Foster Care Experiences Assessment: A Measurement Tool for Assessing Types and Range of Foster Care Experiences

Background: Reports estimate nearly 2 million unaccompanied homeless youth aged 13-24 in the United States each year. Nearly 40% of these youth were formerly a part of the foster care system. A body of research has reported elevated risk for HIV among foster and former foster youth. The accumulation of risk factors common to both homeless youth and former foster youth place this large population of homeless former foster youth in the nexus of life experiences that position them at extreme risk for engaging in a number of HIV risk behaviors, and necessitating an increase in intervention research to address the unique needs of this population. While interventions targeting HIV prevention efforts have focused on homeless youth, little research has focused on the impact of unique foster care experiences on HIV risk behaviors. Current studies have examined some HIV risk behaviors by foster care status, but limitations in the current data do not reflect the heterogeneity of foster care experiences. This study aims to develop an assessment tool for quantifying foster care experiences among homeless youth with the goal of understanding the relationship between foster care experiences and HIV risk behaviors among homeless youth.

Methods: A series of 20 semi-structured interviews were held with former foster youth in the Summer of 2014. These interviews focused on details of foster care experiences, HIV risk-taking, and how foster care experiences impacted the behavioral health choices of former foster youth. The qualitative data collected from these interviews were coded to create stems for quantitative questions, leading to the creation of the Foster Care Experiences Assessment. The augmented Foster Care Experiences Assessment additionally included the quantitative measures created from qualitative interviews, and integrated questions related to their foster care experience. While this assessment is not a validated measure yet, it is a collection of questions coded from interview answers.

Results: Results from the qualitative interviews found the range of experiences among homeless former foster youth while placed in the child welfare system, including age at first placement, transitional living plans, living situation after emancipation, number of foster care placements, type of placement, as well as opinions and feelings surrounding specific types of experiences during placement and types of services received.

Discussion: While this tool has not yet been validated, results from these interviews reveal the large heterogeneity of foster care experiences among homeless former foster youth, recognizing the need for a comprehensive tool for assessing positive and negative experiences while in the child welfare system. Future work in validating this tool will uncover a more complete glimpse into the foster care experiences and transitional experiences of homeless former foster youth, and the impact of these experiences on the drug and sex risk behaviors that place them at risk for HIV.