How does having a supportive adult in their life impact young people's contraceptive knowledge and access?

Katie Massey Combs, PhD

APRIL 16, 2026

Young people involved in child welfare services face persistent disparities in sexual and reproductive health (SRH), including limited access to contraception and delayed or incomplete sexual health education. Research and interventions have focused on identifying and reducing individual-level risk factors (very important stuff!), but less is known about factors that promote access to SRH.

What we wanted to know

In a recent study, we examined whether having a non-parental supportive adult (i.e., someone a young person says they can trust and turn to for guidance) is associated with two indicators of contraceptive access:

• Receiving contraceptive information or education
• Knowing how to obtain contraception

What we did

We followed 245 young people with open child welfare cases due to maltreatment within the family at two points in adolescence: early adolescence (8th/9th grade) and mid-adolescence (about 2.5 years later, when most youth were in 10^th/11^th grade).

What we found

Young people with a supportive adult were…

• More likely to know how to access contraception in early adolescence
• More likely to have received contraceptive information in the past year in mid-adolescence

We also looked at these associations within subgroups (e.g. race/ethnicity groups, gender, grade, and in-home vs out-of-home placement).

• Young men with a supportive adult were about 3× more likely to know how to access contraception compared to males without a supportive adult.
• Hispanic and American Indian & Alaska Native youth with a supportive adult were about 2x as likely to get contraceptive information in later adolescence compared to youth with these identities who did not have a supportive adult.​

We also examined whether the type of supportive adult mattered.

• Young people reported a range of supportive adults, which we categorized into 4 groups: school-affiliated (e.g., teachers, coaches), helping professionals (e.g., caseworkers, therapist), community-based (e.g., youth pastor, formal mentoring program), and non-parent family members (e.g., aunt, grandparent).
• Helping professionals and school-affiliated adults were more strongly linked to indicators of contraceptive access, likely because they are more directly connected to resources and referrals.

What does this mean for practice?

You don’t have to be a sexual health expert to improve access—you have to be a trusted, caring adult.

For youth-supporting professionals, this study reinforces that you don’t have to be a sexual health expert to improve access—you have to be a trusted, caring adult.

That said, supportive adults are most effective when they are also:

• Equipped with accurate information
• Comfortable discussing sensitive topics
• Able to connect young people to services and resources

Programs that train caregivers, caseworkers, and other youth-supporting professionals to engage in these conversations—and to build strong, authentic relationships—are a critical part of the solution.

Implications for systems and policy

As child welfare systems increasingly shift to serving young people in their homes with their families and reducing time in foster care, it’s essential to ensure that all young people have access to non-parental supportive adult relationships regardless of where services are received (in home or out-of-home). Many existing supports (like mentoring programs or transition services) are tied to foster care placement. Our findings suggest that young people receiving services at home may have similar needs but fewer structured opportunities for connection.

Interested in hearing more about our findings and sharing questions and comments with colleagues? Join us May 14, 2026, at 2PM ET for a virtual coffee chat.

READ THE STUDY

Photo By: Reproductive Health Supplies Coalition

Katie Massey Combs is a Research Associate at the University of Colorado Boulder in the Institute of Behavioral Science. Her research focuses on the prevention of behavioral health problems and the promotion of well-being among vulnerable youth, specifically unwanted pregnancy among youth involved in foster care. Trained in social work and public health, she is keenly interested in interdisciplinary and applied research to understand what works, and in using research to inform practice and policy.  Read more about Katie Massey Combs.

The post Supportive Adults Matter: Improving Contraceptive Access for Young People Involved in Child Welfare Services appeared first on Healthy Teen Network.

Since humans have been around, people have been building communities and relationships to stay connected, to be protected, and to resist systems of oppression.

Sam Akers, MSW

MARCH 13, 2026

Whenever I open Instagram, it feels like my entire feed is filled with content about the importance of community…from mutual aid requests to “everybody wants a village, so be a villager.”

When systems fail us, how can we support each other to thrive?

As I’ve been reading and hearing more about folks turning to one another for support, care, and resources, I’ve been thinking about how this drive for connection impacts sex ed. When systems fail us, how can we support each other to thrive? When schools, clinics, and other systems are not showing up for young people, especially for queer, trans, Black, Indigenous, and people of color, what can we do to try to fill in those gaps?

Enter community-based sex education.

