Examining Contraceptive Access and Use among Youth with Child Welfare Involvement

项目摘要 大约一半参与儿童福利的女性在19岁之前报告怀孕，这是19岁怀孕率的两倍。 年龄和种族/民族组成相似的全国青年样本。迄今为止，对性行为知之甚少。 参与儿童福利的青少年的生殖健康和生殖健康，除此之外，他们面临的风险更大 意外怀孕对青少年的性健康和生殖健康所知更少， 此外，妇女、男子和未离家的青年的避孕率也很低，关于获得和使用避孕药具的数据很少。 避孕药具的获得和使用至关重要，这不仅是因为它们对减少意外死亡的影响， 怀孕，而是因为它们对机构，自主权和终身社会经济机会的影响。而 避孕药具的获得和使用在其他人群中进行了研究，这些主题可能与青年不同 儿童福利的参与，考虑到他们通常会遇到的系统和成年人的干扰， 通常提供这种教育和支持（即，家庭、学校）以及与他人的独特联系 正式制度-儿童福利。该项目通过使用来自以下纵向研究的现有数据填补了这些空白： 在向高中过渡期间有未解决的儿童福利问题的青年。多波研究采访了男性 和女性参与者（n=245）在青春期（12至18岁之间）进行了三次，并包括关键 关于避孕药具获得和使用的变量、性健康和生殖健康态度、心理社会预测因素， 儿童福利的特点。我们将首先估计避孕药具获得的纵向经验 在这些关键的青少年年龄（目标1）。我们还将编码开放式的回应，以项目的来源， 避孕药具的获得和使用的避孕药具类型，并说明主题。在估计了 该项目将审查可能缓冲逆境风险的可改变因素， 参与儿童福利的青年面临的问题（目标2）。具体而言，该项目将审查 下列因素预测避孕药具的获得和用途：a）性健康和生殖健康态度，B）学校 依恋，c）成人社会支持，和d）未来的方向。在目标3中，我们将评估关系 可变因素与避孕药具的获得和使用之间的差异可能因生物性别而异， 种族/民族和生活不稳定。因此，除了贡献知识， 避孕药具的获得和使用，该项目将揭示这些因素对谁来说可以预测这些避孕药具 结果。该项目将通过提供以下方面的基本数据， 获得和使用避孕药具，查明促进生殖机构和自主的因素， 区分这些因素如何可能不同的关键人口和儿童福利特征， 由于多重身份和不良童年而被边缘化的人口 经验

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.