"You Have to Go Hunting for Information": Barriers to Service Utilization Among Pregnant/Parenting Young People with Experience in Foster Care

Background and Purpose: Research has shown that among females in out-of-home care, 71% reported experiencing a pregnancy by age 21 compared to 33% for the comparison group (Courtney et al., 2007). The Family First Prevention Services Act (FFPSA) provides an opportunity to further support parenting young people who are involved with the child welfare system (PPYP). Additional research is needed to develop programs addressing the specific needs of this population (Eastman et al., 2019). This study fills this gap by exploring how PPYP interact with providers and agencies that offer services to support the needs of themselves and their children. Three research questions guided our study: 1) What provider characteristics are barriers to service utilization among PPYP?; 2) What agency characteristics are barriers to service utilization among PPYP?; and 3) What characteristics between agencies are barriers to cross-system collaboration to support service utilization among PPYP?

Methods: We conducted a qualitative needs assessment with PPYP and a cross section of service providers in an urban area within a Southwestern state. We conducted 9 individual face-to-face interviews with service providers (n=5) and PPYP ages 12-24 (n=4) as well as 5 focus groups with service providers (n=23) and 3 with PPYP (n=7). The semi-structured interview guide asked the purposive sample about barriers, strengths, and gaps in service delivery for PPYP. The majority of service providers identified as female (75%), White (60.71%), and 25-34 years old (35.71%). The majority of youth identified as female (72.70%), Hispanic/Latina/o (27.30%), White (27.30%) or Mixed Race (27.30%), and 19 years old (M=19.60). An inductive iterative analysis of verbatim transcripts identified topic and in vivo codes that emerged from the data, then second-level codes and themes were identified.

Results: Themes that emerged fell into three major categories: provider attitudes, agency characteristics, and system characteristics. Themes in the provider attitudes category included negative attitudes toward pregnant teens and/or those with child welfare experiences. Agency characteristics included lack of workforce diversity, employee turnover, lack of training about diverse communities, complicated enrollment processes, lack of childcare and transportation, and restrictive eligibility requirements. System-level barriers included lack of centralized services, lack of up-to-date information about existing services, territorialism, funding sources that do not prioritize interagency collaboration, and lack of communication/coordination among agencies.

Conclusions and Implications: Findings from this study can help inform policymakers and practitioners as they expand services to pregnant and parenting young people in foster care as the FFPSA is implemented. Based on our findings, reducing barriers to service utilization by PPYP will require increased efforts in three areas: a) reducing prejudice toward this population through additional workforce training and support to individual service providers; b) supporting agencies in engaging in effective cross-system collaboration, streamlining enrollment and eligibility processes, and diversifying their workforce; and c) increasing support to assist PPYP in identifying and utilizing the services most compatible with their individualized needs. As these programs emerge due to the FFPSA, further research is needed to understand facilitators of service utilization among pregnant and parenting young people involved with child welfare.