how intragastric alcohol feeding may alter the liver-to-brain axis to induce and/or promote AD pathology. Four weeks of intragastric alcohol feeding to mice, which causes significant fatty liver (steatosis) and liver injury, caused no changes in AD pathology markers in the brain [amyloid precursor protein (APP), presenilin], except for a decrease in microglial cell number in the cortex of the brain. Interestingly, the decline in microglial numbers correlated with serum alanine transaminase (ALT) levels, suggesting …

Macrodosing To Microdosing With Psychedelics: Clinical, Social, And Cultural Perspectives, Ayse Ceren Kaypak, Amir Raz

Psychology Faculty Articles and Research

To date, the clinical and scientific literature has best documented the effects of classical psychedelics, such as lysergic acid diethylamide (LSD), psilocybin, and dimethyltryptamine (DMT), in typical quantities most often associated with macrodosing. More recently, however, microdosing with psychedelics has emerged as a social trend and nascent therapeutic intervention. This variation in psychedelic practice refers to repeat, intermittent ingestion of less-than-macrodose amounts that do not cause the effects associated with full-blown “trips”. Microdosing paves the road to incorporating psychedelic drugs into a daily routine while maintaining, or even improving, cognitive and mental function. Unlike macrodosing with psychedelics, the influence of …

Lesbian, Gay, And Bisexual Students Experiencing Homelessness And Substance Use In The School Context: A Statewide Study, Hadass Moore, Kris De Pedro

Education Faculty Articles and Research

PURPOSE

This study explored differences between lesbian, gay, and bisexual (LGB)-housed and homeless students regarding substance use patterns on and off school grounds and the unique contribution of homelessness to substance use in school.

METHODS

Data were from the 2013-2015 California Healthy Kids Survey, a statewide survey of school protective factors and risk behaviors. A representative sample of 9th- and 11th-grade students (N = 20,337) was used. Comparisons between housed (n = 19,456) and homeless (doubled up: n = 715; acute homeless: n = 166) LGB students were conducted. We used chi-square tests to compare rates of lifetime, past-30-day, and …

The Detrimental Impact Of Alcohol Intoxication On Facets Of Miranda Comprehension, Amelia Mindthoff, Jacqueline R. Evans, Andrea C. F. Wolfs, Karina Polanco, Naomi E. S. Goldstein, Nadja Schreiber Compo

Psychology Faculty Articles and Research

Objective: Law enforcement officers often encounter alcohol-intoxicated suspects, suggesting that many suspects are presented with the challenge of grasping the meaning and significance of their Miranda rights while intoxicated. Such comprehension is crucial, given that Miranda is intended to minimize the likelihood of coercive interrogations resulting in self-incrimination and protect suspects’ constitutional rights. Yet, the effects of alcohol on individuals’ ability to understand and appreciate their Miranda rights remain unknown—a gap that the present study sought to address. Hypotheses: Informed by alcohol myopia theory (AMT), we predicted that intoxicated individuals would demonstrate impaired Miranda comprehension compared to sober …

Spatial Disparities: The Role Of Nativity In Neighborhood Exposure To Alcohol And Tobacco Retailers, Georgiana Bostean, Luis A. Sánchez, Jason A. Douglas

Sociology Faculty Articles and Research

Studies of retail environment, one of the social determinants of health, document racial/ethnic disparities in exposure to alcohol and tobacco (A and T) retailers, but have largely overlooked nativity. We examined associations between A and T retailer density and rates of foreign-born Latinx and foreign-born Asian residents in California census tracts (N = 7888), using spatial regressions and controlling for population and ecological confounders (e.g., population density, zoning, residential instability, urbanicity). Socio-demographic data came from the American Community Survey (2012–2016); census tract density of A and T retailers came from geocoded addresses from state license data for off-sale alcohol distributors …

Temporal Trends In Smoking And Nicotine Dependence In Relation To Co-Occurring Substance Use In The United States, 2005-2016, Yun Wang, Ying Liu, Mary Waldron, Alexandra N. Houston-Ludlam, Vivia V. Mccutcheon, Michael T. Lynskey, Pamela A. F. Madden, Kathleen K. Bucholz, Andrew C. Heath, Min Lian

Pharmacy Faculty Articles and Research

Background
Despite an overall decline in tobacco use in the United States, secular trends of smoking and nicotine dependence with co-occurring substance use are not well characterized.

Methods
We examined self-reported tobacco and other substance use in 22,245 participants age 21–59 in the United States from six waves of the National Health and Nutrition Examination Survey (NHANES). Using Joinpoint regression, we assessed secular trends of smoking and nicotine dependence as a function of co-occurring use of alcohol, prescription opioids, marijuana/hashish, cocaine/heroin/methamphetamine, or other injection drug use. Multivariable logistic regressions were fitted to identify the potential risk factors.

