Healthy Futures

Developers
Rhea Gordon, Healthy Futures; Paulea Mooney-McCoy, Healthy Futures
Program Summary
Healthy Futures is a three-year program that uses a multi-level approach that aims to empower sixth to eighth grade adolescents to avoid the health, social, and psychological consequences of risky decisions. The program seeks to meet this goal by increasing the knowledge, skills, and self-efficacy necessary to delay sexual activity and reduce the risk of teen pregnancy and sexually transmitted infections, as well as increase parent-child communication. 

Healthy Futures incorporates classroom-based education, peer education through after-school and summer programs, parent education workshops, school and community connections, and web-based resources to meet these aims.
Intended Population
The curriculum is designed for and was evaluated with youth in grades 6 to 8.
Program Setting

The program was designed to be implemented and evaluated in a school-based classroom setting. It was also designed to include optional interacting components that occur after-school and online.

Contact and Availability Information
Rhea Gordon
Executive Director, Healthy Futures
Phone: 978-458-6064
Website: www.healthy-futures.org
Same as above.
Sample of curriculum available for review prior to purchase
Yes
Adaptation guidelines or kit available
Yes
Languages available
English
Program Core Components
Category Component Core Component Component present Notes Lesson number(s) / activities where present
Content Contraception - Condoms Yes Yes (both versions) Session 7.6 pages 7.6.2-7.6.14, Session 8.4.3, pages 8.4.20, Session 8.4.4, page 8.4.22,
Content Anatomy/physiology Yes Yes (both versions) Session 6.2 pages 6.2.2 to 6.2.28, Session 7.3, pages 7.3.7-7.3.12
Content Other No Optional Can be used with sexual risk avoidance and discontinuation components 8th grade curriculum platform8th Grade Appendix of 2.0
Content Other Yes Yes (both versions) All 24 sessions must include Mantra
Content Volunteering/civic engagement No No
Content Spirituality No No Not addressed directly, however this content emerges in class discussions
Content Morals/values No No Not addressed directly, however this content emerges in class discussions
Content Identity development Yes Yes (both versions) Session 6.3, pages, 6.3.2-6.3.17
Content Social support/capital Yes Yes (both versions) Session 6.1, pages 6.1.1-6.1.11, Session 7.2, pages. 7.2.1-7.2.14
Content Social influence/actual vs. perceived social norms Yes Yes (both versions) Session 6.6, page, 6.6.6
Content Social competence Yes Yes (both versions) Session 6.7, pages 6.7.2-6.7.15, Session 7.4, pages 7.4.2-7.4.15, Session 8.7, pages 8.7.11-8.7.13
Content Parenting skills Yes Yes (current version) Session 7.5.5 Pregnancy Scenario, pages 7.5.13-7.5.14,
Content Normative beliefs Yes Yes (both versions) Session 6.7, pages 6.7.2-6.7.15, Session 7.4, pages 7.4.2-7.4.15, Session 7.7, pages 7.7.1-7.7.12, Session 8.7, pages 8.7.11-8.7.13, Session 8.8.2-8.8.17
Content Leadership Yes Yes (both versions) Usually discussed in reviews content emerges in class discussions Session 6.8, page, 6.8.2-6.8.3
Content Gender roles Yes Yes (both versions) Session 6.3, pages, 6.3.2-6.3.17
Content Cultural values No Yes (both versions) Not addressed directly, however this content emerges in class discussions
Content Connections with trusted adults Yes Yes (both versions) Session 6.1, pages. 6.1.11, Session 6.5, pages. 6.5.6-6.5.9, page 6.7.21-6.7.22, Session 7.7, pages 7.7.10- 7.7.11, Session 8, page 8.2.6, Session 8.8 pages, 8.8.7-8.8.8
Content Conflict resolution/social problem solving Yes Yes (both versions) Session 6.7, pages 6.7.2-6.7.15
Content Communication skills Yes Yes (both versions) Session 6.7, pages 6.7.2-6.7.15, Session 7.4, pages 7.4.2-7.4.15, Session 8.7, pages 8.7.11-8.7.13
Content Child development No No
Content Boundary setting/refusal skills Yes Yes (both versions) Session 6.6, pages 6.6.7-6.612, Session 7.5, pages 7.5.6-7.5.10, Session 8.7 pages 8.7.2-8.7.13
Content Substance use cessation Yes Yes (both versions) Session 6.6., pages 6.6.6, Session 8.1, pages 8.1.2-8.1.16
Content Substance use - Other drugs Yes Yes (both versions) Session 6.6., pages 6.6.6, Session 8.1, pages 8.1.2-8.1.16
Content Substance use - Alcohol Yes Yes (both versions) Session 6.6, pages 6.6.6, Session 8.1, pages 8.1.2-8.1.16
Content Substance use - Abstinence Yes Yes (both versions) Session 6.6, pages 6.6.6, Session 8.1, pages 8.1.2-8.1.16
Content Brain development and substance use Yes Yes (both versions) Session 6.6, pages 6.6.6, Session 8.1, pages 8.1.2-8.1.16
Content Vocational/skills training No No Not addressed directly, however this content emerges in class discussions
Content Supplemental academic services No No Not addressed directly, however this content emerges in class discussions
Content School engagement No No Not addressed directly, however this content emerges in class discussions
Content Graduating from high school Yes Yes (both versions) Expanded in Decision Making and Goal Setting , Also in Optional 8th Grade Component of 2.2 which includes the Success Sequence Activity Session 6.1 pages 6.1.8-6.1.10, Session 7.1, pages 7.1.8-7.1.16, Session 8.1, pages 8.1.2-8.1.16
