"They're scared that somebody's gonna judge them": Female African American youth in foster care's perspectives on sexual and reproductive health communication with caregivers

J Pediatr Nurs. 2024 Mar-Apr:75:8-15. doi: 10.1016/j.pedn.2023.11.024. Epub 2023 Dec 12.

Abstract

Background: Obtaining accurate information is critical for youth's sexual and reproductive health (SRH). Youth not in foster care often learn about SRH from their biological parents. Separated from their biological parents, youth in care depend on healthcare providers and caregivers for SRH information. However, they often receive insufficient information and feel unsupported in meeting their needs for SRH information.

Purpose: This study explored female African American adolescents in foster care's perspectives on effective SRH communication with caregivers to help them avoid sexual risks.

Methods: A qualitative study was conducted using semi-structured interviews. We used purposive sampling to recruit 16 adolescents aged 18 to 20 years old with a history of foster care placement. The transcribed interviews underwent inductive thematic analysis. The Positive Youth Development theory underpinned this research.

Results: Two prominent themes emerged: establishing a relationship and preferred communication approach. Youth reported that for caregivers to engage in effective SRH communication, they must first establish a relationship by being aware of the youth's childhood trauma, building trust, having patience, and being vulnerable. Youth also appreciated caregivers who ensured comfortability and were honest and straightforward.

Discussion: Caregivers should be trained on adverse childhood experiences, trauma-informed approaches, SRH knowledge, and communication.

Implications to practice: Healthcare providers should make use of the time spent with youth and discuss SRH topics during clinical encounters. This time spent with youth may be their only chance to obtain accurate SRH information. Youth's perspectives regarding communication about SRH should be implemented in future SRH communication interventions.

Keywords: Foster care; Positive youth development; Sexual and reproductive health; Sexuality communication.

MeSH terms

  • Adolescent
  • Black or African American
  • Caregivers
  • Female
  • Health Communication*
  • Humans
  • Reproductive Health*
  • Sexual Behavior
  • Young Adult