Abstract
Expectant or parenting youth (EPY) with foster care histories are often in need of a range of services yet experience barriers to accessing and utilizing those services. This exploratory qualitative study was informed by ecological systems theory and utilized interviews and focus groups with EPY (n = 11) and service providers (n = 28) to identify factors that facilitate service utilization for EPY. We found characteristics at the service provider, agency, and system levels that act as facilitators. Service provider characteristics that facilitate service use include empathy and trustworthiness, supportive navigation, and youth-centeredness. Agency facilitators included representative diversity and inclusivity, trauma-informed training and practice, and availability of tangible supports. System facilitators included having a variety of service providers, systems integration, and co-location. Findings provide a more nuanced understanding of the facilitators that contribute to EPY’s service utilization. Future research is warranted to examine how these youth- and provider-identified drivers of service use influence health, mental health, parenting, education, relationships, employment, and housing outcomes for EPY.
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References
Abbott, M., Landers, P., & Pratt, E. (2019). Peer-to-peer supports: Promoting employment and well-being. https://aspe.hhs.gov/sites/default/files/migrated_legacy_files/189416/promotingemploymentwellbeing.pdf
Aparicio, E. M., Pecukonis, E. V., & O’Neale, S. (2015). “The love that I was missing”: Exploring the lived experience of motherhood among teen mothers in foster care. Children and Youth Services Review, 51, 44–54. https://doi.org/10.1016/j.childyouth.2015.02.002
Arroyo, J., Zsembik, B., & Peek, C. W. (2019). Ain’t nobody got time for dad? Racial-ethnic disproportionalities in child welfare casework practice with nonresident fathers. Child Abuse and Neglect, 93, 182–196. https://doi.org/10.1016/j.chiabu.2019.03.014
Bartlett, J. D., Barto, B., Griffin, J. E., Fraser, J. G., Hodgdon, H., & Bodian, R. (2016). Trauma-informed care in the Massachusetts Child Trauma Project. Child Maltreatment, 21(2), 101–112. https://doi.org/10.1177/1077559515615700
Bramlett, M. D., & Radel, L. F. (2014). Adverse family experiences among children in nonparental care 2011–2012. National Health Statistics Reports, 74, 1–8.
Bronfenbrenner, U. (1979). Ecology of human development: Experiments by nature & design. Harvard University Press.
Bronfenbrenner, U. (1989). Ecological systems theory. In R. Vasta (Ed.), Annals of Child Development, Vol. 6, Six Theories of Child Development: Revised Formulations and Current Issues (pp. 187–249). JAI Press.
Bronfenbrenner, U. (1994). Ecological models of human development. In T. Husen & T. N. Postlethwaite (Eds.), International Encyclopedia of Education (2nd ed., Vol. 3, pp. 1643–1647). Elsevier Science.
Center for the Study of Social Policy. (2018). Family First Prevention Services Act: Pregnant and parenting youth FAQs. https://cssp.org/wp-content/uploads/2018/10/Family-First-FAQs.pdf
Chan, W. S. Y., & Leung, A. Y. M. (2018). Use of social network sites for communication among health professionals: Systematic review. Journal of Medical Internet Research, 20(3), e117. https://doi.org/10.2196/jmir.8382
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Sage.
Connolly, J., Heifetz, M., & Bohr, Y. (2012). Pregnancy and motherhood among adolescent girls in child protective services: A metasynthesis of qualitative research. Journal of Public Child Welfare, 6, 614–635. https://doi.org/10.1080/15548732.2012.723970
Courtney, M. E., Okpych, N. J., Charles, P., Mikell, D., Stevenson, B., Park, K., Kindle, B., Harty, J., & Feng, H. (2016). Findings from the California Youth Transitions to Adulthood study (CalYOUTH): Conditions of youth at age 19. Chapin Hall Center for Children at the University of Chicago.
