The Fourth R Program, developed by Dr David Wolfe at the Center for Addiction and Mental Health (CAMH) in Toronto, is a classroom-based curriculum that focuses on building relationship knowledge and skills to reduce adolescent risk behaviors, such as violence, bullying, unsafe sexual behavior, and substance abuse, in recognition that these behaviors often occur in the context of relationships. The Fourth R model engages school and community in the delivery of information and positive messages to help youth make good decisions. There are currently six versions of the program available: 1) Physical and health education (which includes components on personal injury prevention, substance abuse and healthy eating), 2) English (for Grade 9 to 12 students with instruction on violence, unhealthy sexual behaviour, and substance use); 3) Alternative Education (a more flexible curriculum adapted for students in the alternative education system); 4) Uniting Our Nations (which includes culturally relevant experiences and contexts to support Aboriginal youth learning); 5) The Healthy Relationships Plus Program (for delivery in a non-classroom setting, with a strengthened focus on mental health and suicide prevention, and drug and alcohol use); and 6) a Catholic version (adapted curriculum that is consistent with Catholic teaching and beliefs).

Some studies show positive youth outcomes, such as enhanced communication skills, better peer resistance, reduction in dating violence and increased condom use. More research evidence available here.