The Drug Resistance Strategies (DRS) Project grew out of the need to understand the adolescent perspective on drugs and drug offers. DRS research describes the process of drug offers - the "who, what, where, how and why" of the process. Most importantly, it describes effective ways for youth to refuse or resist these offers.
The project has been conducted in a series of phases, each founded by the National Institute of Drug Abuse (NIDA). These grants, DRS 1-4, as well as the current project DRS Rural are described below:
The High School Study 1988-1991 - DRS 1
DRS1 was the first large-scale research project to examine how youth are offered and resist drugs. The goals of the 1988 Arizona high school study were to: (1) begin to identify adolescents' perceptions of drug resistance strategies, (2) design a training program for teaching resistance skills and (3) conduct a pilot study of its effectiveness. Two high schools in Mesa and Tempe , Arizona participated in these studies which 
identified the four resistance strategies (Refuse, Avoid, Explain, and Leave) that are the core of the DRS Project.
These strategies became known by their acronym, REAL, and were later found to be used by college and middle school students as well. The youth narratives collected in this research were used to develop live and videotaped performances, entitled Killing Time (produced and directed by Joe Rassulo). These performances proved successful in reducing youth drug use in a pilot study, creating the model for our keepin’ it REAL prevention curriculum.
The studies from this phase of the Drug Resistance Strategies Project produced a set of resistance strategies and specified some of the situations under which these strategies were effective and ineffective. In addition, these studies suggested differences in resistance to alcohol and other drugs, the importance of resistance beyond the initial refusal, the role of implicit and explicit peer pressure, the utility of language analysis, and the significance of initial skill level.
The Middle School Studies 1993-2001 - DRS 2 & 3
Having discovered that drug involvement begins before high school, DRS researchers targeted middle-school students in their next phase of prevention testing and research. Michael Hecht, Principle Investigator, obtained funding from NIDA for the Drug Resistance Strategies Minority Project (DRS2). Working in collaboration with Melanie Trost, DRS2 extended research to middle school-aged youth and was the first series of studies to examine ethnicity and adolescent drug resistance.
In this phase of the project researchers developed the keepin’ it REAL prevention curricula using research from the high school pilot study that identified drug resistance strategies used by adolescents. The students then created 5 video-based performance lessons which were incorporated into 10 lessons to be implemented by teachers in the classroom.
Using a research design developed by Michael Hecht and John Graham of Penn State University and with the involvement of Elvira Elek, Stephen Kulis, David Wagstaff, and Tanya Nieri, keepin' it REAL was implemented in 35 middle schools by Flavio Marsiglia and Dee Spencer. The project proved successful in limiting increases in alcohol, tobacco, and marijuana use between 7th and 8th grades and keepin' it REAL was selected as a Model Program by the Center for Substance Abuse Programs (CSAP) at the Substance Abuse and Mental Health Services Administration.
Additional research advanced our understanding of how the program works, how ethnicity and gender are related to adolescent drug use, the role of social norms, and identifies acculturation status as an important aspect of drug decisions.
DRS4
Starting in 2003, the DRS team has been working under a new grant from the National Institute on Drug Abuse. The current research concentrates on determining the best grade level to introduce the prevention program (5th vs. 7th grade), including elementary school implementation in addition to middle school. In addition, work on DRS4 continues the long-term study examining the relationships among acculturation, decision-making, different types of norms, identity, family structure, parent-child communication, and drug use.
Michael Hecht and the teams at Penn State University (headed by Elvira Elek and John Graham) and Arizona State University (headed by Flavio Marsiglia) obtained additional funding from the National Institute on Drug Abuse to continue the Drug Resistance Strategies project (DRS4). Under the new grant, research is being conducted to determine the best grade level to start drug prevention (5th versus 7th grade) and to try to improve the curriculum to better meet the needs of immigrant populations. In addition, longitudinal research is planned to examine the relationships among acculturation, identity, and drug use.
During the first year, the multicultural version of the keepin' it REAL curriculum was adapted for fifth grades by Nancy Gonzalez, Patricia Dustman, and Mary Harthun. In addition, an acculturation enhancement was developed by this team and a group support component is developed by a team lead by Flavio Marsiglia. During year two, curriculum materials were developed by Leslie Reeves, teachers from 29 elementary schools were trained by Mary Harthun and the curriculum was implemented under the leadership of Patricia Dustman. During 2007-08, the multicultural version of keepin’ it REAL was implemented in 27 middle schools in Phoenix, Arizona. Evaluation research, under the leadership of Elvira Elek, Stephen Kulis, David Wagstaff, and Tanya Nieri, is being conducted to measure the program's impact.
DRS Rural
The development of an effective school-based substance use prevention programs has given rise to a recent focus on implementation issues. This study will help us understand how to implement programs beyond their original target audience as well as how to guide teachers when they adapt curriculum to their classes.
The goals of the study are to conduct an effectiveness trial of the keepin’ it REAL middle school substance use prevention curriculum among a new target audience in Pennsylvania and Ohio, describe how teachers adapt the curriculum when they present it, and develop, implement, and evaluate a rural-version of the curriculum to test whether an evidence-based universal curriculum can be improved by adapting it to local cultures. SAMSHA's National Registry of Effective Programs recognized keepin’ it REAL as a “model program”, one of the few that are multicultural. The study will evaluate the effectiveness of the original curriculum, grounded in the cultures of the southwest and compare that to a new version, “regrounded” in the rural culture of Pennsylvania and Ohio, while studying how teachers adapt both versions. This proposal responds to NIDA calls for investigations addressing, “1) the development of novel drug abuse prevention approaches; 2) the efficacy and effectiveness of newly developed and/or modified prevention programs; 3) the processes associated with the selection, adoption, adaptation, implementation, sustainability, and financing of empirically validated interventions.”
A randomized control trial will be conducted in middle schools to accomplish these goals. First, we will conduct formative research to develop the rural version of the curriculum. Second, 42 schools will be randomly assigned to one of these three conditions: teacher adaptation (implementing the original keepin’ it REAL curriculum); researcher adaptation (implementing the new rural version of the curriculum), and a control group. We hypothesized that participation in either form of the curriculum will reduce substance use and that researcher adaptation will produce better outcomes than teacher adaptation. A pretest will be administered followed by posttests in 7th-9th grades. Three measures will assess adaptation and quality/fidelity: a Program Quality and Adaptation online measure completed by teachers after each lesson, observation of two lessons, and audio recording of two lessons. The major hypothesis tests utilize variants of the general linear model, taking into account the multilevel structure of the data (e.g., multilevel multiple regression), tests of a mediation model, and growth modeling.