Dettlaff, A. J., Rivaux, S. L., Baumann, D. J., Fluke, J. D., Rycraft, J. R., & James, J. (2011). Disentangling substantiation: The influence of race, income, and risk on the substantiation decision in child welfare. Children and Youth Services Review, 33(9), 1630–1637. https://doi.org/10.1016/j.childyouth.2011.04.005
Dworsky, A. (2015). Child welfare services involvement among the children of young parents in foster care. Child Abuse & Neglect, 45, 68–79. https://doi.org/10.1016/j.chiabu.2015.04.005
Dworsky, A., & Courtney, M. E. (2010). The risk of teenage pregnancy among transitioning foster youth: Implications for extending state care beyond age 18. Children and Youth Services Review, 32, 1351–1356. https://doi.org/10.1016/j.childyouth.2010.06.002
Dworsky, A., & Gitlow, E. (2017). Employment outcomes of young parents who age out of foster care. Children and Youth Services Review, 72, 133–140. https://doi.org/10.1016/j.childyouth.2016.09.032
Dworsky, A., Gitlow, E. R., & Ethier, K. (2021). Bridging the divide between child welfare and home visiting systems to address the needs of pregnant and parenting youth in care. The Social Service Review, 95(1), 110–164. https://doi.org/10.1086/713875
Eastman, A. L., Palmer, L., & Ahn, E. (2019). Pregnant and parenting youth in care and their children: A literature review. Child and Adolescent Social Work Journal, 36(6), 571–581. https://doi.org/10.1007/s10560-019-00598-8
Fallot, R. D., & Harris, M. (2009). Creating cultures of trauma informed care (CCTIC): A self-assessment and planning protocol. Community Connections.
Family First Prevention Services Act, P.L. 115–123 (2018). https://www.congress.gov/115/plaws/publ123/PLAW-115publ123.htm
Font, S. A., Cancian, M., & Berger, L. M. (2018). Prevalence and risk factors for early motherhood among low-income, maltreated, and foster youth. Demography, 56(1), 261–284. https://doi.org/10.1007/s13524-018-0744-x
Gandy, M. E., McCarter, S. A., & Portwood, S. G. (2013). Service providers’ attitudes toward LGBTQ youth. Residential Treatment for Children & Youth, 30(3), 168–186. https://doi.org/10.1080/0886571X.2013.813344
Greeson, J. K. (2013). Foster youth and the transition to adulthood: The theoretical and conceptual basis for natural mentoring. Emerging Adulthood, 1(1), 40–51. https://doi.org/10.1177/2167696812467780
Greeson, J. K. P., Briggs, E. C., Kisiel, C. L., Layne, C. M., Ake, G. S., Ko, S. J., Gerrity, E. T., Steinberg, A. M., Howard, M. L., Pynoos, R. S., & Fairbank, J. A. (2011). Complex trauma and mental health in children and adolescents placed in foster care: Findings from the National Child Traumatic Stress Network. Child Welfare, 90(6), 91–108.
Hales, T. W., Green, S. A., Bissonette, A., Warden, A., Diebold, J., Koury, S. P., & Nochajski, T. H. (2019). Trauma-informed care outcome study. Research on Social Work Practice, 29(5), 529–539. https://doi.org/10.1177/1049731518766618
Hass, M., Allen, Q., & Amoah, M. (2014). Turning points and resilience of academically successful foster youth. Children and Youth Services Review, 44, 387–392. https://doi.org/10.1016/j.childyouth.2014.07.008
Hayes, M. J., Geiger, J. M., & Lietz, C. A. (2015). Navigating a complicated system of care: Foster parent satisfaction with behavioral and medical health services. Child and Adolescent Social Work Journal, 32(6), 493–505. https://doi.org/10.1007/s10560-015-0388-2
Hernandez, L., Magana, C., Zuniga, D., James, J., & Lee, S. (2014). Navigating the system: A how-to guide for implementing a kinship navigator program. Journal of Public Child Welfare, 8, 397–415. https://doi.org/10.1080/15548732.2014.939248
Heyman, J. C., White-Ryan, L., Kelly, P., Farmer, G. L., Leaman, T. L., & Davis, H. J. (2020). Voices about foster care: The value of trust. Children and Youth Services Review, 113, 104991. https://doi.org/10.1016/j.childyouth.2020.104991
Hyde, J., & Kammerer, N. (2009). Adolescents’ perspectives on placement moves and congregate settings: Complex and cumulative instabilities in out-of-home care. Children and Youth Services Review, 31(2), 265–273. https://doi.org/10.1016/j.childyouth.2008.07.019
James, S., & Meezan, W. (2002). Refining the evaluation of treatment foster care. Families in Society, 83(3), 233–244. https://doi.org/10.1606/1044-3894.24
Kim, J., Pierce, B. J., Jaggers, J. W., Imburgia, T. M., & Hall, J. A. (2016). Improving child welfare services with family team meetings: A mixed methods analysis of caseworkers’ perceived challenges. Children and Youth Services Review, 70, 261–268. https://doi.org/10.1016/j.childyouth.2016.09.036
Kimbrough-Melton, R. J., & Melton, G. B. (2015). “Someone will notice, and someone will care”: How to build strong communities for children. Child Abuse & Neglect, 41, 67–78. https://doi.org/10.1016/j.chiabu.2015.02.015
