Foster Parent Access and Use of Healthcare Resources: Influences of Foster Parent Educational Attainment

Background/Purpose: Foster parents promote foster child well-being by utilizing community healthcare resources. Few studies have examined the relationship of foster parent education level with how foster parents access and use healthcare resources for their foster children. This study fills this gap by examining a sample of foster parent experiences accessing and using community healthcare resources.

Methods: In one southeastern state in the United States, participants were recruited through foster parent support networks. Snowball sampling was used within these networks. Twenty semi-structured phone interviews were conducted which elicited participants’ experiences fostering, seeking healthcare resources, and maintaining records. Interviews were transcribed verbatim. For this analysis, participants were separated into two groups: higher education (having at least a bachelor’s degree, 65%) and lower education (less than a bachelor’s degree, 35%). A qualitative team used an inductive approach and in-vivo coding to analyze the interview transcripts. The analysis focused on two domains: access to community healthcare and the utilization of community healthcare resources. Demographic survey results indicated that participants (n = 20) had an average age of 52.1 years old (SD = 11.97), had on average of 10.65 years (SD = 11.00) of experience fostering youth, were predominately female (85% female; 15% male), and predominately White (70% White; 25% Black/African American; 5% Hispanic/Latino).

Findings: Two themes emerged in relation to foster parent access to and use of community healthcare resources: 1) Administrative barriers, and 2) Awareness of healthcare resources. First, in administrative barriers, both participants of low education and high education reported being able to access community healthcare resources for the foster youth in their care but reported difficulties in use. For example, both foster parents with higher and lower education had trouble scheduling healthcare appointments or reported paying out-of-pocket healthcare costs due to not having the health insurance cards and the health records of the foster children during the initial weeks of care. Second, there were differences in awareness by education level and this resulted in differences in access and use of resources. Participants with lower education reported primarily using a local pediatrician and school-based health services as their main healthcare resource, while participants with higher education reported using additional healthcare resources to include healthcare specialists and transportation services to take the foster youth to and from medical appointments. Findings suggest foster parent education level impacts healthcare resource access through a lack of awareness or connection to available resources. Administrative barriers were reported at all educational levels but these barriers had a greater impact on use rather than access.

Conclusions/Implications: This study highlights the importance of foster parent education about existing community resources that children in care can access and utilize. Through training, foster parents of all educational levels can improve their knowledge of resources that can help meet the needs of the foster youth in their care. Future studies could investigate not only the education level of foster parents, but also consider examining income, occupation, and the foster family’s economic and social position in relation to others in their community.