Teen Health Initiative

The Need

According to the May 2013 document, “Why It Matters: Teen Childbearing and Child Welfare,” by the National Campaign to Prevent Teen and Unplanned Pregnancy (“the Campaign”), 48% of girls in foster care have been pregnant at least once by age 19, making them 2.5 times more likely to become pregnant before that age than girls in the general population. Nearly one-third have at least one child by 19. Nationally, half of 21-year-old men aging out of foster care report having gotten someone pregnant, as compared to 19% of their non-foster care peers.

The Campaign also highlights that youth in foster care – both boys and girls – are less likely to use contraception at first sex than their peers. Not surprisingly, young adults 18 to 26 who were in foster care are nearly twice as likely to be diagnosed with an STI.

In September 2010, Our Kids of Miami-Dade/Monroe, Inc. – the lead agency that oversees foster care agencies in Miami-Dade – collected pregnancy-related information on area youth who were then in licensed out-of-home care, as well as on young adults who had “aged out” and were receiving Road to Independence funds. The snapshot that resulted underscores the need for action:

  • Of 240 girls ages 10-17 in foster care at the time, 23 (10%) were pregnant or parenting, with 19 children among them.
  • Of 387 youth ages 18-23 who had aged out of foster care and were receiving Road to Independence funds, 153 (40%) were pregnant or parenting, with 198 children among them.

Foster youth’s struggle to achieve long-term success is exacerbated when they become teen parents. “When You Decide,” a judge’s guide jointly produced by the Campaign and the National Council of Juvenile and Family Court Judges, notes that only 40% of teen mothers graduate high school (as compared to 75% of women who become mothers in their early 20’s), and only 5% complete two years of college by their late 20’s. Parenting teens are more likely to be poor as adults, to continue the cycle of abuse and neglect, and to become involved with the child welfare system as parents. The Campaign reports that daughters of teen mothers are more than three times as likely to become teen mothers themselves. Taxpayers pay $9.1 billion annually for teen childbearing, with a full $2.3 billion of those costs attributable to “increased child welfare costs from foster care and Child Protective Services.”

The Work

Phase I of FFCR’s Teen Health Initiative revealed numerous missed opportunities to break this tragic cycle. In a survey conducted by Our Kids and FFCR, 57% of case managers, 80% of Guardians ad Litem, and 73% of FFCR volunteers reported that youth in foster care do not receive the necessary information and support to make good choices about their reproductive health, sexuality, and relationships. The goal of FFCR’s initiative is to provide the information and create the support network that teenage girls, and the boys they interact with, need.

Through the Teen Health Initiative, FFCR will contribute to the system-wide effort to reduce teen pregnancy, improve reproductive health awareness and outcomes, and promote healthy relationships for youth in foster care. Girls tend to suffer the most when teen pregnancy rates skyrocket, reproductive health is neglected, and intimate relationships turn toxic. However, improving outcomes for girls requires addressing these issues with both girls and boys. Project goals include:

  • Increasing foster teens’ access to information, education, and resources that support good decision-making with respect to reproductive health, pregnancy, and relationships;
  • Increasing the frequency with which reproductive health and well-being are assessed, discussed, and addressed by case managers and other child welfare system stakeholders;
  • Increasing FFCR’s volunteer and staff knowledge about teens’ sexual/reproductive health needs and appropriate, effective community resources; and
  • Sharing successes and challenges with the child welfare community in order to improve system-wide efforts.

FFCR’s Teen Health Initiative has two phases. In Phase I, rolled out during 2013, nine reproductive health-related questions adapted from a nationally-developed Pregnancy Prevention Benchcard were embedded in FFCR’s CRP hearing process. Depending on responses to the questions, the CRP recommends specific services and tasks to ensure that the teen’s sexual/reproductive health needs are addressed by the case management agency. FFCR’s volunteers and staff also received training about foster teens’ reproductive health needs and available community resources.

Embedding the questions enabled FFCR to begin collecting data in February 2013 on foster teens’ reproductive health, which allowed identification of common gaps in knowledge and resources, and recommendations for system-wide solutions. Data collection is ongoing, with quarterly analysis.

FFCR is now planning for Phase II, to develop 1) mechanisms to promote greater involvement of youth in their CRP hearings and 2) an effective and meaningful process for talking with youth about their reproductive health. FFCR will engage a former foster youth as a part-time peer advocate to encourage youth to participate in the review, to appear with youth at the review upon request, and to provide information about available community resources. Phase II will also include additional training for the peer advocate, staff, and volunteers on talking to youth about sex and assisting youth with making personally empowering decisions related to their sexual health and long-term well-being.