The Reach, Implementation, and Effectiveness of Virtual Sex Education for Foster Care Youth


  • Ailish Cornwell Indiana University School of Medicine
  • Monica Farrelly Indiana University School of Medicine
  • Doug Cope-Barnes Health Care Education and Training, Inc.
  • Carolyn G. Meagher Indiana University School of Medicine
  • Mary A. Ott Indiana University School of Medicine



Background and Objective:   Foster care youth have high rates of adverse sexual health outcomes (i.e. STIs, teen pregnancy, sexual trauma), and are important targets for evidence-based sex education.With the COVID-19 pandemic, sex education programming was moved to a virtual format. However, few data existed to guide this transition. We conducted a mixed-methods analysis of the reach, implementation, and effectiveness of    virtual vs in-person sex education for foster care youth before, after, and during the COVID-19 pandemic.  

Methods:  Indiana Proud and Connected Teens (IN-PACT) provided three evidenced-based programs to system-involved youth. The data used in this study includes facilitator forms (n=64) from 2020-2021 virtual programming and youth surveys from 2018-2020 representing in-person (n=965) and virtual (n=50) delivery. Reach was measured using youth survey demographics and sexual behaviors; implementation by free responses from facilitators on challenges and adaptation for virtual teaching; and effectiveness by youth behavior intention and attendance records.

Results:Reach: demographic diversity was maintained for virtual programs, but youth in virtual programs had lower rates of risk behaviors.Implementation: technical, curricular, and relational challenges were experienced and these inspired creative solutions. The sensitivity of the topics likely contributed to relational challenges such as decreased group trust.

Effectiveness: more virtual youth planned to be abstinent in the future, however they had less sexual experience to start with. Fewer youth completed more than 75% of virtual programming as compared to in-person. Conclusions and Impact:  In-person sex education programming has a wider reach, experiences less implementation challenges, and holds better attendance records than virtual programming. However, if virtual programming becomes necessary again from a public health perspective, sex educators and researchers can build on these findings to design virtual sex education that maintains the reach, implementation, and effectiveness of in-person formats.