Sexual health promotion programming for youth in or at-risk for foster care: Improving knowledge, attitudes, and behaviors.

Abstract

Among girls in foster care, 48% become pregnant at least once by age 19 (Dworkey & Courtney, 2010). Teen moms are less likely to graduate from high school and their children also are more likely to be placed in foster care due to abuse or neglect (Hoffman, 2006). Furthermore, 50% of 21-year-old men aging out of foster care report they have gotten someone pregnant, compared to 19% of their peers not involved in foster care (Courtney et al., 2007). Youth in or at-risk for foster care (YFC) report limited knowledge about, access to, and use of condoms; ambivalent attitudes toward teen parenting; and participation in other risky behaviors. For the current study, we adapted and supplemented an evidence-based sexual health program called SiHLE, using a systematic adaptation framework (ADAPT-ITT, Wingood & DiClemete, 2008), to address these unique and targeted needs of YFC. Thirty-six youth participated in four sessions of SiHLE-YFC during their stay at a temporary shelter. Four 90-minute sessions focused on increasing sexual health knowledge, improving attitudes toward and selfvii efficacy of condom use, and developing core skills such as problem-solving and communication. As hypothesized, youth showed high satisfaction with the intervention and significant improvement in sexual health knowledge from pre to post. At one month follow-up, youth continued to show significant improvement in sexual health knowledge, along with a significant reduction in risky sexual behaviors. Though not significant, there were moderate effect sizes for changes in attitudes toward teen pregnancy and condoms.There were no changes in attitudes towards teen parenting. Taken identify low-cost ways to disseminate evidence-based practices in communities of need, using indigenous resources; and (c) attend closely to workforce and organizational factors that support feasibility, effective implementation, and sustainability of evidence based practice. Public Health ImpactSignificant challenges in transporting evidence-based programs to community In this spirit, my research has developed along two lines. The first reflects that multiple poor outcomes share common underlying risk and resilience pathways, and seeks to examine modular approaches to prevention and intervention as a way to minimize the burden on community agencies. The second relates to forming and sustaining community partnerships and capacity building for the implementation of evidence-based programs in community settings. Common Elements to Risk and ResilienceComorbidities among mental health problems are high, and risky behaviors among youth tend to co-occur, reflecting overlap among the empirical predictors of poor outcomes such as substance abuse, conduct problems and sexual risk-taking. It stands to reason that if problems co-occur, so too might the tools and strategies we can use to build resilience Current and Future Directions. I am currently preparing a companion paper, for which I am exploring the common elements of empirically-supported prevention programming for element...