An Evidence-Based Program

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2023 Departmental SRAE Tool Kit

The purpose of the SRAE program is to fund projects to implement sexual risk avoidance education, defined by statute as voluntarily refraining from non-marital sexual activity. The services are targeted to participants who reside in underrepresented or underserved communities with high rates of teen births and/or are at greatest risk of contracting sexually transmitted infections (STIs). Departmental SRAE FOA Due 7/18/23

We will be updating the HFNC tool kit as necessary. Please check back frequently.

Click here for a description of program goals, each unit’s objectives, time required to administer each unit, and expected outcomes.

Healthy Futures Nu-CULTURE (HFNC) aligns with the goals and objectives of the SRAE program because our medical information was updated in 2023 and includes medical references from peer reviewed publications by scientific, governmental, or health organizations. The program implements prevention education aimed to teach youth to avoid non-marital sexual activity, self-regulation, goal setting, healthy decision-making, success sequencing for poverty prevention, a focus on the future, and the prevention of youth risk behaviors such as drug and alcohol usage.

Healthy Futures Nu-CULTURE (HFNC) uses a strengths-based approach to motivate adolescents to embrace the developmentally appropriate truth that “The choices you make NOW affect you LATER!” Engaging youth throughout the program with interactive activities, competitions, and games inspires youth to create a strong sense of individual agency.

Click Here for details regarding the theoretical frameworks supporting the program activities.

Click Here to access the program’s logic model.

Through engaging activities, HFNC develops skills youth need to avoid sexual activity during their teen years. The program serves youth in middle school by delivering 8 (50) minute lessons in the sixth, seventh and eighth grades, targeting youth ages 11-15 from diverse communities and backgrounds. HFNC provides lessons about contraceptives and STD prevention without normalizing sexual activity for youth because the information includes both the risks and benefits of risk reduction strategies. Engaging activities support adolescents encouraging them to consider making the healthiest decision which is to avoid sexual risk during their teen years. The program is implemented successfully in diverse communities including urban, suburban, rural and in tribal nations across the United States.

HFNC weaves a positive youth development (PYD) approach throughout the three-year program. Strategies include positive connections with supportive adults, self-regulation and self-control, planning and decision making, developing a sense of purpose, and practicing a healthy lifestyle addressed in the core components of the curriculum. Click here for a detailed analysis of the PYD utilized in Healthy Futures.

Using a spiral curriculum design, developmentally appropriate concepts are introduced beginning with the grade 6th and then expanded in the 7thand 8th grade. Parents, caregivers, and other trusted adults receive a Parent/Trusted Adult Connection form highlighting each lesson. All Parent/Trusted Adult Connection forms provide talking tips useful for parents and caregivers to expand and reinforce the critical conversations with their teen.


TopicLesson #
Benefits of Self-RegulationSession 6.4 Interpersonal Interactions and Romantic Relationships
Session 6.7 Conflict Resolution
Session 7.4 Stress, Positive Character Traits and Peer Pressure
Activity 7.5.3 Rules, Limits and Boundaries
Session 8.7 Peer Pressure and Avoiding Risky Behavior

Success Sequencing for Poverty Prevention

Session 8.1 Introduction to Healthy Futures, Goals and Dreams, Healthy Relationships, and Emotional Needs. This lesson includes a supplemental lesson about Success Sequencing for Poverty Prevention
Healthy Relationships
Session 6.4 Interpersonal Interactions and Romantic Relationships
Session 6.5 Healthy Relationships with Family and Peers
Session 8.6 Healthy and Unhealthy Relationships
Goal Setting
Session 8.1 Introduction to Healthy Futures, Goals and Dreams, Healthy Relationships and Emotional Needs
Resisting Sexual Coercion
Session 6.5 Healthy Relationships with Family and Peers
Session 6.6 Abstinence and Developing Refusal Skills
Session 7.4 Stress, Positive Character Traits, Peer Pressure
Session 8.7 Peer Pressure and Avoiding Risky Behavior
Session 8.8 Sex and the Law, Media Influence
Dating Violence
Session 6.7 Conflict Resolution Skills: Sexual Abuse and Cyber Assault
Session 7.7 Sexual Offenses

Risks of underage drinking, illicit drug use

Activity 6.1.6 Decision Making
Activity 6.1.7 Decision Making Scale
Activity 7.4.9 Refusal Scenarios
Activity 7.5.3 Rules Limits and Boundaries
Session 8.7 Peer Pressure and Avoiding Risky Behavior

Program elements used in HFNC that have been found to be effective in positive youth behavior change through a rigorous randomized controlled study demonstrating the program significantly delayed the initiation of sexual activity.

The evidence-based version implements a total of 1200 minutes over 3 years (400 minutes per year). Each lesson includes a Parent/Trusted Adult Connection form. Click on the links below to review the scope and sequence of each grade.

