Sexual Health Promotion Programming for Youth in or At-Risk for Foster Care: Improving Knowledge, Attitudes and Behaviors

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 self-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 together, findings suggest that sexual health education directly targeting the unique needs of YFC may improve sexual health knowledge and behavior, and are discussed in the context of challenges associated with intervention and research with this population