By ensuring caregivers, local leaders, and youth-supporting folks have access to medically accurate and understandable information, we’re meeting young people where they are. Bringing young people and their caregivers to learn together, having community conversations, and making your resources accessible is CRUCIAL always, but especially now. When schools, federally funded programs, and beyond are being told they cannot say “gender” or “sexuality” or even share medically accurate information, we need to turn to folks outside of the normal systems we may typically rely on.

Here are some examples of youth-supporting professionals across the nation who are showing up for their communities.

• Your Empowered Sexuality is a Philadelphia-based organization providing education not only to young people in schools, but also to teachers, caregivers, and healthcare providers. Beyond the “typical” sex education topics, they also do workshops on nutrition, body liberation, and anti-fatness.
• Talk More is doing incredible work to support caregivers in having shame-free conversations with their young people in the Atlanta area and beyond! They’re holding workshops in the community, but they also have AMAZING free resources on their website, like Parent Planners, categorized by age to prepare caregivers for age-appropriate conversations with their youth. Their Values Expressions Exercise and Conversation Generator provide guidance for a conversation that so many parents are afraid of!
• Healthy Native Youth holds virtual Community of Practice calls for folks supporting Native young people. By bringing folks together to focus on specific topics, they’re offering space for caring adults to problem-solve, commiserate, share wins, and find resources. They also have a text message service that gives caring adults tips on talking with young people about mental health!
• Other educators, like SexEdU, SxEdFiles, SexEdForGuys, and more are turning to social media to reach their communities! Young people (and really, anyone) may find themselves using TikTok as a search engine for health information, and it’s folks like these who are ensuring that there is medically accurate, understandable, and relatable information there for them.

While restrictions on federal funding and public education are rampant, community-based sex education can offer a different perspective that public education may not be able to. In an individualist society rooted in white supremacy, for some of us, the more organic, grassroots community approaches can feel like intimidating.

And yet, at the same time, since humans have been around, people have been building communities and relationships to stay connected, to be protected, and to resist systems of oppression. From neighborhoods to group chats to villages and beyond, a sense of belonging has provided people with purpose. Turning to our neighbors instead of relying on systems designed to oppress us helps us support young people and, in turn, makes us all better.

Photo By: Vonecia Carswell

Sam is an experienced facilitator of curriculum focused on sexual health, puberty, safety, and relationships for adolescents. She has expertise in outreach, communications, and strengths-based critical thinking. Sam is passionate about the ways in which trusted adults can provide skills, knowledge, and support so adolescents can make informed decisions. Sam is dedicated to the advancement of justice through collaboration and co-creation. Read more about Sam.

The post The Power of Community Sex Education appeared first on Healthy Teen Network.

Young people involved with the child welfare system are resilient, but they need the right tools and support to thrive.

Katie Massey Combs, PhD

JANUARY 30, 2025

Though research has documented disproportionate rates of sexual and reproductive health outcomes like STIs and unintended pregnancy among young people with child welfare involvement, we know little about whether this group of young people are receiving the contraceptive information or services they need to make informed decisions about their reproductive health. 

Our research followed 245 adolescents with child welfare involvement as they transitioned from middle school to high school. We explored whether these young people received contraceptive education, knew how to access services, and if they received any contraceptive services.  

What We Found

By 10th or 11th grade, most young people reported knowing how to access contraception, but there were significant gaps in education and services: 

• 18% of young women and 54% of young men had never received contraceptive education or information. 

• Young men were significantly less likely than young women to receive information, know how to access services, or actually receive contraceptive services. 

• Schools were often the primary—and sometimes the only—source of information for young men, while young women more commonly received information from both schools and medical providers. 

Why This Matters

Contraceptive information was often received too late, was incomplete, or in some cases, never provided—especially for young men. This delay leaves many young people vulnerable to unintended pregnancies or sexually transmitted infections during a critical developmental period. 

Contraceptive information was often received too late, was incomplete, or in some cases, never provided—especially for young men.

The data also highlights the gender disparity in access to resources. While young women are typically considered the responsible party for contraceptives, external condoms are the most common contraceptive method used among teens.   

What You Can Do

As someone who works with vulnerable young people, you play a critical role in bridging these gaps. Here are some key takeaways: 

1. Start Early: Begin conversations about reproductive health and contraception before high school. Waiting until later can mean missed opportunities. 
2. Include Everyone: Ensure that all young people are included in contraceptive education. All young people need this information. 
3. Leverage Multiple Sources: Schools are a common source of information, but they shouldn’t be the only one. Medical providers, parents and family members, and community organizations can all help provide consistent and accurate information. 

