Keepin' it R.E.A.L. (Refuse, Explain, Avoid, Leave)


An Evidence-Based Practice


The Keepin' it R.E.A.L. (Refuse, Explain, Avoid, Leave) program is a video-enhanced intervention that uses a culturally grounded resiliency model that incorporates traditional ethnic values and practices that protect against drug use. A school-based prevention originally designed for middle-school students, the program has been implemented with youths ages 10 through 17. The program teaches youths to live drugfree lives by building on their existing cultural and communication strengths and the strengths of their families and communities. Students are taught how to resist substance use through practical, easy-to-remember and -use strategies that are embodied in the acronym REAL (Refuse, Explain, Avoid, Leave). Using Keepin' it R.E.A.L. strategies, students learn how to recognize risk, value their perceptions and feelings, embrace their cultural values (e.g., avoiding confrontation and conflict in favor of maintaining relationships and respect), and make choices that support them. Distinct Mexican-American, African-American/Non-Latino, and multicultural versions of keepin' it R.E.A.L. were developed so students could recognize themselves in the prevention message and see solutions that are sensitive to their unique cultural environments.

Goal / Mission

The objective of this program is to increase life skills such as risk assessment, decision-making and drug resistance, while enhancing anti-drug norms and attitudes.

Results / Accomplishments

The initial keepin' it R.E.A.L. evaluation was conducted over 48 months. The study sample consisted of 3,318 Mexican or Mexican-American students (47 percent female), 1,141 students of other Latino or multiethnic Latino origin (e.g., Mexican and white, Mexican and American Indian; 50 percent female), 1,049 non-Hispanic white students (48 percent female), and 527 African-American students (44 percent female). The evaluation findings suggest that keepin' it R.E.A.L. succeeded in decreasing substance use, in reducing negative attitudes/behaviors, and in improving positive attitudes/behaviors. The data showed a 32 percent to 44 percent reduction in marijuana, tobacco, and alcohol use; a 29 percent to 34 percent decrease in intent to accept substances; and a reduction and cessation of substance use. Improvements in antidrug attitudes/behaviors were apparent in the 30-38 percent increase in knowledge about and negative attitude toward drug use, increased repertoire of resistance skills, more frequent use of those skills, and increased adoption of strategies to resist using alcohol, cigarettes, and marijuana. Other types of outcomes included significantly less substance use (especially alcohol), retention of unfavorable attitudes against someone their age using substances, and perception that their peers' increase in substance use experimentation was significantly less than previously believed.

About this Promising Practice

Primary Contact
Patricia Dustman, Ed.D.
Southwest Interdisciplinary Research Center Arizona State University-Downtown Phoenix Campus 411 N. Central Avenue, Suite 720 Phoenix, AZ 85004-0693
(602) 496-0700
Health / Substance Abuse
Health / Teen & Adolescent Health
Southwest Interdisciplinary Research Center
The Office of Juvenile Justice and Delinquency Prevention's Model Programs Guide (MPG)
Date of publication
Geographic Type
Phoenix, AZ
For more details
Target Audience
Children, Teens

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