Native STAND

About Native Students Together Against Negative Decisions (STAND)

The Native STAND Dissemination, Implementation, and Evaluation Project is located within the Center for Healthy Communities housed at OHSU.  The Northwest Portland Area Indian Health Board (NPAIHB) is the project’s community partner.

Oregon Health & Science University (OHSU) and the Northwest Portland Area Indian Health Board (NPAIHB) are partnering to disseminate a culturally appropriate health intervention for sexual health education in American Indian/Alaska Native (AI/AN) teens.  Native STAND is a school- and community-based program that was developed by a national working group comprised of AI/AN youth, elders, and professionals.


The original evidence-based practice intervention, STAND, was created by Dr. Mike Smith at Mercer University School of Medicine in Georgia, and designed for youth in the rural South. “STAND” is the acronym for Students Together Against Negative Decisions.  The program was very effective and showed promising benefits for other groups of youth, including tribal teens.  Subsequently, Lori de Ravello and Scott Tulloch of the CDC and the I.H.S. National STD Program assembled tribal health leaders from around the United States to develop a culturally respectful version of STAND for use in American Indian and Alaska Native communities.  The national work group, funded and supported by the CDC and Prevention/Division of STD Prevention, the I.H.S. National STD Program, and the National Coalition of STD Directors made substantial enhancements to the original STAND, providing cultural fit and relevant teachings.  Native youth groups reviewed portions of the curriculum in addition to a cadre of external expert reviewers from Indian Country.  Subsequently, Native STAND was validated in four B.I.E. schools and one reservation community.


Native STAND is a culturally-relevant, inter-tribal curriculum for high school-aged (14-18 years old) teens that draws on cultural teachings and values from across Indian Country. It can be delivered as a peer education program or in a variety of other ways.

The program is comprised of 27 sessions employing active learning methods.  The 90-minute sessions are designed to be held once per week, and work best for groups of 15 to 20 teens. The curriculum holistically addresses healthy decision-making and develops knowledge and skills for healthy relationships and self-esteem, preventing STDs and early pregnancy, and avoiding substance abuse.

Native STAND Session Curriculum Topics:

Welcome & Introduction
Culture & Tradition
Healthy Relationships
Early Pregnancy & Parenting
Negotiation & Refusal Skills
Stages of Change

Team Building
Diversity & Respect
Reproductive Health
Preventing Early Pregnancy
Drugs & Alcohol
Taking Care: the Whole Person
Effective Communication

Acting Out
Goals & Values
Downside of Hooking Up
Birth Control Methods
Field Trip: Local Health Clinic
Being a Peer Educator
Putting It All Together

Teens who receive the Native STAND program often go on to act as peer educators, engaging in health promoting conversations with other teens.  In this way, Native STAND empowers tribal youth to communicate accurate information on sexual health to other teens. In several cases, communities have formed Native STAND clubs to continue learning and provide peer education.


Native STAND has been validated in four BIE schools and one reservation community.  The major positive impacts are:

  • Teens demonstrated significant and consistent improvements in knowledge of STD/HIV prevention, reproductive health, and healthy relationships.
  • Teens reported sharing information they had learned with other teens.
  • The tribal adults who facilitated the Native STAND curriculum learned how to better communicate and teach teens on these sensitive topics.
  • School staff and administrators felt Native STAND was addressing critical gaps in tribal adolescent sexual health education.