Moving Forward

Young people involved with the child welfare system are resilient, but they need the right tools and support to thrive. By providing timely, comprehensive, and equitable contraceptive education, we can empower them to make informed decisions about their health and futures. 

You can access the full research article or contact Katie Massey Combs.

Interested in talking more about these findings and implications? Join us for a virtual coffee chat! 

Register

Katie Massey Combs is a Research Associate at the University of Colorado Boulder in the Institute of Behavioral Science. Her research focuses on the prevention of behavioral health problems and the promotion of well-being among vulnerable youth, specifically unwanted pregnancy among youth involved in foster care. Trained in social work and public health, she is keenly interested in interdisciplinary and applied research to understand what works, and in using research to inform practice and policy.  Read more about Katie Massey Combs.

The post Empowering Young People with the Knowledge They Need: Contraceptive Education for Those Involved with Child Welfare appeared first on Healthy Teen Network.

A new report highlights six ways abortion restrictions are influencing social service providers' work

Katie Massey Combs

January 9, 2025

Although social service providers are not directly linked to reproductive health care and abortion, by the nature of their primary role as brokers and facilitators of services in settings such as domestic violence shelters, hospitals, and child welfare agencies, they are often a gateway to access. To better understand how recent changes in abortion laws affect social service providers and their clients, a study at the University of Colorado Boulder surveyed and interviewed social service providers in Texas in January 2023. The study identified six key themes (below) highlighting how abortion restrictions are influencing their work and their clients’ access to care. The report describes these in greater detail.

1. Social service providers are witnessing harm to their clients.
2. Social service providers do not understand crisis pregnancy centers.
3. Agency leadership is not providing guidance, so providers work with a code of silence around the topic of abortion.
4. Social service providers are not sure what is legal.
5. Social service providers need resources.
6. Social service providers are experiencing intense anxiety for themselves and their clients.

Learn more in the full report.

Get It Now

Katie Massey Combs is a Research Associate at the University of Colorado Boulder in the Institute of Behavioral Science. Her research focuses on the prevention of behavioral health problems and the promotion of well-being among vulnerable youth, specifically unwanted pregnancy among youth involved in foster care. Trained in social work and public health, she is keenly interested in interdisciplinary and applied research to understand what works, and in using research to inform practice and policy.  Read more about Katie Massey Combs.

The post Working in the Aftermath: How Texas Social Services Providers are Navigating Services Post Roe appeared first on Healthy Teen Network.

Service providers who knew Jaden through her participating in a job readiness program and a subsidized housing program heralded her as a “poster child of success” for someone “aging out” of foster care. Jaden, which is a pseudynm to protect her identify, is one of the people featured in the book Some Type of Way: Aging out of Foster Care. While in foster care, she graduated from high school and started her associate’s degree at the local community college. She moved into an independent living apartment, where she lived on her own, with staff members always available on the ground level of the building. At age 19, Jaden left foster care and got her own apartment through a subsidized housing program. She worked in housekeeping at a hotel. Jaden aspired to work as a bartender after she completed a course where she received a bartending certificate. She planned to return to community college as soon as she could pay the fees that were incurred when she withdrew from classes the semester her mother died.

Jaden’s Perspective

While Jaden was being lauded for her successes, she was struggling. She may have “checked the boxes” of having housing, a job, and educational plans; yet life remained challenging for Jaden. The first day that Jaden moved into her apartment she spent the night at a friend’s home because Jaden—a self-proclaimed “scaredy cat”—was afraid to be alone in the apartment at night. It was several days before she felt comfortable by herself in the apartment.

Jaden felt woefully unprepared to live alone. She didn’t know how to operate the gas range and was afraid it would blow up the building. Even after a friend showed her how to use the range, Jaden did not have great cooking skills. Growing up in foster care and group homes had not prepared her for adulthood, she explained: “It’s scary…There is a lot of things I don’t know how to do.”

It wasn’t just the struggling with life skills that made Jaden’s view of herself inconsistent with service providers’ seeing her as successful. Jaden’s housekeeping job was a physically-demanding, part-time, entry-level position that didn’t pay a livable wage. There was also a 90-minute commute each way to the hotel. If Jaden had not received a bus pass and subsidized housing, she knew she would not be able to make ends meet.

Though she was making ends meet with the assistance of programs, Jaden constantly worried about her future. She shared that she didn’t know if she could keep her job in housekeeping because of the long commute and working conditions:

“I don’t know what I’m going to do. I don’t know what I’m going to do. I don’t know where I’m going to be in a month. I don’t know what is going to happen to me. I don’t know if I can keep this up any longer. ‘Cause I hate this job. I don’t know what’s going to happen if I don’t get another job. I don’t know if. I don’t know. I just don’t know. I’m just living every day and, and, kinda doing my best. Just get up and go to work every day.”

