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This study examined how cultural adaptation and delivery quality of the school-based intervention keepin' it REAL (kiR) influenced adolescent substance use. A total of 39 middle schools in rural communities of two states in the U.S. were randomly assigned to one of three conditions (i.e., control, urban non-adapted kiR, and rural adapted kiR). Data were adolescent self-reported lifetime substance use and trained observers' ratings of delivery quality from the video records. Observer ratingsdoi:10.1007/s11121-018-0937-y pmid:30056616 fatcat:s3ku27ow2bd2dcurfrkoy2i4hy