Content College preparation No No
Content Alternative schooling No No
Content Self-regulation Yes Yes (both versions) Session 8.7, pages 8.7.2-8.7.13
Content Self-esteem Yes Yes (both versions) Session 6.3, pages 6.3.2- 6.3.17Session 6.7.3, pages 6.7.20-6.7.24
Content Self-efficacy/empowerment Yes Yes (both versions) Session 6.6, pages 6.6.7-6.6.13, Session 7.1, pages 7.1.2-7.1.15, Session 8.1, pages 8.1.2-8.1.16
Content Resilience Yes Yes (both versions) Session 7.1, pages 7.1.8-7.1.16, Session 7.4 pages 7.4.4-7.4.10
Content Sexual health Yes Yes (both versions) Session 7.5 pages 7.5.2- 7.5.18, Session 8.5, pages 8.5.4-8.5.9
Content STIs - Treatment Yes Yes (both versions) Resource Brochure Appendix, Activity 8.4.3, page 8.4.11-8.4.12,
Content STIs - Screening Yes Yes (both versions) 7.6.10 , Resource Brochure Appendix , Session 8.4, pages 8.4.2-8.4.22
Content STIs - Prevention Yes Yes (both versions) Session 7.6 pages 7.6.2-7.6.14, Session 8.4, pages 8.4.2-8.4.22
Content STIs - Information Yes Yes (both versions) Session 7.6 pages 7.6.2-7.6.14,Session 8.4, pages 8.4.2-8.4.22
Content Sexual risk reduction Yes Yes (both versions) Session 7.3, pages 7.3.7-7.3.12, Session 7.6 pages 7.6.2-7.6.14, Session 8.3, pages 8.3.2-8.3.14, Session 8.4, pages 8.4.2-8.4.22
Content Sexual risk discontinuation Yes Yes (current version) Optimal Health Version Session 6.6 Abstinence and Refusal Skills, Session 7.5, page 7.5.12, Session 7.6 , pages 7.6.3 - Session 8.2 pages 8.2.11-8.2.14
Content Sexual risk avoidance Yes Yes (both versions) Session 6.6 Abstinence and Refusal Skills, Session 7.6 , pages 7.6.3 - Session 8.2 pages 8.2.11-8.2.14
Content Sexual orientation No Optional Healthy Futures 2.0 includes inclusive language throughout included optional handouts.
Content Maternal health No No
Content Contraception - Long-acting reversible contraceptives Yes Yes (both versions) Session 8.3, Appendix 8.3.2A and 8.3.2B
Content Contraception - Other Yes Yes (both versions) Session 8.3, Appendix 8.3.2A and 8.3.2B
Content Contraception - Pills, patches, rings, and shots Yes Yes (both versions) Session 8.3, Appendix 8.3.2A and 8.3.2B
Content Reproduction Yes Yes (both versions) Session 6.2, pages. 6.2.5-6.2.28, Session 7.3, pages 7.3.7-7.3.12
Program Objectives
The primary goal of Healthy Futures is to empower adolescents to avoid the health, social, and psychological consequences of risky decisions. The program seeks to meet this goal by increasing the knowledge, skills, and self-efficacy necessary to delay sexual activity and reduce the risk of teen pregnancy and sexually transmitted infections, as well as increase parent-child communication.
Program Content
Healthy Futures is based on the social ecological model and uses a multi-level approach that includes classroom-based education, peer education through after-school and summer programs, parent education workshops, school and community connections, and web-based resources. The main components of the Healthy Futures program are:
  1. Nu-CULTURE (Cultivating Urban Leaders Through Unique Relationship Education): a classroom-based relationship education program for grades 6-8. The curriculum helps students understand the risk associated with early sexual activity and develops skills necessary to make healthy decisions and avoid risky behaviors. It emphasizes increasing skills and self-efficacy in communication and refusal skills using through age appropriate, medically accurate information about teen pregnancy prevention, sexually transmitted infections, and other sexual health topics.
  2. An online virtual classroom that students have unlimited access to where they can find additional information and ask anonymous questions that are answered by Healthy Futures staff.
  3. Rhymin’ it Write (RIW) (optional): A 10-week after-school program for middle school students. Using poetry, writing, and other forms of artistic expression, students discuss steps to good decision making, how to set limits and boundaries, and healthy relationships.
  4. Code A (optional): A summer program that compliments the Nu-Culture classroom-based relationship education program and further develops the leadership skills of students who participated in RIW. Teens receive instruction on the basics of improvisational theater and performance preparation. Students work together to develop their own skits and other dramatic presentations to be performed at youth and community events.
  5. True Connections: The Healthy Futures parent education program, which includes sessions at schools or in the community with the goal of increasing parents’ capacity to parent using active listening, honest communication, and problem solving. It teaches parents to use natural and logical consequences to reduce risky behaviors. Topics include data on teen sexual health, relationships, responsible sexual behavior, alcohol and drug use, bullying, and more.
Program Methods
Nu-CULTURE is delivered through a variety of activities designed to maximize student participation, including small group activities, role-plays, audiovisual materials, and daily parent connection forms.
 