“I don’t know what I’m going to do. I don’t know what I’m going to do. I don’t know where I’m going to be in a month. I don’t know what is going to happen to me. I don’t know if I can keep this up any longer. ‘Cause I hate this job. I don’t know what’s going to happen if I don’t get another job. I don’t know if. I don’t know. I just don’t know. I’m just living every day and, and, kinda doing my best. Just get up and go to work every day.”

Jaden feared that she was one step away from being without a home and felt alone: “I have to take care of myself. Nobody’s going to give me money…That is why I get scared. If I quit, you know, or if I don’t just do something, that I can’t fall back on anything but myself.” Jaden’s words were not hyperbolic. She knew others aging out of foster care who were living under a bridge. The fear of losing her job and apartment and needing to live on the streets kept her awake some nights.

Fluidity of Success

Jaden is not alone in her experiences of aging out of foster care. As young people transition out of foster care and into adulthood, they frequently experience hardships. Many of these are caused by structural barriers. While experiencing hardships, young people also display tremendous grit and resilience. They overcome challenges and experience successes.

The paradox of being a poster child of success while also being an embodiment of the challenges highlights the fluidity of success for young people aging out. Getting a job, being in school, or having housing does not end young peoples’ hardships. Struggles continue. As young people transition into adulthood, the structural barriers they face can become larger as they have fewer resources and supports.

Young people aging out of foster care are resilient, yet also in a precarious position where their lives can unravel after a crisis. Jaden knew that losing her job and housing would be catastrophic. Even when young adults are succeeding, a change in one thing can happen that serves as a turning point and potentially alters their trajectory. To make sure that young people aging out like Jaden can successfully transition out of foster care and into adulthood, sustainable support and resources must be offered. It is imperative to make sure that even someone who is considered a “poster child of success” receives support.

Taking Action

What can we do to make sure that Jaden and others aging out of care can be successful? First and foremost, we need to understand the experiences of aging out and commit to helping youth negotiate the transition out of foster care and into adulthood.

Beyond our knowledge of and commitment to young people aging out, there are countless ways that we can support the well-being of and provide smoother transitions for those aging out of care—including action at the policy or agency level. This support can look like investing in young people aging out, preventing child maltreatment, and reforming the child welfare system—all of which could improve the lives of young adults. Services should be expanded to serve young people as they leave foster care and transition into adulthood. The resources and support offered should be developmentally appropriate for young adults, giving them autonomy and opportunities to learn from mistakes.

Everyone has the opportunity to make a difference in the lives of young people aging out of care. Our contributions will be unique, as our abilities and resources can vary. However, there is always something that we can do.

Together, we can help young people aging out of the foster care system; we can:

Be kind. Reach out to others. Build community. Help a family who may be struggling. Check-in on new parents. Fight for equity. Promote diversity. Speak up against injustices. Volunteer at agencies that help children, youth, and families. Become a guardian ad litem. Provide respite care for foster parents. Cook a meal for a foster family. Become a foster parent. Mentor a child or youth. Pursue a career serving children, youth, and families. Donate to agencies serving children and youth. Attend events promoting well-being for children and youth. Support politicians who prioritize child welfare. Advocate for children and youth. Call a senator or representative. Educate ourselves about foster care. Talk about foster care with others. Write an editorial. Fight for change. Make a difference. Get to know youth aging out of foster care. Listen to them. (Some Type of Way: Aging out of Foster Care, p. 211-212)

Listening to young people and learning their stories is something each of us can do, right now.

To learn more about the experience of Jaden and other youth aging out (and get more concrete ideas about how best to help make a difference in their lives), check out Some Type of Way: Aging out of Foster Care.

Get the Book

Dr. Lisa Schelbe is the Interim Associate Dean for Academic Affairs and Associate Professor at the Florida State University College of Social Work. She also is the Director of the Child Well-being Research Institute at the University of Kentucky College of Social Work.  She would love to be a poster child of work/life balance, but acknowledges that probably she is more of a meme than a poster child! (In her photo at the top of this blog post, Lisa sits on the floor doing mobility exercises between conference sessions.)  Her book, Some Type of Way: Aging out of Foster Care is available anywhere books are sold. (And ask for it at your local library!) Read more about Lisa Schelbe.

