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Public Health - Seattle & King County

Questions about the Family Life And Sexual Health (F.L.A.S.H.) Curriculum

What's unique about the FLASH curricula?

The FLASH curriculum is unique in several ways:

  • Addresses such issues as physical development, promotion of sexual health, prevention of disease, affection, interpersonal relationships, body image, and gender roles.
  • Spans the school-age years (grades 5-12 and secondary special education).
  • Embraces an abstinence-based approach, as well as information related to the prevention of pregnancy, HIV and other sexually transmitted diseases.
  • Rests on a foundation of positive and healthy sexuality across the life span.
  • Focuses on the needs of public schools and diverse communities.
  • Ensures discussion about the wide spectrum of beliefs on sensitive issues.
  • Values family involvement.
What theory(ies) is it based on?

The FLASH curriculum, like most of the sexual health curricula that have been proven effective, is grounded in Social Learning Theory. It is designed to encourage people to make healthy choices: abstain longer, use protection if they do have sex, seek health care when they need it, communicate effectively with their families and with their partners and health care providers, seek help for sexual abuse, treat others with respect (not harass or exploit them), and stand up to harassment and exploitation.

Based on Social Learning Theory literature, FLASH lessons include a variety of strategies designed to help students choose and succeed in these behaviors.

  • There are activities that focus on cognitive factors (knowledge, expectations about likely consequences, attitudes about such things as gender roles and who should take responsibility for protection).
  • There are activities that focus on environmental factors (norms and students' accurate perceptions of norms).
  • There are activities that focus on the behaviors themselves (students see skills modeled, they practice, and they experience growing confidence in their own efficacy).

For more about Social Learning Theories we recommend ETR Associates' Resource Center for Adolescent Pregnancy Prevention (RECAPP): www.etr.org/recapp (see "theories and approaches").

The sexual violence prevention lessons are further based on the Social-Ecological Model and the Confluence Model. The Social Ecological model seeks to impact factors that support violence at four levels: 1) individual, 2) relationship, 3) community and 4) society. FLASH focuses primarily on the levels 2, 3 and 4. The use of scenarios, introspective work and social norm re-setting addresses these levels. Visit the CDC's Violence Prevention website for more information: www.cdc.gov/ncipc/dvp/social-ecological-model_dvp.htm

The Confluence Model[i],[ii],[iii] has long been used to explain sexual violence, but has only recently begun to be applied in the realm of prevention. This model posits that adverse developmental experiences during childhood have a detrimental impact on the ways in which individuals view themselves and others, and their ability to form meaningful and healthy relationships. In particular, these experiences can lead to a rigid, violent and objectifying view of women, which is a significant risk factor for perpetrating sexual violence.[iv] FLASH addresses this risk factor by focusing heavily on increasing respect for all genders and breaking down harmful gender stereotypes.


[i]Malamuth, N., Heavey, C., & Linz, D. (1996). The confluence model of sexual aggression: Combining hostile masculinity and impersonal sex. Journal of Offender Rehabilitation, 23(3), 13-37.

[ii]Malamuth, N., Sockloskie, R., Koss, M., & Tanaka, J. (1991). The characteristics of aggressors against women: Testing a model using a national sample of college students. Journal of Consulting and Clinical Psychology, 59, 670-681.

[iii]Malamuth, N., Heavey, C., & Linz, D. (1993). Predicting men's antisocial behavior against women: The Interaction Model of sexual aggression. In G. Hall, R. Hirschman, J. Graham & M. Zaragoza, (Eds.) Sexual Aggression: Issues in etiology and assessment, treatment and policy. (63-97). New York: Hemisphere.

[iv]Centers for Disease Control and Prevention. (2010). Sexual Violence and Risk Protective Factors. Retrieved from www.cdc.gov/ViolencePrevention/sexualviolence/riskprotectivefactors.html.

Is it science-based? Evidence based?

It has never been rigorously evaluated in terms of actual behavior change, with large random samples, comparison schools and lagged-follow-up. That is much more costly than a county health department can afford; we are not a commercial distributor of curricula. In terms of the Kirby/Rolleri/Wilson model, FLASH would be better described as "promising," rather than as "proven." That is to say, we did participate, with other experts, in a day-long examination of 9/10 FLASH to assess its concurrence with the characteristics of sex ed programs that have been rigorously evaluated and found to be effective. 9/10 FLASH got good grades.

Is there evaluation data for the curriculum?

While there have not been large-scale, rigorous studies of FLASH, there have been three small post-test evaluations in the early 1990's. Evaluations of 4/5/6 FLASH by the Vashon Island and Federal Way School Districts showed that it increased students' knowledge in important ways and that they improved their attitudes about such things as puberty (less fear, more confidence) and sexual exploitation (their confidence in their ability to say "no" and tell an adult). And an evaluation of 7/8 FLASH comparing a health class that experienced the curriculum to a social studies class that didn't found similar increases in knowledge, ability to formulate an assertive objection to another's behavior, and attitudes about their own ability to be safe.

High School FLASH is undergoing a longitudinal, randomized, behavioral evaluation in 2011-2014 - with results expected in 2015 - by Mathematica Policy Research, Inc. in partnership with Center for Health Training, under contract with the U.S. Department of Health and Human Services (DHHS), Administration for Children and Families (ACF), Family and Youth Services Bureau, with the support of the DHHS ACF Office of Planning, Research, and Evaluation.

Is the curriculum modular or adaptable for different settings, number of sessions, length of time?

Yes and no. It can certainly be used in flexible ways. A teacher can do the social skills and decision making lessons, for example, early in a semester, the HIV and other STD lessons when other diseases are being studied, and the pregnancy and contraception lessons (in grades 7-12) at still another point in a semester. That said, pulling out a single lesson or two, especially without the climate-setting introductory lesson in the curriculum, is unlikely to be effective with respect to actual, sustained health behavior change.

Is there training available for the people that will deliver this curriculum in a given setting? If so, is the cost of training rolled into the curriculum price or is there an additional fee required (if so, how much)?

Yes, training is available. No, the cost is not included in the curriculum price. Teachers need a minimum of 2-days of training to do a really skilled job with the curricula - more if possible. Each day (6-7 contact hours) of training would cost $1,500. plus trainers' travel and per diem. That is negotiable within King County (since we are a County agency). Download this flyer for more information (PDF).

Is there anything innovative about the curriculum we may want to know about?

It includes a strong family-involvement component. The Special Education version of the curriculum is flexible, depending upon the kind and severity of students' disabilities. The curriculum at all grade levels honors students' intelligence and avoids condescending. It is teacher-friendly. Updated lessons and parts of lessons can be down-loaded free, as new vaccines are developed, new diseases discovered, new contraceptives approved, etc. And, perhaps most important, it is abstinence and value-based without preaching and it teaches respect for diverse community values about controversial issues.