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Based on social cognitive theory and narrative engagement theory, the current study examined hypothesized indirect effects of engagement with keepin’ it REAL (kiR) curriculum entertainment–education (E–E) videos on youth alcohol use via youth drug offer refusal efficacy. Students in 7th grade (N = 1,464) at 25 public schools in two Midwestern states were randomly assigned to one of the two versions of the kiR curriculum, the kiR urban version and the kiR rural version. Each version had their own set of five culturally-grounded E–E videos depicting communicative skills to refuse drug offers. Differential effects for engagement components were expected depending on the degree of cultural matching. Pre/post surveys were administered at the beginning and the end of 7th grade. Structural equation modeling analysis resulted in partial support for the research hypotheses. Rural youth receiving the urban curriculum who reported higher interest in the E–E videos were more likely to report having higher refusal efficacy, and in turn, less likely to use alcohol. Rural youth receiving the rural curriculum who identified with the E–E video main characters were more likely to report having higher refusal efficacy, and in turn, less likely to use alcohol. Implications for E–E health promotion are discussed.


This is an Accepted Manuscript of an article published in Health Communication, volume 33, issue 7, in 2018, available online at DOI: 10.1080/10410236.2017.1321163. It may differ slightly from the final version of record.


Taylor & Francis



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