The post How We Can Better Support Young People Aging out of Foster Care appeared first on Healthy Teen Network.

When I first joined Healthy Teen Network in March 2022, my first project was to “create stories about young parents that can affect policy change.”

Wow, I thought, a huge undertaking.

I had learned about the power of storytelling in my graduate program, and I have seen the impact of personal stories in the advocacy space firsthand, but I had always been the reader, watcher, and listener of these stories. However, to be on the other side, to turn real-life stories with all their nuances and complexities, into something that can tangibly improve policies and impact governance? I had to admit—I was slightly paralyzed.

We started the project by interviewing a caring, big-hearted young parent named Bella. Their lived experience as a young mother navigating homelessness was extremely layered and their challenges, real and present. At our first meeting, they called us from their car, struggling not to get evicted from their current housing. They powerfully and vulnerably shared their journey, challenges, and hopes and dreams with us. We were left speechless, listening to how unjust, discriminatory, homophobic, and broken the care system is.

We turned to human-centered design to guide us, as we attempted to package such complex stories into digestible content in an accessible format, so that policymakers and advocates could use these stories to push for services that better support young parents and foster youth. To help us create these stories, we dove deep into academic research, storytelling tool kits, policy frameworks, and language strategies—all while relying on the honest feedback from our young parents, our on-the-ground advocacy partners, and our staff to drive our work.

We learned many lessons throughout the process, but here are six that I value the most from developing these stories.

Don’t expect to change the world with a single story.

This may sound obvious, but learning to temper my expectations, and keeping this in the back of my head, kept me going. The aim for this project, and for most stories for that matter, is to open minds and hearts, and to start conversations. When conversations happen, culture can start to shift, and that’s when policies can begin to change. As Marya Bangee said at the SSIR’s Nonprofit Management Institute, “Cultural change precedes policy change. When we neglect the cultural element, our political wins are more vulnerable.”

Be flexible with structure.

Every story has a beginning, a middle, and an end; a plot, a conflict, and a resolution. There are different ways to “arrange” these building blocks into a story, each resulting in a different narrative. There’s the famous Pixar framework, the Hero’s journey, Rags to Riches—the list goes on. Our team spent some time plotting our young parents’ stories using these tried-and-true frameworks, iterating on various permutations to find the most compelling narrative. In the end, while the story frameworks helped get us started, we learned that there is no perfect story arc. In true human-centered design fashion, we let the process guide us, and we created a final narrative that didn’t neatly fall into these pre-existing story structures. And that’s 100% okay.

Trust the process, while knowing when to pivot.

The core principle of the human-centered design approach is to place the people we are designing with at the center of the process. While deciding on the format of these young parents’ stories, we had a hunch that a traditional storybook, in its physical format, would allow readers to reminisce their childhood experience and be connected on a deeper level with the young parents in the stories. However, after gaining more insights from our young parents, we discovered that a digital format would be most accessible, desirable, and viable for both young parents and policy advocates. We trusted the process, used these Design Principles as our north stars, and were able to pivot from our early-stage prototypes. (After all, prototypes serve that exact purpose of ensuring that our products are usable!)

Aim for the heart.

Some of the best stories out there allow us to tap into the deepest parts of ourselves, make meaning in our own lives, and empathize with people we’ve never met. Focus on the emotional aspect, yet use emotions with intention. Don’t use sadness and fear tactic narratives as the end-all-be-all—we feel so much more than sadness. As Samantha Wright and Annie Neimand said, ”different emotions lead people to do different things.” Finding ways for our audience to identify with a character in our stories can make it more meaningful. 

Leave things between the lines.

We don’t have to try to include every single detail, insight, challenge, systemic factor, and call-to-action in our narrative. Some things are better left unsaid—there’s an art to leaving parts of a story open for the audience’s interpretation, allowing them to ‘fill in the blanks’ and participate in the creation of the story. “You don’t have to tell the reader what it all means. You don’t have to raise difficult questions. The people reading, watching, or hearing your story will find plenty to think about if your story is crafted carefully,” said Dinty Moore in his book The Truth of the Matter: The Art and Craft in Creative Nonfiction. Moreover, the use of powerful imagery can also elaborate more on what can’t be said in words.

As designers, facilitators, and professionals, we owe it to young people to cultivate a safe and healing-centered, trauma-informed environment for them to share their story, which means always prioritizing their well-being and ensuring that they have agency over their own narrative.

