High School FLASH, 3rd Edition

Developers

Public Health - Seattle and King County

Program Summary

High School FLASH is a sexual health education curriculum designed for classroom settings in grades 9–12. The program aims to (1) prevent unintended pregnancy, HIV and other sexually transmitted diseases (STDs), and sexual violence; (2) increase knowledge about reproductive and sexual health; and (3) improve family communication about relationships and reproductive health. FLASH covers the following topics: healthy relationships, communication, decision making, online safety, coercion and consent, pregnancy, the reproductive system, sexual orientation and gender identity, abstinence, birth control and condoms, HIV and STD prevention, STD testing, and improving school health. 

Intended Population

The program is designed for and was evaluated with high school students in grades 9–12.

Program Setting

The program is designed for and was evaluated in high school classrooms, though it has been implemented in a wide variety of settings.

Contact and Availability Information

For curriculum, materials, and pricing information, please contact:
Website https://kingcounty.gov/flash.
Email FLASH@kingcounty.gov. 

For training and support, please contact:
Website https://kingcounty.gov/flash.
Email FLASH@kingcounty.gov.

Sample of Curriculum Available for Review Prior to Purchase
Yes
Languages Available
English, Spanish
Monitoring and Evaluation Tools
Monitoring and evaluation tools available
Yes
Monitoring and evaluation tool usage required
No
Information about available monitoring and evaluation tools (if applicable)

High School FLASH provides observation and fidelity forms for each lesson. In addition, it provides core components, adaptation guidance, a logic model, and medical accuracy overview.

Program Core Components

Last updated in 2023

The data presented on this page reflects responses from the program’s developer or distributor to a program component checklist that asked them to report on the individual components within their TPP program. The same program component checklist was sent to the developer or distributor of every active TPP program with evidence of effectiveness. The program component table provides data on seven types of program components including content, delivery mechanism, dosage, staffing, format, environment, and intended population characteristics; whether the component was present or optional in the program; whether the component is considered to be core to the program; and the lesson number or activity where the component can be found in the program. For more details, refer to the FAQ.

Category Component Core Component Component present Notes Lesson number(s) / activities where present
Content Graduating from high school No No
Content Anatomy/physiology No Yes (evaluated version) Lesson 2
Content Other No No
Content Volunteering/civic engagement No Yes (evaluated version) Lesson 15
Content Spirituality No No
Content Morals/values No No
Content Identity development No Yes (evaluated version) Lesson 4, 5
Content Social support/capital No Yes (evaluated version) Lessons contain optional family homework
Content Social influence/actual vs. perceived social norms Yes Yes (evaluated version) These lessons contain social norms activities Lessons 7, 15
Content Social competence No Yes (evaluated version) Lessons 5, 6, 9, 14
Content Parenting skills No No
Content Normative beliefs No No
Content Leadership No No
Content Gender roles Yes Yes (evaluated version) Lesson 5
Content Gender identity Yes Yes (evaluated version) Lesson 4, 5
Content Cultural values No No
Content Connections with trusted adults No Yes (evaluated version) Lessons contain optional family homework All lessons
Content Conflict resolution/social problem solving No Yes (evaluated version) Lessons 6, 9
Content Communication skills Yes Yes (evaluated version) Lessons 6, 9
Content Child development No No
Content Boundary setting/refusal skills Yes Yes (evaluated version) Lessons 5, 6, 9
Content Substance use cessation No No
Content Substance use - Other drugs No No
Content Substance use - Alcohol No No
Content Substance use - Abstinence No No
Content Brain development and substance use No No
Content Vocational/skills training No No
Content Supplemental academic services No No
Content School engagement No No
Content College preparation No No
Content Alternative schooling No No
Content Self-regulation No Yes (current version) Lesson 9
Content Self-esteem No No
Content Self-efficacy/empowerment No No
Content Resilience No No
Content Sexual health Yes Yes (evaluated version) Lesson 2, 6, 7, 9
Content STIs - Treatment Yes Yes (evaluated version) Lesson 13
Content STIs - Screening Yes Yes (evaluated version) Lesson 13
Content STIs - Prevention Yes Yes (evaluated version) Lesson 1, 9, 10, 11, 12, 13, 14, 15
Content STIs - Information No Yes (evaluated version) Lesson 11, 13
Content Sexual risk reduction Yes Yes (evaluated version) Lessons 1, 9, 10, 11, 14, 15
Content Sexual risk discontinuation No Yes (evaluated version) Lesson 9
Content Sexual risk avoidance Yes Yes (evaluated version) Lesson 9
Content Personal vulnerability No No
Content Maternal health No Yes (evaluated version) Lesson 3
Content Contraception - Condoms Yes Yes (evaluated version) Lessons 10, 12, 13
Content Contraception - Long-acting reversible contraceptives Yes Yes (evaluated version) Lesson 10
Content Contraception - Other Yes Yes (evaluated version) Lesson 10
Content Contraception - Pills, patches, rings, and shots Yes Yes (evaluated version) Lesson 10
Content Reproduction No Yes (evaluated version) Lesson 3
Program Objectives

The program aims to (1) prevent unintended pregnancy, HIV and other STDs, and sexual violence; (2) increase knowledge about reproductive and sexual health; and (3) improve family communication about relationships and reproductive health.

