Fourth R National Scale Up Study
The Fourth R: Promoting readiness, fit and delivery system capacity to maximize reach and impact in five provinces and territories
The Fourth R is an evidence-based program developed to promote healthy relationship skills and target risk behaviours through encouraging safe decisions about substance use, sexual relationships, bullying, and violence. Phase II of our Public Health Agency of Canada (PHAC) funded project included a major scale up of the Fourth R program. In terms of reach, more than 1300 educators, 1800 pre-service teachers and 21735 youth participated in Fourth R programs in 7 provinces and territories. We developed several new programs, including the Healthy Relationships Plus Program (HRPP), a mental health promotion-enhanced small groups program. Our programs were also adapted and expanded to meet a variety of different contexts including particular Aboriginal groups, geographic settings, linguistic groups (French and English), different school systems (e.g., public versus Catholic), and different delivery contexts. Our evaluations included a cluster randomized controlled trial (RCT) of our grade 8 program in Saskatchewan, a multi-method cross-sectional evaluation of our First Nations, Métis, and Inuit (FNMI) programming, and a longitudinal evaluation of our FNMI programming.
We have just completed Phase III of our research project in September 2018. Phase III focused on the continued expansion in reach of our multi-faceted programming. There was an emphasis on creating the conditions for sustainability by addressing scale up factors and readiness and fit in the Northwest Territories, Alberta, Saskatchewan, Ontario, and Nova Scotia. Our research objectives included evaluating the successes and barriers to scale up in different delivery system contexts and developing an assessment for schools and divisions to provide suggestions to build organizational capacity.
- Estimating costs and benefits associated with evidence-based violence prevention: Four case studies based on The Fourth R program
- Exploring the strengths, impacts, and challenges of Fourth R partnerships: Lessons learned from stakeholder interviews
- Fourth R Regional Reports: Successes, challenges, sustainability outlook
- Northwest Territories
- Educators' perceptions of Fourth R benefits for youth and the relationship with implementation quality
- Fourth R programs: Are educators implementing 1 to 2 years after training?
- Applying a Health Equity Lens to the Fourth R Programs, Research and Program Partnerships
- Fourth R/Healthy Relationships Plus Program Training Feedback Summary
- Promising Practices for School-based Mental Health Promotion and Violence Prevention
- Full Report (French)
- Developing and Sustaining Effective Partnerships (French)
- Implementing School-based programming (French)
- Strengths-based programming with Indigenous Youth (French)
- Mental health promotion programming with Lesbian, Gay, Bisexual, Trans, Two-Spirit, Queer-Questioning (LGBT2Q+) youth (French)
- Scale-Up for school-based programming (French)
- Sustainability of school-based programming (French)
- Conducting meaningful and effective evaluation (French)
- Influencing policy (French)
- Full Report (French)