Teen Pregnancy Prevention Among Youth in Foster Care. Katy Suellentrop, Director of State Support

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1 Teen Pregnancy Prevention Among Youth in Foster Care Katy Suellentrop, Director of State Support

2 Workshop Agenda Get to know each other & the issue Explore the research Brainstorm solutions Share resources

3 The National Campaign s Mission The Campaign s mission is to improve the wellbeing of children and families, and in particular, to help ensure that children are born into stable, two-parent families who are committed to and ready for the demanding task of raising the next generation. Our specific strategy is to prevent teen pregnancy and unplanned pregnancy among single, young adults.

4 Getting to Know Each Other Name Why did this training topic interest you? How long have you been working with youth in foster care?

5 Getting to Know the Issue

6 DATA

7 Why Focus on Youth in Foster Care? 33% of girls in foster care became pregnant at least once by 17 compared to 13.5% of their peers Making teen girls in foster care 2.5 times more likely to experience a pregnancy by age 19 Over ½ of young women and ½ of young men in foster care have had a child by age 21. Almost half of all teen girls in foster care who have been pregnant experience a subsequent pregnancy by age 19 compared to less than one-third of girls not in foster care

8 100% 80% 60% 40% 20% 0% Reproductive Health Behaviors Among Young Adults (Age 18-26) 93% 87% Sexually Experienced 46% 34% Young Age at First Sex 33% 18% Ever Experienced Forced Sex Reproductive Health Behaviors Youth Who Ever Lived in Foster Care 56% 72% Contraceptive Use at First Sex All Other Youth Source: The National Campaign to Prevent Teen and Unplanned Pregnancy. Fast Facts: Reproductive Health Outcomes of Youth Who Ever Lived in Foster Care df

9 50.0% 40.0% Why Focus on Youth in Foster Care? 30.0% 20.0% Child Reported for Maltreatment by Age % 0.0% No Report of Maternal Victimization Unsubstantiated Report of Maternal Victimization Substantiated Report of Maternal Victimization Substantiated Report of Child Maltreatment by Age 5

10 Why Focus on Youth in Foster Care? Older age of transition might be protective: Sexually active teens who age out of foster care are less likely than youth still in foster care to report using condoms or birth control at all in the last year Remaining in foster care until age 19 is associated with a 38 percent reduction in becoming pregnant compared to those youth who age out before 19 Source: The National Campaign to Prevent Teen Pregnancy. Why It Matters: Teen Pregnancy and Child Welfare

11 Our Efforts Documenting and understanding the issue Work with states to develop action plans and strategies for how to address Partnership with American Public Human Services Agency (APHSA) to systematically integrate an evidence-based teen pregnancy prevention program

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13 What We Know

14 Risk Factors Histories of abuse and neglect. Not knowing the difference between a healthy vs. unhealthy relationship. Wanting someone to love. Not having a trusting adult in their life. Multiple placements. Breaks in their education. Susceptible to becoming victims of sexual exploitation.

15 Listening to the Youth Voice Sex education they receive is too little, too late. Want mentors who were formerly in foster care and/or can relate to them. Having goals and dreams as a youth in care is not realistic. NO HOPE Self-sabotaging your own relationships is common. Leave them before they leave you.

16 What do they say? We live with adults who don t understand where we are coming from. We deal with staff members who don t seem to care. I need to have this conversation [about sex] with a person who is not going to be jumping down my throat all the time. My mom really didn t promote birth control because she was really saying don t have sex at all. So we really didn t hear much about birth control.

17 Findings

18 Youth in foster care lack some important relationships Many foster youth report poor relationships with their foster parents. Both foster parents and youth stress the importance of family involvement, combined with good communication overall. Foster care youth want to have conversations about sex with their foster parents.

19 Youth see benefits to having a baby o Provides stability and a sustainable relationship. o Creates a family and a source of unconditional love. o Motivates them to become more responsible. o Brings them closer to their birth family.

20 Pressure, Information, Perceptions Some youth are already sexually active (or teen parents) before they received any information about pregnancy prevention. Youth want to hear from people with personal experience. Youth respect abstinence as a concept, but many indicate that it is not the right decision for them.

21 What we hear from Providers

22 Youth Serving Professionals The majority (59%) of respondents report their programs are inadequately prepared to address pregnancy prevention. While only 33% feel adequately trained to work with teens on issues of pregnancy prevention, staff recognize pregnancy prevention as an important need and address the issue with teens.

