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Addressing Sexual Health Among Youth in Foster Care Group Homes: A Community-Engaged Grounded Theory Study



US foster youth have elevated pregnancy and sexually transmitted infection (STI) rates, yet receive limited sexual health education and intervention. Thus, we sought to co-develop a comprehensive model of sexual health needs among youth in foster care group homes through a community-engaged research process with foster youth and foster care staff to inform such intervention.


Our team conducted five in-depth focus groups with both foster youth placed in group homes and foster care staff (social workers and group home staff) in 2018–2019. We analyzed the data through iterative open, focus, axial, and selective/theoretical coding using constructivist grounded theory (GT) methods to produce a model of sexual health needs among youth in foster care group homes.


GT analysis revealed the model’s core category, Addressing Sexual Health among Youth in Foster Care Group Homes, has three supporting categories: reproductive health system, relationship health, and mental health.


The study model offers new pathways for comprehensively addressing sexual health and well-being in this specialized population, grounded in foster youth and staff members’ direct, lived experiences.

Policy Implications

This conceptualization expands current intervention options beyond pregnancy/STI education programs alone to a holistic, multilevel focus on the interrelated need for trauma-informed family planning and contraception care, mental health and substance use care, sexual and emotional safety, and healthy relationships.

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We are deeply grateful to our study participants for sharing their experiences, to our community partner Hearts and Homes for Youth, and Hearts and Homes for Youth staff, who made this research possible, and to the journal reviewers and editors for helping us to strengthen earlier versions of this manuscript. This work was supported by the University of Maryland Department of Behavioral Health and the University of Maryland Prevention Research Center cooperative agreement #U48DP006382 from the Centers for Disease Control and Prevention (CDC). Any interpretations and opinions expressed herein are solely those of the authors and may not reflect those of the CDC.


University of Maryland Department of Behavioral and Community Health and US Centers for Disease Control and Prevention.

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Correspondence to Elizabeth M. Aparicio.

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Informed consent was provided by each study participant.

Ethical Approval

This study was approved by the University of Maryland Institutional Review Board.

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Aparicio, E.M., Kachingwe, O.N., Salerno, J.P. et al. Addressing Sexual Health Among Youth in Foster Care Group Homes: A Community-Engaged Grounded Theory Study. Sex Res Soc Policy (2021).

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  • Sexual health
  • Foster youth
  • Grounded theory
  • Community-engaged research
  • Reproductive health
  • Mental health
  • Relationship health