Chapman professor’s prevention program cited by U.S. Surgeon General

The U.S. Surgeon General’s groundbreaking recent report, Facing Addiction in America, cites a program co-founded by Chapman University professor Michelle Miller-Day, Ph.D., as a model for substance-abuse prevention.

Issued amid an opioid crisis that has seen annual overdose deaths surpass deaths from both car accidents and gun violence, the Surgeon General’s 428-page November report commends Miller-Day’s keepin’ it REAL as one of the most effective prevention programs for youths. It also cites keepin’ it REAL
as one of the most cost-effective programs and as one proven effective across different cultures.

Miller-Day, a professor in the Department of Communication Studies, developed the program with Penn State professor Michael Hecht. The approach emphasizes the acronym REAL – Refuse, Explain, Avoid, Leave – and focuses on young people’s own narratives as a way to teach others how to decline to use alcohol and drugs.

“For us, it’s all about kids’ stories,” says Miller-Day, explaining that studies have proven lectures from authority figures such as police officers or teachers are ineffective. “Fear appeals don’t work,” she says.

After examining some 600 prevention programs, the Surgeon General’s office cites just 42 evidence-based prevention programs and policies that have been proven scientifically effective. In addition, keepin’ it REAL is one of three highlighted as the most effective school-based programs for adolescents ages 10-18.

Adopted by D.A.R.E. in 2012 to replace the “Just Say No” program that had been proven ineffective in studies, “keepin it REAL” is one of the most widely disseminated prevention efforts. The program uses student-developed videos and narratives, and seeks to heighten identification and engagement through role-playing and sharing.

Miller-Day notes that the first offers of alcohol, tobacco, marijuana or illegal drugs adolescents receive don’t typically come from an addict, dealer or even a much older person.

“It’s almost always someone you know, offering it in a social context,” she said. “He may not be a jerk. Maybe he’s the good-looking quarterback of the football team.”

Young people might fear refusing could subject them to ridicule, but Miller-Day said an explanation bolsters a refusal.

“It’s not an excuse, it’s a reason,” she said. “Like, ‘I have a test tomorrow,’ or, ‘That made me sick.’ Eight times out of 10, people are like, ‘Cool,’ and they respect that.

“Some other ways to avoid it would be like my red cup: I have ginger ale in it, but it looks like beer.

“This program offers different strategies for teens if they choose not to use.”