The Fourth R is an evidence-based program developed to promote healthy relationship skills and target risk behaviours through encouraging safe decisions about substance use, sexual relationships, bullying, and violence. Phase II of our Public Health Agency of Canada (PHAC) funded project included a significant scale-up of the Fourth R program. In terms of reach, more than 1300 educators, 1800 pre-service teachers and 21735 youth participated in Fourth R programs in 7 provinces and territories. We developed several new programs, including the Healthy Relationships Plus Program (HRPP), a mental health promotion-enhanced small groups program. Our programs were also adapted and expanded to meet a variety of different contexts including particular Aboriginal groups, geographic settings, linguistic groups (French and English), different school systems (e.g., public versus Catholic), and different delivery contexts. Our evaluations included a cluster randomized controlled trial (RCT) of our grade 8 program in Saskatchewan, a cross-sectional multi-method assessment of our First Nations, Métis, and Inuit (FNMI) programming, and a longitudinal evaluation of our FNMI programming.