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A Study of the Sex Education and Reproductive Health Needs of Foster and Transitioning Youth

Funding Agency: Walter S. Johnson Foundation

Dates: 2008

Staff: Norman Constantine (principal investigator), Carmen Nevarez (co-principal investigator), Wendy Constantine (consulting project manager), Petra Jerman (research scientist), William Brown (research associate), Robert Friend (consultant)

There are approximately 83,000 youth in out-of-home, state-supervised care in California, with about 4,000 aging out of foster care each year. Studies have shown that youth who grow up in and emancipate from foster care tend to have poor outcomes in employment, education, housing, and physical and mental health. And as shown by data from a longitudinal survey of teens in three Midwestern states conducted by the Chapin Hall Center for Children (CHCC) at the University of Chicago, by age 19, young women who were in foster care are 2.5 times as likely as those not in foster care to have been pregnant, and 3 times as likely to have had a sexual partner with a sexually transmitted infection. Further, by age 19, 46% of young women who were in foster care and have been pregnant have had a subsequent pregnancy, compared with 29% of their peers outside the system. Teenage parenthood has considerable costs for both young women and their children, and delaying pregnancy among foster youth is widely considered a worthwhile goal for child welfare policy.

The Center for Research on Adolescent Health and Development of the Public Health Institute is conducting a rigorous multiple case study to assess the need for and provision of sex education and reproductive health services to foster and transitioning youth in three California counties. Counties were selected from those receiving California Connected by 25 (CC25) Initiative funding, and to represent the Northern urban, Southern urban, and Central urban and rural areas of the state: San Francisco, Orange, and Fresno. The study will involve background research, county data collection, data analysis, and white paper development.

Background research. Research reports on the need for and provision of sex education and reproductive health services to foster care youth in California and in other states will be identified and thoroughly reviewed. Available sex education and reproductive health services resources for foster care youth will be identified and reviewed. Researchers that have been involved in supporting or studying CC25 will be interviewed to ensure that existing knowledge is captured.

County data collection. Five types of data collection will be conducted in each of the three selected counties: (1) documents regarding the program's structure and goals, (2) phone interviews with the director of social services and two directors of independent living centers and other foster youth serving organizations, (3) phone interviews with two foster parents in each county, (4) a web-administered survey of case workers and other staff serving foster care youth, and (5) site visits including two focus groups for each county, one with foster care youth and one with program staff.

Data analysis. Information collected via interviews, surveys, and focus groups will be analyzed by county so that each county becomes a separate case. Findings from the qualitative and quantitative data collections will be interpreted on a county level so that a profile of each county's practices and needs in regard to sex education and reproductive health services can be developed. Findings also will be analyzed and compared across counties.

White paper report development. A draft white paper report, summarizing findings across each of the three counties, will be produced, together with preliminary recommendations for service improvement and potential resources for providing appropriate information to youth on pregnancy and disease prevention, reproductive health, and healthy relationships. The draft white paper will be presented and discussed at a roundtable meeting convened by the CC25 Initiative coordinator, which will include representatives from the three counties in which the case studies were conducted. Following the roundtable meeting, the white paper report will be revised as appropriate.