Abstract
Objectives
This study describes the perspectives of caregivers of youth in foster care in Texas
about the caregiver’s role in adolescent contraception decision-making for adolescents
in their care, particularly for long-acting reversible contraception. The study also
explores how providers and foster care agencies can better support pregnancy prevention
for youth in care.
Study design
Researchers recruited 18 caregivers of youth in care from an academic center in Texas
to complete in-person, one-on-one, semistructured interviews from August to December
2019. Two independent coders identified the main concepts with thematic analysis;
discrepancies were resolved by consensus.
Results
Most caregivers identified as female (88%), Black (59%), and ranged in age from 30
to 69 years old. Half (47%) reported previously caring for an adolescent who was pregnant
or parenting. Themes from the interviews included the importance of building relationships
before contraception conversations, the balance between adolescent autonomy and strict
caregiver oversight in contraceptive decision-making, variation in beliefs about contraception
for youth in care, and extreme reactions to long-acting reversible contraception in
both directions. Providers and foster care agencies played an important role managing
confidential expectations and providing resources or trainings about contraception.
Conclusions
In a region of the country with high rates of adolescent pregnancy, strategies that
empower adolescent autonomy allow delicate caregiver oversight, provide comprehensive
information about all contraceptive options, and respond to extreme long-acting reversible
contraception reactions and trainings that focus on the context of contraception that should
inform communication-based interventions to address teen pregnancy prevention among
youth in care.
Implications
Few studies address the experiences of caregivers of adolescents in foster care. This
study highlights a range of caregiver attitudes about contraception for adolescents
in care. Provider training regarding contraception should include strategies to manage
caregiver beliefs and extreme reactions to contraception use among youth in care.
Keywords
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Article info
Publication history
Published online: February 23, 2023
Accepted:
February 16,
2023
Received in revised form:
February 7,
2023
Received:
August 15,
2022
Publication stage
In Press Corrected ProofFootnotes
☆Conflicts of interest: None.
☆☆Funding: This work was supported by the Children’s Health Clinical Research Advisory Committee (CCRAC) Award, an NIH K23 HD097291 Mentored Patient-Oriented Research Career Development Award, and the UT FOCUS award.
Identification
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© 2023 Elsevier Inc. All rights reserved.