The core components implemented in the program are:

  • Incorporating the message “The choices you make now affect you later!”
  • Implement (24)50-minute lessons over 3 three years to 6th, 7th, and 8th grade students.
  • Building participants’ skills and self-efficacy to effectively weigh the benefits and consequences of their choices.
  • Incorporating activities that increase knowledge and influence positive attitudes, beliefs and self-efficacy to prepare teens for making healthy choices regarding relationships and sexual activity.
  • Using age appropriate and medically accurate materials and activities
  • Delivering high quality, participatory, and interactive sessions.
  • Engaging parents and guardians via distribution of daily Parent/Trusted Adult Connection forms.

Dr. Lisa Rue and developer Rhea Gordon conduct the training for school district health teachers and community-based organizations that desire to become licensed users of HFNC. For over twenty years, HFNC has served multiple populations including those communities and youth who face significant needs and who have systemic disparities.

Rhea Gordon, the developer of the program, was the foster parent for over 35 youth. This keen insight into the needs of youth who have experienced significant trauma and loss supported the development of an effective program for ALL youth. Click here for Rhea’s resume.

Dr. Lisa Rue has over 30 years of experience working with adolescents including school-based sex education. She received her PhD from Colorado State University in 2005. She has developed both risk reduction and risk avoidance prevention programs for adolescents and emerging adults. Dr. Rue has been funded as Principal Investigator or Co-Principal Investigator on 10 teen pregnancy prevention program evaluations. She is a popular presenter both in the U.S. and Internationally with 24 professional publications, including 51 juried and invited conference presentations in the field of education and adolescent health promotion. Click here for Lisa’s resume.

HFNC is successfully implemented in diverse communities experiencing health disparities and high levels of adolescent pregnancy including African American, Hispanic and Tribal communities.

All facilitators/educators participate in a 3-day licensure training that reviews the program model, theoretical models, youth risk and protective factors, and elements of successful implementation. Click here to review a sample training agenda.

In 2023, the entire curriculum was independently reviewed and updated for medical accuracy, trauma informed implementation, and inclusive language and strategies. All citations related to the prevalence of sexually transmitted diseases, contraception, and HIV prevention were updated to 2019 statistics and referenced in peer-reviewed publications by educational, scientific, governmental, or health organizations.

Where appropriate, sections include trigger warnings for sensitive content. The program and training include Creating Safe Spaces: SRAE Facilitator Guide to Trauma Informed Programing, by Family and Youth Services Bureau. The program aligns with the CDC’s Health Education Curriculum Assessment Tool accessible by clicking here. Inclusive materials representing diverse populations are provided in the updated HFNC 2.0 curriculum. The training licenses facilitators using guidelines to ensure their program implementation is inclusive to all children. Refusal skills and scripts for role play scenarios include characters from diverse groups. Click here for Inclusive Guidelines.

Each session includes fidelity monitoring checklists (6th Grade, 7th Grade, 8th Grade) including guidelines for appropriate adaptations to the evidence-based model. Several lessons provide opportunities supporting the decision to delay sexual activity or return to a lifestyle that avoids sexual risk taking (Decision Making Session 6.1, Session 7.3 Rules, Setting Limits, and Boundaries, Session 8.7 Peer Pressure and Avoiding Risky Behavior).

Dr. Lisa Rue provides all SRAE facilitators with ongoing technical assistance support throughout the year. In addition, SRAE facilitators participate in an annual 4-hour technical assistance networking meeting. This support session is designed to encourage licensed facilitators by providing tips and tricks to overcome barriers and enhance the effective delivery of the program. During this meeting, new strategies and research are presented and SRAE facilitators are provided the opportunity to troubleshoot successes, barriers, and share capacity building ideas with the other licensed facilitators across the country.

Healthy Futures Nu-CULTURE (HFNC) was found effective at increasing the percentage of adolescents that delay the initiation of sexual activity. The study concluded that the program delayed sexual initiation for girls and for Hispanic populations1. Empowering youth to delay the onset of sexual activity improves health equity and sexual reproductive health outcomes by:

  • reducing the chances of a pregnancy early in adolescence2
  • reducing the chances of STI infection


In 2016, the program’s outcomes were published in the American Journal of Public Health in 2016.1 This independent evaluation found that the program significantly delayed the onset of sexual activity specifically for girls and for Hispanic populations. This study placed HFNC on the Health and Human Services list for evidence-based programs.  

1 Calise, T. V., Chow, W., Dore, K. F., O’Brien, M. J., Heitz, E. R., & Millock, R. R. (2016). Healthy futures program and adolescent sexual behaviors in 3 Massachusetts cities: A randomized controlled trial. American Journal of Public Health, 106, SI03-Sl09. doi:10.2105/AJPH.2016.303389

2 Rotz Dana, Brian Goesling, Nicholas Redel, Menbree Shiferaw, and Claire Smither-Wulsin (2020). Assessing the Benefits of Delayed Sexual Activity: A Synthesis of the Literature. OPRE Report 2020-04, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

For the full report about the benefits of delayed sexual activity, click here.

For the full impact study about the Healthy Futures program, click here.      

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