Sharing stories can be healing in and of itself

In addition to the impact that stories can create for the audience, stories can also be healing for the storyteller. There are numerous scientific and anecdotal evidences of the healing power of sharing and taking control of your narrative. “Storytelling allows a space for one to empathize with [themselves], as a step to gradually empathizing and finding a verse to add with the world around them…Young people are shifting mindsets away from being passive consumers of a world in constant change, and discovering their capacities for being active creators of a new narrative of the self,” said Mohsin Mohi Ud Din, Founder of #MeWeSyria. As designers, facilitators, and professionals, we owe it to young people to cultivate a safe and healing-centered, trauma-informed environment for them to share their story, which means always prioritizing their well-being and ensuring that they have agency over their own narrative.

I think of Bella, Lucero, and Carmen’s stories while moving through my work and my life. I think of their hopes and dreams—for themselves and for other young parents—and how the current systems get in the way of achieving their dreams. I hope that their stories touch the hearts and lives of other advocates in a way that they did mine.

To learn more about their stories, visit the Young Parents Stories.

PHOTO CREDIT: Illustration by Tony Midi

Patricia is a curious learner who loves to ask questions and find patterns. If you look closer, you might see a literal light bulb above Patricia’s head when she sees a connection or realizes something in her research. Patricia loves using those insights to co-create changes— big or small— that make the world a better place. Having grown up in three different countries, Patricia sees the world differently and always makes time for travel. In her free time, Patricia can be found browsing offbeat Airbnbs or walking her sweet, black cat on a leash (yep —it’s one of Patricia’s proudest accomplishments). Read more about Patricia.

The post How to Use Storytelling as a Vehicle for Social Change appeared first on Healthy Teen Network.

December 12, 2022

The United States has seen a dramatic reduction in the rates of both unintended pregnancy and childbearing among people of all races and ethnicities [1–2] . Researchers have attributed much of this reduction to an increase in the use of contraception [3]. Critical to the increased use of contraception is the availability of affordable, high-quality sexual and reproductive health care [3, 4]. However, some groups of young people in the U.S. have not experienced as dramatic a reduction in teen pregnancy and childbearing. In particular, young people in foster care continue to experience significantly higher rates of early pregnancy and parenthood than their peers in the general population [5, 6, 7, 8]. Several individual and system-level factors are likely to contribute to persistently high rates of teen pregnancy and childbearing among young people in foster care. These include less access to both sexual and reproductive healthcare services and information about contraception as well as fewer trusted adults with whom to discuss sensitive topics including sexual and reproductive health [9, 10, 11, 12].

As researchers who aim to improve the sexual and reproductive health of youth in foster care through their research, we are concerned about the impact that the Dobbs decision will have on their access to sexual and reproductive healthcare services.

The recent reversal of Roe v. Wade by the U.S. Supreme Court under the Dobbs v. Jackson Women’s Health decision will disproportionately impact already marginalized populations [13, 14, 15], including youth in foster care. As researchers who aim to improve the sexual and reproductive health of youth in foster care through their research, we are concerned about the impact that the Dobbs decision will have on their access to sexual and reproductive healthcare services. Below we discuss how youth in foster care are likely to be harmed by the end of the federal right to abortion and suggest action steps that practitioners, policy-makers, and researchers can take to reduce these adverse effects. 

Systematically oppressed populations, including youth in foster care, will be disproportionately affected by abortion restrictions.  

Many child welfare professionals understand the importance of youth in care having access to the full range of sexual and reproductive healthcare services. However, they are sometimes uncertain about their role in facilitating access to those services or even to information about sexual and reproductive healthcare [16]. From a reproductive justice perspective [17], barriers to equitable access to sexual and reproductive healthcare services are amplified by historic and systemic marginalization based on race/ethnicity, gender identity, class, immigration status, and age [18]. 

Youth in foster care have long faced barriers to accessing abortion services.

Only a few studies have looked at abortion rates among young people currently or formerly in foster care [19, 20, 21]. These studies have found that pregnancies among young people currently or formerly in foster care are less likely to end in abortion than pregnancies among adolescents in the general population. Although the reasons for this difference have not been studied, they probably include a lack of transportation, a lack of financial resources, and, in the case of minors, difficulty obtaining a guardian’s consent. Post-Dobbs, those barriers may be even greater, and in some states, abortion is no longer an option.  

Abortion restrictions will further limit access to contraception, sexually transmitted infection (STI) testing and treatment, and other sexual and reproductive healthcare services among youth in foster care

Abortion restrictions will further limit access to contraception, sexually transmitted infection (STI) testing and treatment, and other sexual and reproductive healthcare services among youth in foster care.  