23 Creating Solutions

24 Making Proud Choices! For Youth In Out-of- Home Care Partnership with the American Public Human Services Association with support from the Annie E. Casey Foundation. Goals: 1. Adapt an evidence-based curriculum for youth in care Making Proud Choices! 2. Embed curriculum into existing IL and TP programs to educate youth and support their efforts to prevent early pregnancy.

25 Who Is Involved? National Advisory Council Five teams of state and local child welfare and teen pregnancy professionals Alameda County, California North Carolina Rhode Island Hawaii Minnesota

26 The Youth Voice Youth input and guidance was necessary and invaluable to achieving project goals including: Understanding the risk factors from the youth perspective. Adapting the curriculum to engage youth and include activities they want to participate in. Producing a sexuality education curriculum that was appropriate and relevant.

27 Adaptations Worked closely with the program developer (Dr. Loretta Jemmott) Informed by the National Advisory Council and a panel of former foster youth Experts in trauma, child welfare, youth, etc. Pilot tested with a group of youth in foster care

28 Adaptations Message incorporated throughout the curriculum was the same as the original: Youth can make proud and responsible choices. Types of adaptations: Facilitator manual Materials and activities for youth themselves (i.e. workbooks, posters, role-plays etc.)

29 Adaptations Overall curriculum changes: Increased effort to be welcoming and inclusive of LGBT (lesbian, gay, bisexual, and transgender) youth and youth who ve experienced pregnancy or are teen parents More time for each module (75 minutes vs. 60 minutes) (also more modules 10 vs. 8) Greater focus on birth control Focus on healthy relationships Tailoring of discussions, case studies, and role-play scenarios for youth in care Addition of a new module on broader sexuality issues

30 Adaptations Adaptations for Facilitators: Sensitivity to different types of placements Sensitivity to previous trauma Data about the risk for youth in care

31 What was unique about this project? Partnered with the American Public Human Services Association (APHSA) to take teams through an organizational change process (called an Institute) to increase potential for integration and sustainability of the program Invited interested entities to apply for an opportunity to participate in the Institute process Required sponsorship and participation from key leaders Included intersession work and support Focused on integrating a new curriculum into child welfare practice

32 Implementation: What did we learn from the Institute? Institute framework and written plans helpful Dedicated time to work as teams away from normal, busy schedules was important Idea exchange, collaboration & networking aspect across states was very helpful Varied representation/diversity across sites Teams increased cross-collaboration, particularly between child welfare and public health

33 The Youth Response Overall, youth liked the material presented in the class. Average score 4.35 on a scale of 1-5. Overall, youth found the material to be relevant to experiences they have had. Average score 4.3 on a scale of 1-5 Youth wished they learned more about: STDs and HIV/AIDS How to avoid peer pressure Sex and relationships Healthy relationships

34 The Youth Response 88% of participants felt the program helped them learn more about preventing pregnancy 89% said the program helped them learn more about STD prevention 84% of participants said they would recommend the class to a friend 86% of participants said, overall, they enjoyed the class

35 State Successes Hawaii: Implemented MPC for Youth in Out-of-Home Care in 3 out of 4 ILPs statewide. Alameda, CA: Presented MPC curriculum overview to child welfare staff and caregivers Minnesota: increased awareness and process between Public Health & Child Welfare systems

36 Lessons Learned Getting buy-in from the leadership level The importance of integration across sectors Build in strategies for sustainability from the beginning think training!

37 So What Can You Do?

38 Messages

39 Identifying Points for Intervention among Youth in Foster Care Initial Trauma Removal from Home Family Court Judge Case Worker Court Appointed Special Advocate Guardian Ad Litem Placement in Care Group Home Staff Foster Parents Social Worker Educational Setting Teachers After-School Program Coordinator Educational Advocate School Social Worker / Counselor GED Program Director Transitioning Out of Care Possible Secondary Placements: Juvenile Justice Independent Living Programs (ILP)

40 Guiding Questions When does the topic of sex come up? What helpful resources could you provide to your youth / foster parents / judge / etc.? What are the messages you want to deliver? How will you deliver them? What are the support systems available to you and your youth within the community? (i.e. clinics, trainings, classes, mentors, etc.)

41 National Campaign Resources

42 Thank You! Feel free to contact me with questions or resource requests Katy Suellentrop Check out our website for more: