REAL strategies help youth resist peer pressure

June 14, 2010

From Nancy Reagan’s "Just Say No" campaign to the oft-spoofed egg and a frying pan public service announcement ("This is your brain, this is your brain on drugs"), substance abuse prevention has long been based on teaching youth ways to resist peer pressure without involving the youth in the message.
All that's changed with keepin' it REAL, a program conducted by Penn State Department of Communication Arts and Sciences faculty Michael Hecht and Michelle Miller-Day, both in the College of the Liberal Arts.

Hecht, distinguished professor of communication arts and sciences and crime, law and justice; and Miller-Day, associate professor of communication arts and sciences; lead the drug-resistance-skills training curriculum which teaches middle school youth techniques for assessing risks and consequences of their behaviors, decision-making and communication skills, and the REAL strategies -- refuse, explain, avoid, leave -- through kids' own voices. The program -- which has been proven effective and is being distributed nationally and internationally through different partnerships, including D.A.R.E America -- is the winner of the 2010 Penn State Award for Community Engagement and Scholarship.

The award recognizes a project that best exemplifies an "engaged institution" as defined by a Kellogg Commission report on the future of land-grant universities --  an institution that has redesigned teaching, research and extension and service functions to become even more sympathetically and productively involved with its communities.

From kids, to kids, through kids
The program got its start in the 1980s when Hecht and Miller-Day, along with a team of Arizona State researchers, invited youth to share stories about their efforts to resist peer pressure. "These stories became the basis for our middle school substance abuse curriculum," said Hecht. "It starts with the premise of understanding youths' substance use experiences and working with them and others to create a 'kid-centric' substance abuse prevention curriculum."

Substance abuse remains a significant public health problem. Among eighth grade students in the United States, an estimated 22 percent smoke cigarettes, 39 percent use alcohol and 19 percent have used some other illicit substance. This early use is not only associated with later substance abuse problems, but it also puts youth at risk for school and delinquency problems and has implications for health and welfare throughout their lives.

After the team collected the youth narratives about resisting drugs and peer pressure, they brought the stories to other youth in a high school video production class and invited them to help develop the curriculum. Professional video producers were on hand to enhance the students' and teachers' skills.

"We talked with the video producers about prevention and what we hoped to accomplish," said Hecht. Students asked questions, and together with the video producers and their teachers came up with a plan to produce a series of videos teaching the refuse, explain, avoid, leave (REAL) strategies to say no to drug offers.

For example, the refusal strategy can be seen in a narrative of a 13-year-old boy, Dylan: "I was at this boy’s house seeing a friend ... and this guy pulled out some dope. He asked all of us if we wanted to, and we said no." Maya, age 12, is able to resist marijuana with an explanation to the boy that offered it to her: "One of my past friends used to sell it himself. He got arrested and ... we had to take care of his child." Jacqueline prefers to avoid situations altogether where there are drugs, finding other things to do. And Raul simply leaves the setting.

With the project originally taking shape in Phoenix, the researchers, with insight from student producers, led the creation of a multicultural curriculum targeting Latinos, Caucasians and African Americans.

The videos are the core aspect of the curriculum, with the lessons surrounding them developed in collaboration with teachers, drug prevention specialist, curriculum experts and a youth advisory board working with faculty and graduate students.

Adaptability is key
While the curriculum was first written for Phoenix youth, it has been adapted for other areas throughout the United States and 23 other countries. "In most areas, we work with the schools to develop a new set of videos," said Miller-Day. "The idea is that the kids hear the message from kids in their own community, so they can identify with it."

Most recently Hecht and Miller-Day led an effort, funded by the National Institute on Drug Abuse, with Janice Krieger at Ohio State, to develop the first rural substance abuse prevention curriculum, concentrating on rural areas in Pennsylvania and Ohio. For rural youth, alcohol use by parents seems particularly influential, said Miller-Day, especially when alcohol use, as well as chewing tobacco, are a part of adult pastimes.

One teen said: "It's hard… my dad drinks beer after beer after beer, and I know a lot of parents like that. They never stop drinking, and I think that could be what gets some people into alcohol. Actually, when I was, like, a really little kid, my daddy used to offer me sips of beer." Rural youth offered up many REAL strategies to resist peer pressure. For example, one girl explained to her peers why she doesn’t smoke cigarettes: "I told them I don't smoke because my gram smokes, and she's, like, really old … you can see how it affected her though because her nails are, like, bright yellow and her teeth are yellow."

As the rural curriculum emphasizes that youth view peers that "look like them," the rural program invokes images of campfires, ATVs and Friday night football. "Yet, because rural youth exhibit many commonalities with their urban/suburban counterparts, images of technology and socialization remain similar to the original curriculum," noted Tim Tanner, who, as a project community liaison acts as the point of contact between the researchers and the schools. The other liaisons include Kris Glunt in central Pennsylvania and Susan Mizenko and Cathy Terwilliger in northeast Pennsylvania.

Aaron Matthews, a professional filmmaker who worked with kids in central Pennsylvania to create the videos for the rural curriculum, said that the kids genuinely seemed to get a lot out of both the storytelling process and the hands-on interaction with the themes of keepin' it REAL. "They were enthusiastic and really embraced the spirit of the project," he said.

Maria Andrews, a student in Penns Valley who participated in the video production, said: "What I learned from keepin' it REAL is that when it comes to drugs and alcohol, just think, 'No!' Leaving is one of the easiest things to do. You don't need any explanations or excuses."

Real results
Hecht points out that not only is keepin' it REAL now the most widely disseminated middle school substance abuse prevention curriculum, it gives collaborative partners the opportunity to create strong, resilient schools and communities while developing their own communication skills. The school district in Phoenix even won a regional Emmy award for its efforts in producing the videos.

The program has partnered with D.A.R.E America to disseminate more rural, suburban and urban national versions of keepin' it REAL. D.A.R.E licensed the curriculum from Penn State and created these new versions to fit its officer-led model and its national distribution system. This collaboration includes an adaptation for schools in Mexico, with plans in the works for indigenous people in Alaska, as well as for youth in Brazil and Canada.

A Web-based curriculum is distributed through Discovery Health, and hard copies are available from Penn State and ETR Associates, a health promotion publisher.
Recognized by the National Registry of Evidence-based Programs and Practices for its effects on substance use, the program has been proven effective at reducing alcohol, marijuana and tobacco use among middle school students in a randomized clinical trial. The trial compared a control group (kids that did not receive the program) with kids who received the program either for Latinos, for Caucasians and African Americans, or for a multicultural audience (Latino, Caucasian and African American youth). The control group participated in more use of alcohol, cigarettes and marijuana compared with any other group, with the multicultural version producing the best results.

Shawnee Heckman, a seventh grade English teacher in Penns Valley and the parent of a seventh grader, said, "After completing the course, students will have several options at their disposal for getting out of dangerous situations or even avoiding the situation to begin with. I told my students that if I am able to help even one child avoid the pressures of drugs or alcohol, then I have accomplished the job I set out to do. The students were quiet, until one student spoke up and said, 'That makes sense.' I hope it does."

This story is from the spring issue of Penn State Outreach magazine.


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    IMAGE: Jamie Curott

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Last Updated January 09, 2015