In August of 2020, 16 sexual health and child welfare professionals from 5 organizations representing communities across Texas clicked on a common zoom meeting link to begin planning for the Texas Foster Youth Health Initiative, a $5.4 million three year grant, that builds relationships across child welfare and adolescent health systems to promote optimal health for youth who are involved in the Texas foster care system. Despite the virtual environment, there was excitement in everyone’s voices as partners introduced themselves. Leadership and staff from the The Texas Institute for Child & Family Wellbeing (TXICFW), the Texas Campaign to Prevent Teen Pregnancy, the Texas Alliance of Child and Family Services, Healthy Futures of Texas, and the North Texas Alliance to Reduce Unintended Pregnancy in Teens (Ntarupt) were on the call. The truth is, those on the call were not complete strangers, but the 5 organizations had never before worked together to address a common goal: to promote optimal health for youth in care and ensure they feel connected, safe, and empowered and make informed decisions about their sexual health and relationships.
About 50% of females who experience foster care in the United States are pregnant by age 19 compared to 33% of girls across the nation (Eastman, Palmer and Ahn, 2019). Despite disproportionately high pregnancy rates, there are limited interventions and community strategies to help reduce teen pregnancy among foster youth. Among youth in the child welfare system, over 40% of males and over 60% of females experience dating violence perpetration and victimization (verbal/psychological, physical, and sexual (Wekerle et al. 2009)). Current policies and practices limit access to vital sexual health information and skill development.
The Texas Foster Youth Health Initiative aims to change this situation from the ground up by focusing on prevention and working directly with youth, caregivers, and the organizations that serve youth in care. Our Texas Innovation Network is composed of partners that represent both the child welfare and adolescent health systems, and include researchers, program developers, trainers, advocates, educators, and service providers that are committed to improving optimal health outcomes for youth in foster care. The Texas Institute for Child & Family Wellbeing (TXICFW) at UT Austin, the Texas Campaign to Prevent Teen Pregnancy (Campaign), and the Texas Alliance for Child and Family Services (Alliance) are partners with statewide focus that have expertise in advocacy, training, research, evaluation, and collaboration. Healthy Futures of Texas (Rio Grande Valley and San Antonio), the North Texas Alliance to Reduce Unintended Pregnancy in Teens (ntarupt) (Dallas), and the Campaign in collaboration with the Harris County Youth Collective (Houston) focus on providing culturally sensitive sexual health education in their respective communities.
“It is a strength of our network to bring together a multi-disciplinary learning community of child welfare and adolescent health experts, both at the state and the community level,” shared Dr. Barbara Ball, the Initiative’s principal co-investigator. “Our network provides a forum where sexual health educators with years of experience in engaging hard to reach youth can exchange ideas with leaders in child welfare and policy makers. We recognize the potential for learning from each other and leveraging each partner’s expertise and connections.”
Two consultant groups composed of young adults with lived experience in foster care and caregivers joined our network in January 2021 to help us center our work around the needs of youth and their caregivers. They will not only provide feedback on interventions, but have a direct role in developing communications strategies.
We are working with stakeholders in the community and at the statewide level to gather input and direction for the initiative. During the last six months, we met with child welfare agencies, judges, and the Texas Department of Family and Protective Services and spoke with alumni of foster care and their caregivers. In our conversations, we identified the need to engage health care providers to improve access to sexual and reproductive health services for youth in foster care. Thus, we initiated meetings with leading Texas pediatricians and with Superior Health, which manages healthcare for children in DFPS conservatorship, and found that there is an opportunity to develop training and best practice guides for pediatricians to improve the experience of youth during clinic visits and better meet their complex needs. We look forward to continuing to grow our network of stakeholders in 2021 and work together on developing and testing interventions that meet the needs of youth, caregivers, and child welfare organizations.
Since August, TFYHI partners have brought on 8 new staff members to begin community engagement for this project while also participating in weekly trainings on child welfare and adolescent health. Training topics include child welfare system policies and procedures, trauma-informed and inclusive sex education, virtual youth and stakeholder engagement, undoing racism in the child welfare system, and train-the-trainer for curricula and interventions. These trainings will increase capacity among partners, stimulate discussion, and provide a basis for the development of interventions that are tailored to the unique experiences of youth in foster care and the caregivers and organizations that support them.
The group’s next major task will be to expand connections with local stakeholders in the four communities (Houston, Dallas, San Antonio, Rio Grande Valley).
The Texas Foster Youth Health Initiative provides a unique opportunity to design interventions that engage youth and caregivers and to test them in the participating communities. All interventions will be reviewed by TFYHI staff and stakeholders to make sure they are medically accurate, age-appropriate, trauma-informed, and user-centered.
You can read more about the Texas Innovation Network and TFYHI’s first 6 months in our July-December 2020 Community Report here.