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Challenging sustainability in school-based intervention in Nicaragua

Jonathan Pettigrew (Hugh Downs School of Human Communication, Arizona State University, Tempe, Arizona, USA)
Robert Razzante (Arizona State University, Tempe, Arizona, USA)
Joshua Allsup (Asociacion Cristiana Tabernaculo de Fe Rey de Gloria, Masaya, Nicaragua)
Yu Lu (University of Oklahoma, Norman, Oklahoma, USA)
Colter D. Ray (San Diego State University, San Diego, California, USA)

Health Education

ISSN: 0965-4283

Article publication date: 24 March 2021

Issue publication date: 21 May 2021




The current study identifies successes and limitations of sustaining Dale se Real (DsR) as a school-based educational intervention program related to drugs and violence for 7th and 8th grade students in Nicaragua, Central America. As evidence-based interventions are transported and imported across national borders, issues surrounding their adaptation and sustainability become important targets for investigation.


Interviews were conducted with nine key informants (e.g. school directors, implementers) from seven institutions, four of which sustained DsR and three of which did not. This study explores DsR's fit with the institutions' missions and routines, program adaptability, broader community support and sustainability planning.


Findings demonstrate two emerging views of sustainability within the Nicaraguan schools: a deficit approach and an empowerment approach. These two approaches imply different motivational structures for institutions and also led to the practical finding that developers and trainers need to provide structured or formal ways of empowering schools to continue implementing a program after staff no longer routinely contact them.


This study contributes a particular case on what facilitates and impedes sustainability of school-based interventions that can inform future intervention research in Latin American countries.



Compliance with ethical standards: The authors declare that they have no conflict of interest.

Funding: This research was supported in part by grant number S-INLEC-16-GR-1005 from the International Narcotics and Law Enforcement Affairs Bureau to Arizona State University (Dr. Jonathan Pettigrew, PI). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the United States Department of State.


Pettigrew, J., Razzante, R., Allsup, J., Lu, Y. and Ray, C.D. (2021), "Challenging sustainability in school-based intervention in Nicaragua", Health Education, Vol. 121 No. 4, pp. 356-367.



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