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.