Bridging Disciplinary Boundaries (January 11 - 14, 2007)

This study examines gender and ethnic differences in the efficacy of a culturally grounded school-based substance use prevention program. The program, called keepin' it REAL, has been recognized as a model program by the Substance Abuse and Mental Health Services Administration (SAMHSA). Although most evaluation studies focus only on overall program efficacy, we theorize and test how program efficacy in a majority Latino setting is affected by the complex interaction of gender, ethnicity, and acculturation. Data came from a randomized trial in 35 Phoenix, Arizona, middle schools involving 4,622 7th graders. Multi-variate, multi-level SAS Proc Mixed models accounted for clustered data at the school level. Multiple imputation techniques adjusted for missing data. Results from the combined sample showed that the program was more effective at fostering boys' anti-drug norms regarding alcohol and marijuana use. Further analyses investigated gender differences in efficacy by subgroup: more acculturated Latinos, less acculturated Latinos, non-Latino Whites, and other major ethnic groups. These results showed that a range of more beneficial program effects for boys were concentrated among the less acculturated Latinos. Among less acculturated Latinos, the program had stronger effects on lowering boys' alcohol consumption and cigarette use, as well as their acceptance of alcohol and marijuana. There were few consistent gender differences among more acculturated Latinos, whites, and other groups. These findings suggest three sets of explanations. First, higher efficacy for boys may stem from their higher risk. Studies show that drug use rates have generally been higher for boys than for girls in all age. Second, boys and girls have different motivations for engaging in substance use. Boys and girls experience the “ecological transition” (from elementary school to middle school) differently. In this transition, girls also experience physical changes to their bodies, difficulties with body image, increased peer conflict, and difficulty with gender roles. The keepin' it REAL program may be less effective with these female-oriented stressors of substance use. Third, gender differences in efficacy among less acculturated Latinos point to the importance of cultural factors. Substance use risks may vary across acculturation status because of gender differences in the cultural expectations of substance use. In Mexican culture, men are allowed and even encouraged to drink while women are allowed only within the safe confines of masculine boundaries. These gender and substance use norms might change during the acculturation process as individuals adopt the gender and substance use norms of the dominant culture.