Feasibility, Acceptability and Utility of the Evidence-Based Keepin’ It Real Prevention Program for Early Adolescents in Kenyan Schools

Background and Purpose: To address the growing prevalence of adolescent substance use and its early onset in Kenya, US researchers partnered with a Kenyan non-profit organization, African Institute for Children Studies, to pilot test an evidence- and school-based substance use prevention program for early adolescents from the US, keepin’ it REAL (kiR). The current study evaluates the feasibility, acceptability, and utility of the kiR implementation in two Kenyan middle schools from the perspective of 7th grade students and teacher-implementers.

Methods: This study used mixed-methods, drawing data from written post-test evaluations completed by kiR students (N=308) and teacher-implementers (N=7). Quantitative data included 26 closed-ended questions for students and 18 questions for teachers. Descriptive statistics summarized assessments of the feasibility, acceptability, and utility of kiR. Qualitative data came from open-ended questions: students wrote the most important thing they learned from kiR, and teachers answered ten questions about their experiences facilitating kiR lessons. To expand understanding of the quantitative results, the qualitative data were coded independently by two research team members and analyzed with content analysis.

Results: Students evaluated kiR very positively overall. Indicating its feasibility, two-thirds (66%) reported they participated a lot in kiR, and 84% reported their teachers taught kiR enthusiastically. Students viewed kiR as highly acceptable: 80% or more were satisfied with the program, and thought it was interesting, fun, and easy to pay attention. In assessing utility, over 80% of students said kiR provided helpful information and that they learned a lot. Two-thirds or more rated it as highly applicable: like real life, authentic, and similar to people they knew. Almost all students talked about kiR with family members or friends, demonstrating the program’s impact. In the qualitative data, most students (66%) identified the drug resistance strategies taught in kiR (Refuse, Explain, Avoid, Leave) as the most important thing they learned from the program. Teachers agreed that kiR was feasible and a good fit in addressing substance use issues (86%), and successful in engaging students (86%). Teachers also reported technical barriers with video equipment and utility interruptions (86%). They viewed kiR as highly acceptable: satisfied with the curriculum overall and its video components (100%). However, a large majority (86%) was unsatisfied with the limited time for completing the lessons. Most teachers agreed that students were comfortable with the topics (100%) and understood the content well (86%). All agreed on the utility of kiR in imparting valuable knowledge and skills to students. In qualitative data, teachers expanded on technology and time-concerns, and some called for more extensive teacher training. Teachers thought that skills training in kiR changed students’ cognition or behavior in and out of class, noting that some parents reported similar changes at home, which manifest the utility of kiR.

Conclusions and Implications: This study demonstrated that the kiR implementation in Kenya is feasible with attention to technical and class size challenges; that it has highly acceptable, applicable and satisfactory content; and that it provides impactful knowledge and skills to help early adolescents in Kenyan schools resist substance use.