Danielle Phillips, MSW, PhD Student, University of Maryland at Baltimore, Baltimore, MD
Olivia Kachingwe, MPH, PhD Candidate, University of Maryland at College Park
Michelle Jasczynski, MEd, PhD Student, University of Maryland at College Park, MD
M. Kaleipumehana Cabral, MSW, Community-Based Research Assistant, University of Hawai`i, Honolulu, HI
Maisha Huq, MPH, PhD Student, University of Maryland at College Park, MD
Eshana Parekh, BS in Human Ecology Candidate, University of Maryland at College Park
Kaitlyn Lee, MPH, Research Assistant, University of Maryland at College Park
Emily Hillig, Research Assistant, University of Maryland at College Park, MD
Christine Childers, BS, Wahine Talk Peer Mentor and Health Educator, Waikiki Health
Rebecca Chavez, MSW, Program Manager, Waikiki Health, Honolulu, HI
Jaqueline Tellei, BA, PATH Clinic Director, Waikiki Health, Honolulu, HI
Elizabeth Aparicio, PhD, Assistant Professor, University of Maryland at College Park, College Park, MD
Background and Purpose: Half of female youth experiencing homelessness (YEH) become pregnant. Female YEH have high rates of sexual victimization and many have complex trauma histories, escalating incidence of sexual risk behavior and myriad vulnerabilities. Education, healthcare, and social systems are often ill-prepared to address the sexual health needs of YEH. In response, we developed and tested Wahine (“woman”) Talk, a trauma-informed intervention delivered via a youth drop-in center in Honolulu, HI. Wahine Talk functions at the individual, interpersonal, and system level to improve female YEH’s well-being, linkage to sexual healthcare, and uptake of contraception. Wahine Talk has four components: basic need services, peer mentoring, sexual health education groups, and sexual healthcare. Youth receive a smartphone at enrollment to facilitate engagement, data boosts when they participate in program groups, and an upgraded smartphone and data plan if they adopt a longer-acting birth control. This presentation will describe longitudinal clinic outcomes to 12 months following delivery of Wahine Talk.
Methods: Our interdisciplinary team (social work/public health/medicine) delivered Wahine Talk to female YEH (N=68) aged 14-22 years (M=17.66, SD=2.38) in a series of cycles. We collected detailed provider- and participant-reported process and outcome measures during and for 12 months following Wahine Talk.
Results: Wahine Talk participants’ self-reported readiness to use any type of birth control and linkage to sexual healthcare increased significantly* from pre- to post-test. Birth control usage rates tripled at post-test, with 48.5% of Wahine Talk participants using any type of birth control, compared to 14.7% before the program. Long acting reversible contraception (LARC) was the most popular type of birth control selected, with 30.9% of youth still using LARC at 12 months post-Wahine Talk, compared to 0% at pre-test and 27.9% at post-test. Six pregnancies occurred during and within 12 months of youths’ completion of the program.
Conclusions and Implications: YEH, especially young women, are among the most vulnerable populations in society. Addressing their sexual health and well-being requires comprehensive, accessible, and multi-level prevention. Systems that are responsive, inviting, and focused on trauma-informed services are well-positioned to enhance youths’ self-determination and their ability to make well-informed sexual health choices. Holistic approaches such as Wahine Talk have the potential to dramatically improve youths’ sexual healthcare access and adoption of birth control.
(*p < .05)
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