Program Content

FLASH covers the following topics: healthy relationships, communication, decision making, online safety, coercion and consent, pregnancy, the reproductive system, sexual orientation and gender identity, abstinence, birth control and condoms, HIV and STD prevention, STD testing, and improving school health.

Program Methods

The program is delivered through large and small group discussions, interactive activities, role-plays, demonstrations, skills practice, worksheets, and family homework assignments.

Program Structure and Timeline

The program consists of 15 50-minute sessions, offered daily to weekly. It can be adapted for block schedules and multi-hour workshops. FLASH is most commonly delivered over three to five weeks, but implementation is flexible. 

Staffing

The program is delivered by classroom teachers or community-based educators.

Staff Training

FLASH educator training is available but not required. The following resources are available:

  • Self-guided FLASH teacher training modules (asynchronous)
  • FLASH training offered by FLASH instructors (live, remote) 
  • FLASH professional development assessment tool 

Website https://kingcounty.gov/flash.
Email FLASH@kingcounty.gov. 

Program Materials and Resources

The curriculum is available in two formats:

  • Printed curriculum in a three-ring binder with tabs
  • Online paperless curriculum (only the student materials can be printed from the online version)

The following materials and resources are available:

  • Implementation toolkit
  • Student- and parent-facing materials in English and Spanish
  • Pre-tests and post-tests for each lesson, aligned to national health standards
  • Materials for review committees and parent preview
  • All lessons are available in asynchronous format for independent study to provide flexibility during the pandemic.
Additional Needs for Implementation

None

Fidelity

The following resources are available:

  • Implementation toolkit
  • Facilitator forms for each lesson
  • Observation forms for each lesson
  • Logic model
  • Red/yellow/green light adaptation guidance
  • Core components
  • FLASH evaluation overview
  • Medical accuracy overview
  • Trauma-informed overview
  • Age appropriateness overview
Technical Assistance and Ongoing Support

Contact the developers at FLASH@kingcounty.gov for assistance.

Allowable Adaptations

High School FLASH is a flexible curriculum. Please see the red/yellow/green light adaptation guidance at https://kingcounty.gov/flash.

Adaptation Guidelines or Kit
Yes
Study Characteristics
Citation Setting Majority Age Group Majority Racial/Ethnic Group Gender Sample Size

Coyle, K., Anderson, P., Laris, B.A., Barrett, M., Unti, T., Baumler, E. (2021). A group randomized trial evaluating High School FLASH, a comprehensive sexual health curriculum. Journal of Adolescent Health, 68(4), 686–695. https://doi.org/10.1016/j.jadohealth.2020.12.005

 		In school: High school 14 to 17 African American or Black Youth of any gender

1734
Study Findings

Evidence by Outcome Domain and Study

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

Coyle, K., Anderson, P., Laris, B.A., Barrett, M., Unti, T., Baumler, E. (2021). A group randomized trial evaluating High School FLASH, a comprehensive sexual health curriculum. Journal of Adolescent Health, 68(4), 686–695. https://doi.org/10.1016/j.jadohealth.2020.12.005

 		Indeterminate evidence n.a. Potentially favorable evidence n.a. n.a.
KEY
Evidence Indication
Favorable findings
Two or more favorable impacts and no unfavorable impacts, regardless of null findings
Potentially favorable findings
At least one favorable impact and no unfavorable impacts, regardless of null findings
Indeterminate findings
Uniformly null findings
Conflicting findings
At least one favorable and at least one unfavorable impact, regardless of null findings
Potentially unfavorable findings
At least one unfavorable impact and no favorable impacts, regardless of null findings
Unfavorable findings
Two or more unfavorable impacts and no favorable impacts, regardless of null findings
Note: n.a. indicates the study did not examine any outcome measures within that particular outcome domain, or the study examined outcome measures within that domain but the findings did not meet the review evidence standards.
Detailed Findings
Citation Details

Coyle, K., Anderson, P., Laris, B.A., Barrett, M., Unti, T., Baumler, E. (2021). A group randomized trial evaluating High School FLASH, a comprehensive sexual health curriculum. Journal of Adolescent Health, 68(4), 686–695. https://doi.org/10.1016/j.jadohealth.2020.12.005

 		The program was evaluated using a randomized controlled trial involving 9th and 10th graders recruited from seven school districts in the midwestern and southern regions of the United States. Teenage birth rates were at or above the national average in these school districts. Twenty schools were randomly assigned to either a treatment group that received the 15-session FLASH program or a control group that received a five-session, knowledge-based sexual health curriculum. Surveys were administered three months and 12 months after the end of the FLASH program.



The study found that among the subgroup of youth who were sexually inexperienced at baseline, youth participating in FLASH were significantly less likely to report having had vaginal sex without condoms or other birth control in the prior three months than youth in the control group were (effect size = -0.67). This impact was measured three months after the program ended. The impacts were no longer statistically significant by the 12-month follow-up, however.



Three and 12 months after the end of the FLASH program, the study found no statistically significant program impacts for the full sample on the prevalence of vaginal sex in the past three months or the prevalence of vaginal sex without contraception in the past three months. The study also found no statistically significant effect on initiation of vaginal sex among the sexually inexperienced sample, either at the three-month or the 12-month follow-up.



The study also examined program impacts on measures of increased knowledge and attitudes about STI testing and increased comfort with communication with parents about sexual health. Findings for these outcomes were not considered because they fell outside the scope of the review.

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.