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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 significant 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 cross-sectional multi-method assessment of our First Nations, Métis, and Inuit (FNMI) programming, and a longitudinal evaluation of our FNMI programming.

We completed Phase III of our research project in September 2018. Phase III focused on the continued expansion 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 scaling up in different delivery system contexts
• developing an assessment for schools/divisions to provide suggestions to build organizational capacity.

Visit the Fourth R website

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