Alaska Uses Health Education Curriculum to Promote Healthy Teen Relationships

November 12, 2014|2:07 p.m.| ASTHO Staff

Alaska has some of the highest rates of partner violence, sexual assault, and chlamydia in the United States. After examining these rates, and the state’s teen dating violence and teen birth rates, Alaska’s Department of Health and Social Services (AK DHSS) decided to combat these issues using a comprehensive education program for secondary school children known as Fourth R.

AK DHSS brought Fourth R to Alaska thanks to funding from CDC’s Rape Prevention and Education program, the Alaska Council on Domestic Violence and Sexual Assault, and HHS’s Family and Youth Services Bureau, among other partners. Fourth R (R stands for relationships) was created for students in grades seven through nine and is made up of three units containing 21 75-minute lessons that can be incorporated into existing health education courses. To better serve the young Alaska Native population, Fourth R developers rewrote the ninth grade aboriginal population-specific curriculum to create a new version, Alaska Perspectives, which incorporates cultural components pertaining to Alaska Natives.

One of the biggest challenges AK DHSS faced when implementing the Fourth R program was Alaska’s lack of a state health education requirement, and therefore, shortage of trained health education teachers. In addition, because teacher turnover is high in rural Alaskan communities, program coordinators learned to start tracking teacher participants to anticipate which areas might lose a Fourth R-trained teacher. Since Alaska’s health education curricula are developed at the local level, AK DHSS implemented the program by making Fourth R materials and training available to communities across the state, and at least 63 secondary schools took them up on the offer. More than 300 school staff and community partners initially trained to facilitate Fourth R curriculum in their communities.

Canada’s Centre for Addiction and Mental Health Centre for Prevention Science developed the Fourth R curriculum to teach middle and high school students about human growth and sexuality in an environment that promotes healthy relationships and disease prevention. Robert Wood Johnson Foundation chose Fourth R to be part of its Start Strong teen relationships program, and the curriculum has been lauded by educators and researchers for its interconnected content areas and evidence-based focus.

Learn more about how the Alaska Department of Health and Social Services implemented the prevention-based Fourth R curriculum in this story from ASTHO's "Have You Shared" story collection. View ASTHO's complete collection of stories at