Examining Contraceptive Access and Use among Youth with Child Welfare Involvement

点击翻译按钮获取中文摘要

Project Summary Roughly half of females with child welfare involvement report a pregnancy by age 19 , which is twice the rate of a national sample of youth of similar age and racial/ethnic composition. To date, little is known about sexual and reproductive health of youth with child welfare involvement beyond that they are at increased risk of unintended pregnancy. Even less is known about the sexual and reproductive health of younger adolescents, males, and youth who are not removed from their homes, and few data exist on contraceptive access and use. Contraceptive access and use are critical, not only because of their implications for reducing unintended pregnancy, but because of their effect on agency, autonomy, and lifelong socioeconomic opportunities. While contraceptive access and use have been studied in other populations, these topics are likely distinct for youth with child welfare involvement, given disruptions they commonly experience with systems and adults who typically provide such education and support (i.e., families, schools), and the unique connection to another formal system - child welfare. This project fills these gaps by using existing data from a longitudinal study of youth with open child welfare cases during the transition to high school. The multi-wave study interviewed male and female participants (n=245) three times across adolescence (between ages 12 to 18), and included key variables on contraceptive access and use, sexual and reproductive health attitudes, psychosocial predictors, and child welfare characteristics. We will first estimate the longitudinal experiences of contraceptive access across these critical adolescent ages (Aim 1). We will also code open-ended responses to items on sources of contraceptive access and types of contraceptives used and describe themes. After estimating trajectories of contraceptive access and use, this project will examine modifiable factors that may buffer the risk of adversities that youth with child welfare involvement face (Aim 2). Specifically, the project will examine whether the following predict contraceptive access and use: a) sexual and reproductive health attitudes, b) school attachment, c) adult social support, and d) future orientation. In Aim 3, we will assess how relationships between the modifiable factors and contraceptive access and use may differ depending on biological sex, race/ethnicity, and living instability. Thus, in addition to contributing knowledge around what promotes contraceptive access and use, this project will shed light on for whom those factors predict these contraceptive outcomes. This project will open the door for interventions and services by providing basic data on contraceptive access and use, identifying factors that promote reproductive agency and autonomy, and distinguishing how these factors may differ by key demographic and child welfare characteristics for a population who encounter marginalization through a collection of intersecting identities and adverse childhood experiences.