Native STAND 2.0

About

Updated: 09/20/2022

Native Students Together Against Negative Decisions 2.0 (Native STAND 2.0) is a comprehensive sexual health curriculum for Native high school students that focuses on life goals, communication, healthy relationships, sexually transmitted infections, HIV/AIDS, and teen pregnancy prevention, while also covering drug and alcohol misuse, suicide, and dating violence.

The program includes 18 lessons that support healthy decision-making through interactive discussions and activities that promote self-esteem, goals and values, diversity, team building, negotiation and refusal skills, and effective communication skills. Each 50-minute lesson contains teachings and stories from tribal communities that ground learning in cultural teachings.

Updated features in Native STAND 2.0 include:

  • Streamlined the number of lessons, focusing on the most important skills
  • Ensured lessons could be delivered in a 50-minute class
  • Updated content for medical accuracy
  • Improved inclusion for Two Spirit and LGBTQ+ participants
  • Made trauma-informed adjustments to each lesson
  • Updated the teaching methods and formats

  • Age Group Designed For:

    High School
  • LGBT Inclusive:

    Yes
  • Trauma Informed:

    Yes
  • Program Setting:

    Flexible
  • Health Topics Covered:

    Healthy Relationships, Other Healthy Life-Skills, Sexual Health
  • Duration:

    18 sessions (50 minutes each)
  • Cost to purchase:

    Free (plus cost of materials for class activities, roughly $500)
  • Teacher Training or Certification Required:

    No
  • Student to Teacher Ratio:

    20:2
  • Program Outcomes:

    Delayed sexual initiation
  • Endorsements:

    N/A

Program Contact Information

Training

Teacher Training or Certification Requirements:

Everything you need to deliver Native STAND is available on the Healthy Native Youth website. The curriculum includes 18 lessons. Each lesson is 45-50 minutes long. The curriculum is flexible and can be easily adapted to include specific stories and traditions from your own community. Throughout the curriculum, we encourage facilitators to use tribe-specific teachings where appropriate.

A 90-minute Native STAND 2.0 orientation webinar can be viewed by clicking HERE.  Interested users can view the latest updates of this high-school age culturally responsive and holistic strength based adolescent health sex education curriculum.  Click to view: NS 2.0 Orientation Webinar SlidesParticipant Jamboard

Formal training is not required to implement Native STAND 2.0. If you would like to request training or technical assistance on Native STAND, you can do so through our TA Request Form.

Miscellaneous Training Items:

Tips for Answering Sensitive Sexual Health Questions

Handout for Educators – Values Question Protocol

Handout – Answers to common questions about Sex and Sexuality

Cultural Relevance

CULTURAL ALIGNMENT, ADAPTATION OR TAILORING PROCESS

Native STAND 2.0 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 and Alaska. 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

Building on this momentum, the Oregon Prevention Research Center at OHSU and the Northwest Portland Area Indian Health Board teamed up to evaluate Native STAND in AI/AN communities across the U.S. from 2015-2019. Over three years, 48 sites signed up to participate in the study.

At the conclusion of that study, the Healthy Native Youth team at the Northwest Portland Area Indian Health Board, hosted a two-day gathering for Native STAND facilitators, to gather feedback and ideas to improve Native STAND for future use in diverse community settings.

Native STAND 2.0

As we incorporated their feedback, we:

  • Streamlined the number of lessons, focusing on the most important skills
  • Ensured lessons could be delivered in a 50-minute class
  • Updated content for medical accuracy
  • Improved inclusion for Two Spirit and LGBTQ+ participants
  • Made trauma-informed adjustments to each lesson
  • Updated the teaching methods and formats used
  • Brought lessons and handouts together in a single manual

Evaluation

EVALUATION METHODS AND FINDINGS

Native STAND is based on the Transtheoretical Model (Stages of Change). Evaluation data show that participation in Native STAND can lead to increased communication about sexual health topics, improvements in knowledge and self-efficacy, and substantial adoption of risk-reducing behaviors among teens who complete the program.

Recent Evaluations

From 2015-2019, the Prevention Research Center at Oregon Health & Sciences University and the Northwest Portland Area Indian Health Board teamed up to evaluate the implementation and dissemination of Native STAND across the U.S. Over three years, 48 sites signed up to participate in the study.

At the end of the project, site facilitators reported strong community support for the Native STAND program:

  • 43% of participating sites “Strongly Agreed” their organization was committed to implementing Native STAND
  • 65% of participating sites implemented the curricula within 1 year of training
  • 23% of participating sites implemented the program within 2 or 3 years

During the study, over 925 AI/AN youth completed pre- and post-surveys:

  • Youth reported improved confidence using a condom correctly after completing the Native STAND program.
  • We observed encouraging shifts in attitudes and knowledge towards condom use. This was especially true for girls who reported higher levels of confidence being able to negotiate condom use with steady partners and new partners.
  • There was a positive shift in the number of youth who reported getting tested for STIs; an indicator of youth taking responsibility for their health and the health of their partners.
  • Additionally, more youth reported having a conversation about sex with their friends after completing Native STAND, compared to before.

Native STAND Findings: Healthy Native Youth YouTube Channel

Early Evaluations

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, OHSU’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 study:

  • 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.

Evaluation Tools:

Curriculum Endorsements

Native STAND 2.0

Amber Poleviyuma, Hopi Tewa Womens Coalition To End Abuse

I believe that the curriculum for Native STAND was great at starting conversations among students because it made the topics less intimidating. I also liked that Native STAND was able to be tailored to fit our community and our goals.  Our ideas were always welcomed and supported in teaching the curriculum within our local schools.