Virtual Sexual Health Education for Court-Involved & Court-Exposed Girls: A Pilot of the Adapted My Body, My Choice Intervention.

Abstract

Background: Court-involved non-incarcerated (CINI) girls and girls with prior carceral exposure often have heightened sexual and reproductive health (SRH) risks and unique needs but limited access to care. These risks are compounded by childhood trauma and lack of access to trauma-informed, developmentally-aligned SRH education. Despite this, few interventions are tailored to the needs of CINI girls or those with prior carceral exposure.

Objective: We piloted the My Body, My Choice for CINI Girls (MBMC-CINI), a trauma-informed, community-adapted SRH education intervention, with CINI girls and girls with prior carceral exposure, assessing for changes in SRH knowledge, attitudes, and confidence.

Methods: We conducted a pre-experimental, one-group pre-test-posttest study with three cohorts (N = 31). Participants identified as cis-girls, ages 12-18, who were either CINI or had prior carceral exposure. MBMC-CINI was delivered via Zoom and included 11 interactive modules facilitated by health educators, clinicians, and lived experience experts. Participants completed surveys at baseline, 1-month, and 3-months post-intervention. Measures included knowledge of birth control methods, sexual health concepts, confidence using contraception, and communication behaviors. We assessed changes over time using Exact McNemar and Wilcoxon Signed-Rank Tests.

Results: Twenty-four participants completed baseline surveys, 21 completed 1-month follow-up, and 17 completed all three assessments. Delivery of MBMC-CINI was associated with significant improvements in familiarity with multiple contraceptive methods (e.g., birth control pills, condoms, injectable birth control) and confidence in correctly using condoms and contraception. Retention was high, with most participants attending the majority of sessions, despite substantial structural barriers; for example, 42% of participants reported homelessness in the prior year.

Conclusions: The MBMC-CINI intervention was associated with improvements in SRH knowledge and confidence, along with strong intervention engagement, supporting further testing of this intervention at scale. Expanding access to tailored, trauma-informed SRH education has the potential to advance reproductive health outcomes and health equity for marginalized youth.