Foster Caregiver-Adolescent Communication about Sexual Health Education: A Scoping Review

Context: Foster care adolescents are at high risk of many negative health outcomes, including adverse sexual health outcomes.

Objective: This study aims to summarize existing literature on foster caregiver-adolescent sexual health communication and education.

Study Design and Analysis: Scoping review of existing literature and a qualitative thematic analysis of the included studies.

Setting/Dataset: Appropriate search terms were developed related to (1) sexual education or communication and (2) parents and primary caregivers within the following databases: PubMed, PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE (EBSCO), EMBASE, and ERIC (EBSCO). Date ranges were January 1, 1990 to April 16, 2023. Articles were included if they met all specified criteria.

Population Studied: Foster caregivers, adolescents, and child welfare professionals in the U.S. who reported data on foster caregiver-adolescent sexual health communication.

Intervention/Instrument: N/A.

Outcome Measures: Findings from included articles were analyzed and organized into three key themes: (1) Foster adolescent-reported experiences with sexual health communication from caregivers; (2) Barriers to sexual health outcomes and communication identified by foster caregivers and child welfare professionals; and (3) Interventions to improve sexual health communication between foster caregivers and adolescents and caregiver-reported recommendations for future programs.

Results: Initial database search yielded 19,739 results, of which 11 met the specified inclusion criteria. Foster care adolescent perspectives on sexual health communication from caregivers was mixed, with some reporting open and honest communication, while others identified avoidance of sexual communication for religious reasons. Foster caregivers or child welfare professionals identified multiple barriers to sexual health communication, including differences in racial and sexual identities, caregiver discomfort or lack of confidence, and caregiver worry regarding the appropriateness of sexual health conversations. Several studies reported interventions or proposed strategies aimed at improving sexual health communication.

Conclusions: Foster caregivers and adolescents face multiple barriers to sexual health communication. Healthcare providers can play an important role in providing sexual health knowledge to both caregivers and adolescents and engaging in non-judgmental sexual health conversations.