P3A004: A Community-academic Partnership to Explore Health Empowerment Priorities Among Young Adults with Lived Experience in Foster Care

Background: Emerging research engages adolescents and young adults with lived experience in foster care (AYAFC) as experts who can inform interventions to narrow health disparities. Project Foster Power (pFP), a Colorado group of AYAFC using their voices and experiences to improve the child welfare system through youth-led organizing and advocacy. Through an Academic-Community Partnership Development grant, pFP collaborated with Denver Health’s Connection for Kids Clinic, a medical home serving youth in foster care, to explore AYAFC priorities and challenges for health empowerment.

Project Description: We recruited pFP members to join a Health Empowerment Committee (HEC). HEC held five two-hour meetings, facilitated by community (JG) and academic (JK) partners, discussing health empowerment priorities among AYAFC between May and September 2022. To facilitate participation, we adopted a hybrid approach for meetings; the initial four meetings were virtual while the final meeting allowed in-person and virtual attendance. Through a Delphi method, HEC members identified health empowerment problems among AYAFC, selecting one problem as the highest priority for future research. HEC members received compensation for their expertise ($25/hour).

Discussion: Ten AYAFC joined HEC. The majority of members identified as female (N 8), minoritized racial and ethnic groups (N 8) and Metro Denver residents (N 8). Four members were parents. Permanency outcomes included emancipation, adoption and ongoing placement in foster care. Member continuity varied between meetings: one member attended all meetings; two members attended three meetings; one member attended two meetings; and six attended one meeting. Four members attended the final meeting, including two joining in-person. Overall, members valued virtual meetings as a format that provided flexibility to participate as their schedules allowed and reduced, but not eliminate, transportation and childcare barriers. HEC identified challenges (Figure 1) before selecting three priority problems specific to health empowerment: 1). “Navigating Health Care”; 2). “Problems with Medicaid”; and 3). “Communication between Systems” (Figure 2). “Communication between Systems” was the lowest priority problem in health empowerment among HEC members. Members perceived “Problems with Medicaid” as the most desirous health empowerment problem to be changed among AYAFC and health care providers but also the most difficult problem to address. Members were equally passionate to change “Problems with Medicaid” and “Navigating Health Care”; however, “Navigating Health Care” was the problem most easily addressed. Members, therefore, selected “Navigating Health Care” as the highest priority health empowerment problem for future research.

Conclusion: This Community-Academic partnership was an effective mechanism to identify and prioritize health empowerment problems among HEC members. HEC members articulated several important problems related to health empowerment among AYAFC. While HEC members selected “Navigating Health Care” as the highest priority problem for future research, understanding the problem’s relevance among the broader AYAFC community is necessary.