Feasibility, Acceptability and Utility of the Evidence-based “keepin’ it REAL” Substance Use Prevention Program for Early Adolescents in Kenyan Schools

Abstract

The growing prevalence of youth substance use in Kenya calls for the implementation of efficacious substance use  prevention programs. The overall aim of this study was to evaluate the feasibility, acceptability, and utility of an  evidence-based substance use prevention program, keepin’ it REAL (kiR), in Kenyan secondary schools. The study had  three objectives: (1) Test if the program can be successfully delivered by assessing whether teachers agreed that kiR was  well suited to their educational context and engaged student participation (i.e., feasibility); (2) Test if teachers and  students found the prevention program’s components applicable, appropriate and satisfactory (i.e., acceptability); (3)  Test if teachers and students found the kiR program useful in imparting knowledge and motivating changes in attitudes  and behaviors related to substance use (i.e., utility). Data were drawn from post-test evaluations completed by kiR students (N=348) and teacher-implementers (N=7) during a pilot test in two Nairobiarea secondary schools. Quantitative  data were analyzed using descriptive statistics. Qualitative data were coded and contentanalyzed. Students  evaluated kiR positively: large majorities participated highly (feasibility); viewed kiR as highly satisfactory, interesting, and capturing their attention (acceptability); and reported it provided useful and highly applicable  information (utility). Teachers were nearly unanimous that kiR was feasible, addressed youth substance use well and  engaged student interest, but also noted technical issues in delivery (equipment, power interruptions), insufficient time  to complete lessons, and a need for more training. Findings demonstrated that kiR is feasible for implementation in  Kenya with attention to technical and class size challenges; with highly acceptable, applicable and satisfactory content;  and demonstrable impact on acquiring knowledge and skills to help adolescents resist substance use. Future research is  needed to adapt the implementation model for Kenya and test the efficacy of kiR in a randomized controlled trial with  a larger and more representative sample of schools.