Evidence-based sexual health programs for youth involved with juvenile justice and child welfare systems: Outcomes across settings

Abstract

IntroductionSystem-involved youth experience disproportionately high rates of teen pregnancy and sexually transmitted infections. Although many evidence-based sexual health programs exist, few have been evaluated among system-involved youth. We aimed to assess the impact of two evidence-based programs (Making Proud Choices! and Be Proud! Be Responsible!) among this population, and to explore whether impacts differed by juvenile justice (JJ) and foster care (FC) settings. MethodsSystem-involved youth (N = 803) received an evidence-based sexual health program across five facilities. Providers were trained in trauma-informed care and made related minor “green-light” changes to the curricula. Youth completed pre- and post-test measures examining their sexual health knowledge and attitudes towards condoms and birth control. ResultsUnadjusted t-tests found that participants in both JJ and FC significantly (p < .001) improved in sexual health knowledge, but only participants in JJ increased in positive attitudes towards using condoms and birth control. However, after controlling for demographic variables, hierarchical multiple regressions indicated that youth in FC settings had greater increases in sexual health knowledge, and that the program's impact on attitudes towards condoms and birth control did not differ by FC or JJ setting. DiscussionResults suggest that Making Proud Choices! and Be Proud! Be Responsible! can improve system-involved youths' sexual health knowledge, and attitudes towards condoms and birth control across JJ and FC settings. Outcomes may depend upon facilitators' training in trauma-informed care and “green light” tailoring modifications to adjust language and approach to be more trauma-informed.