In states where abortion is either banned or highly restricted, many clinics that provide abortion services have been forced to close [22]. As these closures continue to occur, already limited access that youth in foster care may have had to low or no-cost contraception, STI testing and treatment, and other sexual and reproductive healthcare services will be further limited [23–24]. 

Abortion restrictions will further limit bodily autonomy for youth in foster care

The end of Roe deprives young people with the capacity to become pregnant of their bodily autonomy. Given that many youth in foster care have experienced abuse or other traumas, and may already feel they have limited autonomy over basic life circumstances (e.g., where or with whom they live), additional threats to their bodily autonomy can adversely affect their emotional well-being.

Abortion pills may not be an option for youth in care. 

Medication abortions (“abortion pills”) now account for more than half of all abortions in the U.S. [25] Unlike surgical procedures, medication abortions can be completed outside of a medical setting. The two-drug abortion pill combination (mifepristone followed by misoprostol) can be obtained from a clinic or through mail order. However, mail order abortion pills may not be an option for youth in care who are living in a foster home, the home of relatives, or a congregate care setting. Additionally, the cost of those pills is likely to be prohibitive for a young person in care. 

Recommendations for Healthcare Providers: 

• Primary care providers can help fill gaps in the availability of sexual and reproductive health services, especially in states that have banned or restricted access to abortion care. 
• Youth in care should have an opportunity to speak privately (i.e., without their foster parent or other caregiver being present) with their healthcare provider to discuss their sexual and reproductive health, and those conversations should be confidential. 
• Healthcare providers should initiate conversations with youth in care about their sexual and reproductive health. Conversation starters might include “Some youth start to have sex around this age. We are here to help connect you to information about birth control or STI testing if that is the case for you.”
• Healthcare providers should reach out to their county or state child welfare agency to let them know about the sexual and reproductive healthcare services they provide and how youth can be referred to those services.

Recommendations for Child Welfare Practitioners

• Child welfare practitioners can find out where the nearest Title X clinics (i.e., clinics that receive federal funding to provide family planning services) are located. You can search for Title X clinics here.
• Child welfare practitioners should know the age at which young people in their state can consent to contraceptive services, STI testing and treatment, and abortion care (in states where abortion is still legal).
• Child welfare practitioners should reach out to Title X clinics or public health departments for information about sexual and reproductive health education or training options for youth, caregivers, or practitioners in their area. 
• Child welfare practitioners should familiarize themselves with online sexual and reproductive health resources for youth, caregivers, or practitioners. One option is Activate: The Collective to Bring Adolescent Sexual & Reproductive Health Research to Youth-Supporting Professionals.

Recommendations for Research

Abortion among youth in foster care has been understudied, even by researchers with a broader interest in sexual and reproductive health among this population. Future research should investigate potential changes in both birth rates and abortion rates among youth in foster care during the post-Dobbs era, barriers to and facilitators of access to abortion services, child welfare administrator and case worker experiences around youth seeking abortion care, and abortion decision-making among youth in foster care. These lines of inquiry will aid child welfare systems and other service providers in developing best practices for ensuring that youth in foster care have access to the full spectrum of sexual and reproductive healthcare services, including abortion. 

Main authors on behalf of ReSHAPING (alphabetical order)

Liz Aparicio, Katie Massey Combs, Amy Dworsky,  Kristen Ethier, Bryn King.

PHOTO CREDIT: Gayatri Malhotra on Unsplash

ReSHAPING (Research on Sexual Health and Adolescent Parenting in Out-of-Home Environments Group) is an international network of scholars in social work, public health, public policy, and psychology dedicated to collaborative research on understanding needs and improving outcomes related to sexual health and parenting for youth who are homeless, trafficked, or in out-of-home environments, whether in child welfare, juvenile justice, or other systems. Read more about us.

The post How the Dobbs Decision Affects Youth in Care and Recommendations for Providers appeared first on Healthy Teen Network.

Young parents thrive when they have access to quality supports and services. The complicating factor is that these supports and services cross over so many areas—education, housing, child care, mental and physical health, relationships, financial stability, parenting and child development. It’s a lot. And it can be overwhelming for one organization to take it all in, much less to do it all. 

But this big picture vision is necessary. How can a young parent be focused on their schoolwork when they don’t have reliable childcare? Or they are worried about where they will be sleeping that night? Who will help a young parent know about and advocate for their rights for excused absences and reasonable accommodations during pregnancy and after birth? 

