Where the Rubber Meets the Road: Variation, Successes and Challenges with the Healthy Relationships Plus Program Implementation in Alberta

Although classroom-based programming is an important avenue to advance youth prevention goals, programming that is restricted to this setting alone may not meet the needs of all youth (e.g., youth who require more supportive interventions, youth who are out-of-school). Thus, in addition to classroom-based programs, program design and implementation for adolescents in non-classroom settings are also critical to prevention work with this age group. For healthy relationships promotion specifically, one such program is the Healthy Relationships Plus program (HRPP), a 14-week, out-of-class time program designed to promote mental health and positive relationships among youth ages 14-17. While it can be offered universally, the HRPP was specifically designed for adolescents who need additional support to acquire knowledge, skills and postive attitudes about healthy relationships, mental health, suicide awareness and substance use/abuse. The HRPP is an expansion of the evidence- and classroom-based Fourth R program; the HRPP utilizes the same evidence-based Fourth R strategies to develop skills, but extends these to mental health promotion. Furthermore, it offers more flexibility in delivery in that, as it is not connected to school curriculum, it can be offered in a variety of settings, accommodate a range of ages, and be delivered in different formats.

The HRPP is one of the core components of the described provincial strategy. In the past two years, we have collected data from more than 40 groups in the province, evaluating program implementation in different settings. The purpose of this paper is to describe the variability with which the HRPP has been implemented, as well as implementation successes and challenges. Quantitative and qualitative responses from facilitator implementation surveys (N=40) were utilized for this study, as well as pre-intervention data from more than 350 youth. Facilitators indicated a wide range of benefits for their participants and rated their overall experience as somewhat or very favourable, but also noted significant implementation challenges. Youth and facilitator data indicated significant variability in terms of group characteristics (e.g., age range of participants, risk status), setting characteristics (e.g., urban vs. rural, duration of program delivery), and facilitator characteristics (e.g., age, sex, perceived preparedness to deliver the program). Analyses are currently underway to identify how these varying group, setting and facilitator characteristics predicted a more successful implementation experience for facilitators (i.e., comparing very successful vs. somewhat successful implementation). Implications for scaling evidence-informed interventions in a large geographic area will also be discussed.