Results
During 2005–2016, …

Racial And Ethnic Disparities In Opioid Use For Adolescents At Us Emergency Departments, Michael T. Phan, Daniel M. Tomaszewski, Cody Arbuckle, Sun Yang, Candice D. Donaldson, Michelle A. Fortier, Brooke Jenkins, Erik Linstead, Zeev N. Kain

Pharmacy Faculty Articles and Research

Background

Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED.

Methods

This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11–21 years old were analyzed. …

Analysis Of Gabapentinoids Abuse-Reports In The Middle East And North Africa Region Utilizing The Food And Drug Administration Adverse Event Reporting System, Mona Yaser Alsheikh, Ali Mofleh Alshahrani, Reem Dhayan Almutairi, Hana Abdulmohsen Althobaiti, Ahmed Ibrahim Fathelrahman, Enrique Seoane-Vazquez, Moudi Mubarak Alasmari

Pharmacy Faculty Articles and Research

Objectives: The purpose of this study was to identify abuse-related post-marketing reports associated with gabapentinoids use in the Middle East and North Africa (MENA) region countries. Methods: A retrospective cross-sectional analysis of abuse-related adverse drug event (ADE) reports from the Middle East and North Africa (MENA) region. It was performed using the Food and Drug Administration Adverse Event Reporting System (FAERS) database from January 2008 through June 2020. Abuserelated ADE reports for gabapentin and pregabalin were extracted from the FAERS database. Descriptive statistics were performed, and the proportional reporting ratio (PRR) was calculated to detect disproportional attribution of abuse-related ADEs …

Evaluating Opioid Dispensing Rates Among Pediatrics And Young Adults Based On Cures Data Reporting In California From 2015–2019, Michael T. Phan, Courtney Wong, Daniel M. Tomaszewski, Zeev N. Kain, Brooke Jenkins, Candice D. Donaldson, Michelle Fortier, Sun Yang

Pharmacy Faculty Articles and Research

Background

Receipt of opioid prescriptions in pediatric and young adult patients may be a risk factor for future opioid misuse. Data from prescription drug monitoring programs provide insight on outpatient opioid use. In our study, we analyzed the opioid dispensing rates for pediatrics and young adults in California. Methods

A secondary analysis was performed from 2015–2019 using Controlled Utilization Review and Evaluation System data. This database provides dispensing data of controlled substances in California. Patients younger than 25 years who were prescribed opiates were analyzed by county. We further divided them into two groups (children: ≤14 years; adolescents and young …

A Multivariable Model Of Parent Satisfaction, Pain, And Opioid Administration In A Pediatric Emergency Department, Candice D. Donaldson, Thomas W. Heyming, Louis Ehwerhemuepha, Brooke N. Jenkins, Michelle A. Fortier, William Feaster, Zeev N. Kain

Psychology Faculty Articles and Research

Introduction: Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12–17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children’s care in a pediatric ED.

Methods: We examined data from a tertiary pediatric care facility. A health …

Mechanisms Study: Using Game Theory To Assess The Effects Of Social Norms And Social Networks On Adolescent Smoking In Schools—Study Protocol, Ruth F. Hunter, Felipe Montes, Jennifer M. Murray, Sharon C. Sanchez-Franco, Shannon C. Montgomery, Joaquín Jaramillo, Christopher Tate, Rajnish Kumar, Laura Dunne, Abhijit Ramalingam, Erik O. Kimbrough, Erin Krupka, Huiyu Zhou, Laurence Moore, Linda Bauld, Blanca Llorente, Olga L. Sarmiento, Frank Kee

Economics Faculty Articles and Research

This proof of concept study harnesses novel transdisciplinary insights to contrast two school-based smoking prevention interventions among adolescents in the UK and Colombia. We compare schools in these locations because smoking rates and norms are different, in order to better understand social norms based mechanisms of action related to smoking. We aim to: (1) improve the measurement of social norms for smoking behaviors in adolescents and reveal how they spread in schools; (2) to better characterize the mechanisms of action of smoking prevention interventions in schools, learning lessons for future intervention research. The A Stop Smoking in Schools Trial (ASSIST) …

Children’S Cancer Pain In A World Of The Opioid Epidemic: Challenges And Opportunities, Michelle Fortier, Sun Yang, Michael T. Phan, Daniel Tomaszewski, Brooke N. Jenkins, Zeev N. Kain

Psychology Faculty Articles and Research

The opioid crisis in the United States has grown at an alarming rate. Children with cancer are at high risk for pain, and opioids are a first‐line treatment in this population. Accordingly, there is an urgent need to optimize pain management in children with cancer without contributing to the opioid crisis. This report details opportunities for this optimization, including clinical practice guidelines, comprehensive approaches to pain management, mobile health, and telemedicine. It is vital to balance appropriate use of analgesics with efforts to prevent misuse in order to reduce unnecessary suffering and minimize unintended harms.

