Table 1.

Augmented Fourth R Lessons.

	Example Lesson	Curriculum	Adaptation
Unit 1: Personal Safety and Injury Prevention	Rule of Fives	Students recognize what matters in the present moment may not matter as much in five days, five weeks, five months, or five years (e.g., breaking up with a boyfriend; not receiving an A on a test).	Students encouraged to think of a circumstance where the Rule of Fives may not apply and have life-long consequences (e.g., witnessing severe violence; experiencing racism)
Unit 2: Substance Use, Addictions, and Related Behaviors	Stand on the Line and Communication Line activities	Students discuss influences that predispose or deter them from substance use and addictive behaviors (e.g., peer pressure).	The two activities are replaced with; Take One Step Forward’, which allows students to actively engage and reflect on how substance use can be related to individual, social, and structural factors (e.g., a student is left unattended after school because her parent works multiple jobs).
Unit 3: Human Development and Sexual Health	Stereotypes and support	Students discuss skills and strategies to build a healthy relationship as well as factors that influence our understanding of gender identity, sexual orientation, and stereotypes.	Students learn about societal assumptions when defining masculinity, femininity, and heterosexual relationships and discuss comfort level with various social situations (e.g., ‘you see a little boy playing with a princess barbie’; ‘your Social Studies teacher is a Black person’).
Unit 4: Healthy Eating	How does culture/family background impact food choices?	Students answer questions on how parent/guardian work schedule, family finance, geographical location, religious and cultural background and peers influence food choices.	An additional point is added to be sensitive to other people’s food choices when suggesting healthier alternatives (e.g., think about what the person currently eats and modify it, such as eating smaller portions, instead of suggesting they eat what you eat).