Rhymin' it Write is delivered using poetry, writing, and other forms of artistic expression.
 
Code A is delivered using improvisational theater and performance art.
Program Structure and Timeline

The Healthy Futures program is structured as follows:

  1. The Nu-CULTURE curriculum consists of eight 50-minute sessions each in 6th, 7th, and 8th grades, for a total of 24 sessions over the course of three years.
  2. Rhymin’ it Write consists of a 10 week after school program.
  3. Code A is intended to be delivered over the summer.

The ideal group is less than 30 students per class with 2 health educators. The maximum class size is 60 students with four health educators.

Staffing
The program should be delivered by staff with at least one year of experience facilitating programs with youth (11 to 24 years old) and who is culturally representative of the targeted community. The ideal staff to student ratio is two health educators per class of 30 students or less.
Program Materials and Resources
Core intervention materials are the Nu-CULTURE curriculum and classroom tools.
 
Additional Needs for Implementation
Required needs for implementation are:
  • Classroom space
  • White board/chalkboard
  • Laptop computer
  • Projector
  • Microsoft PowerPoint
  • Media Player for Audio & Videos
Fidelity
Fidelity checklists are included in the Nu-CULTURE curriculum and are available for preview online at no charge. Contact Rhea Gordon (www.healthy-futures.org) to request access to the online preview of materials.
Staff Training
Implementation of Healthy Futures requires a 2-day facilitator training that covers the curriculum, activity tools, fidelity checklists, classroom and time management, teach backs, and follow-up technical assistance. The cost of the training is $5,000 plus travel costs.
 
There is an optional 2.5-day training of trainers that covers all of the topics in the facilitator training as well as intense discussions on how to train facilitators, time management, questions and answers, and school-specific information. The cost of the training is $6,000 and requires certification.
 
Technical Assistance and Ongoing Support
Technical assistance on program implementation is available by contacting the developer. For monitoring or evaluation assistance, please contact:

Katelyn Dore, MPH (Program Evaluator) or Tamara Calise, DrPH (Evaluation Lead)
JSI Research & Training Institute, Inc.
44 Farnsworth St, 7th floor
Boston, MA 02210
Phone: 617-482-9485
Allowable Adaptations
In-depth adaptation guidelines for the Nu-CULTURE curriculum are available through the developer.  

Examples of allowable adaptations are:
  • Making Nu-CULTURE activities more interactive
  • Customizing role play scenarios
  • Updating and/or customizing statistics specific to your community.
Reviewed Studies
Citation High-Quality Randomized Trial Moderate-Quality Randomized Trial Moderate-Quality Quasi-experiment Low Study Rating Did Not Meet Eligibility Criteria

Calise et al. 2015

Calise et al. 2016

 		✓
Study Characteristics
Citation Setting Majority Age Group Majority Racial/Ethnic Group Gender Sample Size

Calise et al. 2015

Calise et al. 2016

 		In school: Middle school 13 or younger Hispanic or Latinx of any race Youth of any gender 2346
Study Findings

Evidence by Outcome Domain and Study

Citation Sexual Activity Number of Sexual Partners Contraceptive Use STIs or HIV Pregnancy

Calise et al. 2015

Calise et al. 2016

 		Potentially favorable evidence n.a. Indeterminate evidence n.a. n.a.
Detailed Findings
Citation Details

Calise et al. 2015

Calise et al. 2016

 		The program was evaluated using a cluster randomized controlled trial involving 15 middle schools in three northeastern cities in Massachusetts. Schools were randomly assigned within matched pairs to either an intervention group that implemented the Healthy Futures program or a control group that offered their regular school curricula as well as two classroom-based sessions per year on general health topics. Surveys were administered before the start of the program and then annually through 9th grade.

The study found that immediately after the program ended in 8th grade, female students in the schools that delivered the intervention were significantly less likely to report they ever had vaginal sex. The study found no statistically significant impacts on ever having sex for males. Additionally, the study found no statistically significant impacts for the full sample on recent sexual activity or contraceptive use.

Measures of program adherence, fidelity, implementation, youth engagement, and implementation of specific program elements were also reported in the study. Findings for these outcomes were not considered for the review because they fell outside the scope of the review. The study also examined a measure of age at the time of sexual initiation. Findings for this outcome were not considered for the review because they did not meet the review evidence standards. Specifically, findings were reported only for subgroups of youth defined by sexual activity at follow-up.

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample. A blank cell indicates the study did not examine any outcome measures within the particular outcome domain or the findings for the outcome measures within that domain did not meet the review evidence standards.

Information on evidence of effectiveness is available only for studies that received a high or moderate rating. Read the description of the review process for more information on how these programs are identified.