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About This Program

Updated: 06/06/2018

Native STAND is a comprehensive sexual health curriculum for Native high school students that focuses on sexually transmitted infections, HIV/AIDS, and teen pregnancy prevention, while also covering drug and alcohol use, suicide, and dating violence. Twenty-seven sessions support healthy decision-making through interactive discussions and activities that promote diversity, self-esteem, goals and values, team building, negotiation and refusal skills, and effective communication. The 1.5 hour lessons contain stories from tribal communities that ground learning in cultural teachings.

Age Group Designed For:

High School

LGBT Inclusive:


Program Setting:



27 sessions (90 minutes each)

Cost to Purchase:

Free (plus cost of materials for class activities, roughly $500)

Teacher Training or Certification Required:


Student to Teacher Ratio:


Program Outcomes:

Teens demonstrated improvements in knowledge of STD/HIV prevention, reproductive health, and healthy relationships.

Evidence of Effectiveness:

Leading Practice



Program Contact Information

Get Started



Teacher Training or Certification Requirements:

Formal training is not required to implement the Native STAND curriculum. Training is available to those who are interested, however. Oregon Health & Science University's (OHSU) Center for Healthy Communities and the Northwest Portland Area Indian Health Board are collaborating to recruit Tribes and American Indian/Alaska Native (AI/AN) organizations to participate in a Native STAND Dissemination, Implementation, and Evaluation Project. The goal of the project is to better understand how tribal communities implement Native STAND. A week-long training is available during the summer to those who participate.

Learn more about the application process here.


Supporting Materials

Cultural Relevance

Cultural Alignment, Adaptation or Tailoring Process

Native STAND is an inter-tribal curriculum for high school-aged teens (14-18 years old) that draws on cultural teachings and values from across Indian Country. We hope that learning other Native cultures, traditions, and perspectives will serve to strengthen a sense of pride, not only for one’s own tribe, but for all Native American tribes. The curriculum is flexible and can be easily adapted to include specific stories and traditions from your own community.

The Native STAND curriculum was adapted by the Indian Health Service, the National Coalition of STD Directors, and the Centers for Disease Control and Prevention from an evidence-based intervention: Students Together Against Negative Decisions (STAND). The original STAND was developed for rural youth to promote healthy decision making around sexually transmitted infections, HIV/AIDS, and teen pregnancy prevention, by Dr. Mike Smith at the Mercer University School of Medicine in Macon, Georgia.

The adaptation process for Native STAND included:
• convening a multi-disciplinary workgroup with AI/AN representation
• convening a workgroup to review an initial draft of the curriculum
• conducting pilot classes using adapted lessons with AI/AN youth groups
• convening a second workgroup to review the revised curriculum
• sending the curriculum to outside expert reviewers
• identifying pilot sites
• supporting pilot sites to implement the curriculum
• evaluating program outcomes and impacts at pilot sites
• finalizing the curriculum
• disseminating and marketing the curriculum



Evaluation Methods and Findings

Native STAND is based on the Transtheoretical Model (Stages of Change) and the Diffusion of Innovations Theory (using popular opinion leaders). Evaluation data show that participation in STAND can lead to increased communication about sexual issues, improvements in knowledge and self-efficacy, and substantial adoption of risk-reducing behaviors among teens who completed the program.

In 2010, a mixed-methods study was conducted to evaluate Native STAND in four Bureau of Indian Education (BIE) boarding schools. Eighty students were selected by fellow students to be trained as peer educators using the curriculum. Native STAND was delivered in 1½ hour classes by two or three adult staff at each school, each of whom had been trained to facilitate the curriculum. A comprehensive pre- and post- computer assisted self-interview (CASI) survey was administered to participating students to assess changes in knowledge, attitudes, intentions, behaviors, and skills over time. At the end of the program, a series of focus groups and key informant interviews were also carried out with separate groups of students, facilitators, and school staff not directly involved in the program to identify programmatic strengths and weaknesses and to inform final program revisions.

Using similar methods, Oregon Health & Science University’s Prevention Research Center, a Northwest Tribe, and the Northwest Portland Area Indian Health Board collaborated to evaluate Native STAND in a tribal Jr High/High School between 2010-2012.

In each of the trials:
• Teens demonstrated significant and consistent improvements in knowledge of STD/HIV prevention, reproductive health, and healthy relationships.
• Teens reported sharing information they learned in the class with other teens.
• Adults who facilitated the curriculum learned strategies to better communicate with teens and teach sensitive health topics.
• School staff and administrators felt Native STAND was addressing critical gaps in sexual health education that were present in their schools.


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