The program is based on two behavior change theories: Diffusion of Innovations (which describes how communities adopt new behaviors or products) and the Transtheoretical Model (popularly known as "Stages of Change"). In addition, STAND takes into account several developmental characteristics of teenagers: their sense of invulnerability, their limited abstract reasoning ability, and their tendency to focus on present rewards rather than long-term consequences.

Peer leaders are selected for STAND training through a combination of self-nomination and referrals from peers, who are asked to identify the friends or acquaintances they would be most likely to ask about sex or birth control or other issues related to sexuality. This process tends to yield a diverse group of educators from many different subgroups — including athletes, teen mothers, religious and abstinent teens.

The STAND peer leaders are trained to initiate informal conversations with their peers, during which they assess their peers' stage of change (pre-contemplation, contemplation, decision, action, maintenance) regarding specific prevention strategies — such as abstinence or condom use. They use this information to provide a tailored, relevant message about a specific change that the peer could try, and support him or her in making that change.

Every month, the peer leaders meet together in the "STAND Club" to compare experiences and help one another solve problems. In addition to their educational activities, STAND peer leaders are active in many other forums, including presentations, teen theater productions about pregnancy and AIDS, mentoring, and national newsletters. They even bring the National High School Quilt Project (part of the NAMES project) to their high schools.

After five years in the pilot county where it began, STAND enjoys strong school and community support and is featured regularly on local news programs. In this rural, conservative community, not a single parent of STAND leaders has registered a complaint about the program. STAND is also popular with high school students. In fact, being a STAND peer leader has come to be a high status position.

Most encouraging are the program's results: increases in condom use self-efficacy and consistent condom use, and a decrease in unprotected intercourse.

For more information about the STAND program, see Smith M and DiClemente RJ. 2000. STAND: A Peer Educator Training Curriculum for Sexual Risk Reduction in the Rural South. Preventive Medicine, 30, 441-449.