King, B., Putnam-Hornstein, E., Cederbaum, J. A., & Needell, B. (2014). A cross-sectional examination of birth rates among adolescent girls in foster care. Child and Youth Services Review, 36, 179–186. https://doi.org/10.1016/j.childyouth.2013.11.007
Kramer, T. L., Sigel, B. A., Conners-Burrow, N. A., Savary, P. E., & Tempel, A. (2013). A statewide introduction of trauma-informed care in a child welfare system. Children and Youth Services Review, 35, 19–24. https://doi.org/10.1016/j.childyouth.2012.10.014
Lang, J. M., Campbell, K., Shanley, P., Crusto, C. A., & Connell, C. M. (2016). Building capacity for trauma-informed care in the child welfare system: Initial results of a statewide implementation. Child Maltreatment, 21(2), 113–124. https://doi.org/10.1177/1077559516635273
La Pelle, N. (2004). Simplifying qualitative data analysis using general purpose software tools. Field Methods, 16, 85–108. https://doi.org/10.1177/1525822X03259227
Lanesskog, D., Muñoz, J., & Castillo, K. (2020). Language is not enough: Institutional supports for Spanish speaking client-worker engagement in child welfare. Journal of Public Child Welfare, 14(4), 435–457. https://doi.org/10.1080/15548732.2019.1621235
Lanesskog, D., Piedra, L. M., & Maldonado, S. (2015). Beyond bilingual and bicultural: Serving Latinos in a new-growth community. Journal of Ethnic & Cultural Diversity in Social Work, 24(4), 300–317. https://doi.org/10.1080/15313204.2015.1027025
Lee, S., Benson, S. M., Klein, S. M., & Franke, T. M. (2015). Accessing quality early care and education for children in child welfare: Stakeholders’ perspectives on barriers and opportunities for interagency collaboration. Children and Youth Services Review, 55, 170–181. https://doi.org/10.1016/j.childyouth.2015.06.003
Lietz, C. A., & Zayas, L. E. (2010). Evaluating qualitative research for social work practitioners. Advances in Social Work, 11(2), 188–202.
Liu, S. W. (2013). Bilingual social workers in mental health service provision: Cultural competence, language, and work experience. Asian Social Work and Policy Review, 7(2), 85–98. https://doi.org/10.1111/aswp.12009
Lombardi, B. M., Zerden, L., & Richman, E. L. (2019). Where are social workers co-located with primary care physicians? Social Work in Health Care, 58(9), 885–898. https://doi.org/10.1080/00981389.2019.1659907
McGuire, A., Cho, B., Huffhines, L., Gusler, S., Brown, S., & Jackson, Y. (2018). The relation between dimensions of maltreatment, placement instability, and mental health among youth in foster care. Child Abuse & Neglect, 86, 10–21. https://doi.org/10.1016/j.chiabu.2018.08.012
Mizrahi, T., Rosenthal, B., & Ivery, J. (2012). Coalitions, collaborations, and partnerships: Inter-organizational approaches to organizing for social change. In M. Weil, M. S. Reisch, & M. L. Ohmer (Eds.), Handbook of community practice (pp. 383–402). Sage.
Narendorf, S. C., Munson, M. R., & Levingston, F. (2013). Managing moods and parenting: Perspectives of former system youth who struggle with emotional challenges. Children and Youth Services Review, 35, 1979–1987. https://doi.org/10.1016/j.childyouth.2013.09.023
Nesmith, A., & Christophersen, K. (2014). Smoothing the transition to adulthood: Creating ongoing supportive relationships among foster youth. Children and Youth Services Review, 37, 1–8. https://doi.org/10.1016/j.childyouth.2013.11.028
Ogbonnaya, I. N., & Keeney, A. J. (2018). A systematic review of the effectiveness of interagency and cross-system collaborations in the United States to improve child welfare outcomes. Children and Youth Services Review, 94, 225–245. https://doi.org/10.1016/j.childyouth.2018.10.008
Ohene, S. K., & Garcia, A. (2020). Narratives of women’s retrospective experiences of teen pregnancy, motherhood, and school engagement while placed in foster care. Children and Youth Services Review. https://doi.org/10.1016/j.childyouth.2019.104563
Ojeda, V. D., Munson, M. R., Jones, N., Berliant, E., & Gilmer, T. P. (2020). The availability of peer support and disparities in outpatient mental health service use among minority youth with serious mental illness. Administration and Policy in Mental Health and Mental Health Services Research. https://doi.org/10.1007/s10488-020-01073-8
Ojeda, V. D., Munson, M. R., Jones, N., Berliant, E., & Gilmer, T. P. (2021). The availability of peer support and disparities in outpatient mental health service use among minority youth with serious mental illness. Administration and Policy in Mental Health and Mental Health Services Research, 48(2), 290–298. https://doi.org/10.1007/s10488-020-01073-8
Osterman, M. J. K., Hamilton, B. E., Martin, J. A., Driscoll, A. K., & Valenzuela, C. P. (2022). Births: final data for 2020. National Vital Statistics System, 70(17), 1–49.