A holistic approach is what it takes, which is why Healthy Teen Network developed the Young Parents Logic Model. Based on the social-ecological model, the Young Parents Logic Model is the blueprint for how to take into account the diverse needs of young parents along with the range of factors, or social determinants of health, in society, in their communities, and in their relationships with family and peers, to provide the necessary supports and services for young parents to thrive. 

Because we know young parents in and aging out of foster care demonstrate great resilience as they balance the life of an adolescent along with the demands of parenthood, and they are motivated to create a better life for their children.

But it’s just a model, a tool meant to be used. Which is why we at Healthy Teen Network were so appreciative of the opportunity to partner with our friends at the ReSHAPING Network to consider how to apply the Young Parents Logic Model to increase postsecondary educational attainment among young parents in and aging out of care.

Our collaboration resulted in an conceptual article: “Promoting Postsecondary Educational Success among Young Parents in and Aging out of Foster Care,” available now, along with an accompanying quick reference guide.

We know that young people in and aging out of foster care are resilient. Nevertheless, they experience higher rates of early parenthood (Dworsky & Courtney, 2010; Putnam-Hornstein & King, 2014; Putnam-Hornstein et al., 2016; Shpiegel & Cascardi, 2018; Svoboda et al., 2012) and poorer educational outcomes (Dworsky et al., 2014), including lower college enrollment and graduation rates (Courtney et al., 2011, 2018; Geiger & Beltran, 2017) than their peers. We also know that postsecondary education can potentially change the life course trajectories of young parents in and aging out of foster care, and hence, the life course trajectories of their children (Okpych & Courtney, 2019). Less is known, however, about what we could do to increase postsecondary educational attainment among this population of young people.

Increasing postsecondary educational attainment in this population requires an understanding of what those young parents need to pursue and complete their postsecondary education. Which is where the Young Parents Logic Model comes in, providing a framework for understanding those needs. We paired this framework with knowledge about what is currently being done to achieve this goal among this population, or at least, similar populations. 

We were able to identify several programs designed to promote educational attainment among both young parents in the general population as well as young people in and aging out of foster care (we did not find any programs solely focused on young parents in and aging out of foster care). As we took a deeper look, we found that these programs, while not developed with the Young Parents Logic Model, used a social-ecological perspective (i.e., they addressed factors at multiple levels—societal, community, relationship, and individual).

These programs also addressed several of the eight determinants most relevant to postsecondary educational attainment among young parents in and aging out of foster care: 

1. Positive messages about the benefits of postsecondary education
2. Development of and motivation to pursue long-term educational and professional goals  
3. Supportive relationships with individuals who support educational attainment
4. Development of positive connection to and engagement with educational institutions
5. Access to and use of community, or school-based, or other social services  
6. Living in a safe environment free of violence
7. Maintenance of physical and mental health and well-being 
8. Consistent, equitable enforcement of Title IX policies, including those related to appropriate living accommodations

One of the benefits of a logic model is that it identifies the path, or it provides the map, to achieve a goal. These 8 determinants are part of that path—we need changes in policy and practice in these areas. Because we know young parents in and aging out of foster care demonstrate great resilience as they balance the life of an adolescent along with the demands of parenthood, and they are motivated to create a better life for their children. Increasing postsecondary educational attainment among these young parents is one way to improve their well-being and the well-being of their children.

Read more in the full article.

Manuscript Authors:

Lisa Schelbe, Ph.D., Florida State University

Amy Dworsky, Ph.D., Chapin Hall at the University of Chicago 

Svetlana Shpiegel, Ph.D., Montclair State University

Andrea Lane Eastman, Ph.D., University of Southern California

Jennifer Geiger, Ph.D., University of Illinois – Chicago

Gina Desiderio, M.A., Healthy Teen Network

Milagros Garrido, M.S., P.M.P., Healthy Teen Network

PHOTO CREDIT: Healthy Teen Network

Gina Desiderio, MA, is Director of Communications for Healthy Teen Network and oversees all of our communications and dissemination. Working here has only sometimes prepared Gina for spontaneous sex-positive conversations with her two young sons. Read more about Gina.

Milagros Garrido, MS, PMP, is the Director for our Innovation and Research Department at Healthy Teen Network. Always ready for a challenge, she is at her best when she is finding clever and new ways of using technology to make the seemingly impossible a reality. Read more about Mila.

The post Eight Factors to Increase Postsecondary Success among Young Parents in and Aging out of Foster Care appeared first on Healthy Teen Network.

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