An E-Learning Adaptation Of An Evidence-Based Media Literacy Curriculum To Prevent Youth Substance Use In Community Groups: Development And Feasibility Of Real Media, Anne E. Ray, Kathryn Greene, Michael L. Hecht, Sarah C. Barriage, Michelle Miller-Day, Shannon D. Glenn, Smita C. Banerjee

Communication Faculty Articles and Research

Background: There is a need for evidence-based substance use prevention efforts that target high school-aged youth that are easy to implement and suitable for dissemination in school and community groups. The Youth Message Development (YMD) program is a brief, four-lesson, in-person curriculum that aims to prevent youth substance use through the development of youth media literacy. Specifically, YMD aims to increase understanding of advertising reach and costs, along with the techniques used to sell products; develop counterarguing and critical thinking skills in response to advertisements; and facilitate application of these skills to the development of youth-generated antisubstance messages. Although …

Cannabinoid Hyperemesis Syndrome: An Unrecognized Cause Of Nausea And Vomiting, Tiffany Smith, Anne Walsh, Christopher Forest

Physician Assistant Studies Faculty Articles and Research

Cannabis has long been used for medical and recreational purposes because of its antiemetic, analgesic, and mood effects. Ironically, chronic use of cannabis can result in paradoxical effects, including a condition known as cannabinoid hyperemesis syndrome. Patients with this syndrome often are seen in the ED with cyclic vomiting, nausea, and epigastric pain. Although the definitive treatment of cannabinoid hyperemesis syndrome is discontinuing the causative agent, medical management that includes rehydration is important to prevent complications. Common antiemetic medications are ineffective, but some studies have shown haloperidol and lorazepam to be effective in treating acute symptoms.

Promoting Support For Public Health Policies Through Mediated Contact: Can Narrator Perspective And Self-Disclosure Curb In-Group Favoritism?, Riva Tukachinsky, Emily Brogan-Freitas, Tessa Urbanovich

Communication Faculty Articles and Research

An online 2 × 2 factorial experiment (N = 203) examined the effect of parasocial contact on support for public health policies in the context of opioid addiction. We hypothesize that because of an intergroup dynamic, individuals are less likely to engage with an outgroup character than an in-group character featured in a news magazine article. Results support the in-group favoritism hypothesis. The study examines two narrative devices for overcoming this tendency: the narrator’s perspective and amount of insight into the character’s inner world through character self-disclosure. We find support for the narrator perspective but not for the self-disclosure effect. …

Trends In Opioid Use In Pediatric Patients In Us Emergency Departments From 2006 To 2015, Daniel M. Tomaszewski, Cody Arbuckle, Sun Yang, Erik J. Linstead

Pharmacy Faculty Articles and Research

Importance The use of opioids to treat pain in pediatric patients has been viewed as necessary; however, this practice has raised concerns regarding opioid abuse and the effects of opioid use. To effectively adjust policy regarding opioids in the pediatric population, prescribing patterns must be better understood.

Objective To evaluate opioid prescribing patterns in US pediatric patients and factors associated with opioid prescribing.

Design, Setting, and Participants This cross-sectional study used publicly available data from the National Hospital Ambulatory Medical Care Survey from January 1, 2006, to December 31, 2015. Analysis included the use of bivariate and multivariate models to …

A Markov Approach For Increasing Precision In The Assessment Of Data-Intensive Behavioral Interventions, Vincent Berardi, Ricardo Carretero-González, John Belletierre, Marc A. Adams, Suzanne C. Hughes, Melbourne Hovell

Psychology Faculty Articles and Research

Health interventions using real-time sensing technology are characterized by intensive longitudinal data, which has the potential to enable nuanced evaluations of individuals’ responses to treatment. Existing analytic tools were not developed to capitalize on this opportunity as they typically focus on first-order findings such as changes in the level and/or slope of outcome variables over different intervention phases. This paper introduces an exploratory, Markov-based empirical transition method that offers a more comprehensive assessment of behavioral responses when intensive longitudinal data are available. The procedure projects a univariate time-series into discrete states and empirically determines the probability of transitioning from one …

Designed Cultural Adaptation And Delivery Quality In Rural Substance Use Prevention: An Effectiveness Trial For The Keepin’ It Real Curriculum, Michael L. Hecht, Youngju Shin, Jonathan Pettigrew, Michelle Miller-Day, Janice L. Krieger

Communication Faculty Articles and Research

This study examined how cultural adaptation and delivery quality of the school-based intervention keepin’ it REAL (kiR) influenced adolescent substance use. The goal of the study was to compare the effectiveness of the multi-cultural, urban (non-adapted) kiR intervention, a re-grounded (adapted) rural version of the kiR intervention and control condition in a new, rural setting. A total of 39 middle schools in rural communities of two states in the USA were randomly assigned to one of three conditions (i.e., control, non-adapted urban kiR, and adapted rural kiR). Data included adolescent self-reported lifetime substance use and observers’ ratings of delivery quality …