Padgett, D. K. (2017). Qualitative methods in social work research (3rd ed.). Sage.
Person, A. E., Clary, E., Zief, S., Adamek, K., Caplan, V., & Worthington, J. (2018). The Pregnancy Assistance Fund: Launching programs to support expectant and parenting youth (GS-10F-0050L/HHSP233201300426G). U.S. Department of Health and Human Services Office of Adolescent Health. https://opa.hhs.gov/sites/default/files/2020-07/paf_crossreport_feb18.pdf.
Piel, M. H., & Lacasse, J. R. (2017). Responsive engagement in mental health services for foster youth transitioning to adulthood. Journal of Family Social Work, 20(4), 340–356. https://doi.org/10.1080/10522158.2017.1348115
Radey, M., Schelbe, L., McWey, M., Holtrop, K., & Canto, A. I. (2016a). “It’s really overwhelming”: Parent and service provider perspectives of parents aging out of foster care. Children and Youth Services Review, 67, 1–10. https://doi.org/10.1016/j.childyouth.2016.05.013
Radey, M., Schelbe, L., McWey, L. M., & Holtrop, K. (2016b). Me, myself and I: Perceptions of social capital for mothers ageing out of the child welfare system. Child and Family Social Work, 22, 981–991. https://doi.org/10.1111/cfs.12318
Schelbe, L., & Geiger, J. M. (2017). Parenting under pressure: Experiences of parenting while aging out of foster care. Child & Adolescent Social Work Journal, 34(1), 51–56. https://doi.org/10.1007/s10560-016-0472-2
Schmidt, M. C., & Treinen, J. (2017). Using kinship navigation services to support the family resource needs, caregiver self-efficacy, and placement stability of children in informal and formal kinship care. Child Welfare, 95(4), 69–89.
Shelton, L. G. (2019). The Bronfenbrenner primer: A guide to develecology. Routledge.
Shpiegel, S., & Cascardi, M. (2015). Adolescent parents in the first wave of the National Youth in Transition Database. Journal of Public Child Welfare, 9, 277–298. https://doi.org/10.1080/15548732.2015.1043687
Shpiegel, S., & Cascardi, M. (2018). The impact of early childbirth on socioeconomic outcomes and risk indicators of females transitioning out of foster care. Children and Youth Services Review, 84, 1–8. https://doi.org/10.1016/j.childyouth.2017.11.001
Stone, K. J., Jackson, Y., Noser, A. E., & Huffhines, L. (2021). Family environment characteristics and mental health outcomes for youth in foster care: Traditional and group-care placements. Journal of Family Violence, 36, 2045–1056. https://doi.org/10.1007/s10896-020-00177-x
Svoboda, D. V., Shaw, T. V., Barth, R. P., & Bright, C. L. (2012). Pregnancy and parenting among youth in foster care: A review. Children and Youth Services Review, 34, 867–875. https://doi.org/10.1016/j.childyouth.2012.01.023
Thompson, A. E., Greeson, J. K. P., & Brunsink, A. M. (2016). Natural mentoring among older youth in and aging out of foster care: A systematic review. Children and Youth Services Review, 61, 40–50. https://doi.org/10.1016/j.childyouth.2015.12.006
Villagrana, K. M., Carver, A. T., Holley, L. C., Ogbonnaya, I. N., Stott, T., Denby, R., & Ferguson, K. M. (2021). “You have to go hunting for information”: Barriers to service utilization among pregnant, expecting, and parenting young people with experience in foster care. Manuscript submitted for publication.
Wulczyn, F., Gibbons, R., Snowden, L., & Lery, B. (2013). Poverty, social disadvantage, and the black/white placement gap. Children and Youth Services Review, 35(1), 65–74. https://doi.org/10.1016/j.childyouth.2012.10.005
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This publication was supported by an award by the Office of Population Affairs (OPA) through the Governor's Office of Youth, Faith and Family. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS, OPA or GOYFF. There are no actual or potential conflicts of interest.
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Villagrana, K.M., Carver, A.T., Holley, L.C. et al. “They Show Us that We’re Important”: Facilitators of Service Utilization Among Expectant and Parenting Youth with Foster Care Histories. Child Adolesc Soc Work J 39, 749–762 (2022). https://doi.org/10.1007/s10560-022-00855-3
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DOI: https://doi.org/10.1007/s10560-022-00855-3