IDEAS home Printed from https://ideas.repec.org/a/eee/cysrev/v173y2025ics0190740925002002.html
   My bibliography  Save this article

Barriers and facilitators to healthcare access among youth transitioning out of foster care: A scoping review

Author

Listed:
  • Smith, Natalia L.
  • Adams, Alauna
  • Abshire, Anthony
  • Cheatham, Leah P.

Abstract

Youth transitioning from the foster care system experience significant healthcare needs. Healthcare access is a critical component of well-being among youth leaving foster care. Yet, few studies have sought to synthesize knowledge focused on healthcare access for youth leaving foster care, specifically and comprehensively. This scoping review aims to identify and analyze the gaps in the knowledge base regarding barriers to and facilitators of healthcare access for youth transitioning out of foster care in the U.S. The authors used the JBI Scoping Review Protocol and engaged in reference harvesting to evaluate the existing literature (n = 33 articles) to understand what hinders and facilitates healthcare access among this population. Studies were included if they explored factors affecting healthcare access among U.S. youth transitioning out of foster care and were published between 2013–2023. Barriers to access included lacking knowledge or experience, insufficient support systems, concerns with confidentiality and trust, treatment accessibility, availability and coverage, stigma and judgment, housing and community instability, as well as provider- (e.g., being inconsistent) and intervention-specific (e.g., manuals too wordy) characteristics. Facilitators to access included encouraging support systems, quality and legitimacy of services, intervention-specific factors (e.g., web-based), health insurance, the necessity of healthcare services, and finances. The findings highlight multitude of complex personal, social, and structural barriers and facilitators impacting youth’s ability to access healthcare while transitioning out of foster care. Practice, policy, and research recommendations are extensively discussed, including increased education for youth and caregivers, expansion of Medicaid, and continued evaluation of underlying drivers of healthcare service use.

Suggested Citation

  • Smith, Natalia L. & Adams, Alauna & Abshire, Anthony & Cheatham, Leah P., 2025. "Barriers and facilitators to healthcare access among youth transitioning out of foster care: A scoping review," Children and Youth Services Review, Elsevier, vol. 173(C).
    • Handle: RePEc:eee:cysrev:v:173:y:2025:i:c:s0190740925002002
    DOI: 10.1016/j.childyouth.2025.108317
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0190740925002002
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.childyouth.2025.108317?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. McKendree, Melissa G.S. & Taylor, Mykel R., 2022. "Extension Program Development for Early Career Faculty," Applied Economics Teaching Resources (AETR), Agricultural and Applied Economics Association, vol. 4(3), August.
    2. Jennifer L. Collins & Laura J. Thomas, 2018. "The influence of social determinants of health among young adults after they have left foster care in the US," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(9-10), pages 2022-2030, May.
    3. Zlotnick, C. & Tam, T.W. & Soman, L.A., 2012. "Life course outcomes on mental and physical health: The impact of foster care on adulthood," American Journal of Public Health, American Public Health Association, vol. 102(3), pages 534-540.
    4. Cheatham, Leah P. & Randolph, Karen A. & Boltz, Laura D., 2020. "Youth with disabilities transitioning from foster care: Examining prevalence and predicting positive outcomes," Children and Youth Services Review, Elsevier, vol. 110(C).
    5. Klodnick, Vanessa V. & Johnson, Rebecca P. & Morris, Cory & Cohen, Deborah A. & Sapiro, Beth & Schneider, Ava & Fagan, Marc A., 2021. "Shifting from receiver to provider: Aging out of semi-institutional child welfare settings with serious mental health diagnoses," Children and Youth Services Review, Elsevier, vol. 127(C).
    6. Ramseyer Winter, Virginia & Brandon-Friedman, Richard A. & Ely, Gretchen E., 2016. "Sexual health behaviors and outcomes among current and former foster youth: A review of the literature," Children and Youth Services Review, Elsevier, vol. 64(C), pages 1-14.
    7. Schelbe, Lisa, 2018. "Struggles, successes, and setbacks: Youth aging out of child welfare in a subsidized housing program," Children and Youth Services Review, Elsevier, vol. 89(C), pages 298-308.
    8. Slayter, Elspeth, 2016. "Youth with disabilities in the United States Child Welfare System," Children and Youth Services Review, Elsevier, vol. 64(C), pages 155-165.
    9. Braciszewski, Jordan M. & Tzilos Wernette, Golfo K. & Moore, Roland S. & Bock, Beth C. & Stout, Robert L. & Chamberlain, Patricia, 2018. "A pilot randomized controlled trial of a technology-based substance use intervention for youth exiting foster care," Children and Youth Services Review, Elsevier, vol. 94(C), pages 466-476.
    10. Blakeslee, Jennifer E. & Kothari, Brianne H. & Miller, Rebecca A., 2023. "Intervention development to improve foster youth mental health by targeting coping self-efficacy and help-seeking," Children and Youth Services Review, Elsevier, vol. 144(C).
    11. Albertson, Katie & Crouch, Julia M. & Udell, Wadiya & Schimmel-Bristow, Allison & Serrano, Jessica & Ahrens, Kym R., 2018. "Caregiver perceived barriers to preventing unintended pregnancies and sexually transmitted infections among youth in foster care," Children and Youth Services Review, Elsevier, vol. 94(C), pages 82-87.
    12. Fusco, Rachel A. & Kulkarni, Shanti J., 2018. "“Bedtime is when bad stuff happens”: Sleep problems in foster care alumni," Children and Youth Services Review, Elsevier, vol. 95(C), pages 42-48.
    13. Greeson, Johanna K.P. & Treglia, Daniel & Morones, Seth & Hopkins, Marcia & Mikell, Dominique, 2020. "Youth Matters: Philly (YMP): Development, usability, usefulness, & accessibility of a mobile web-based app for homeless and unstably housed youth," Children and Youth Services Review, Elsevier, vol. 108(C).
    14. Braciszewski, Jordan M. & Vose-O'Neal, Adam & Gamarel, Kristi E. & Colby, Suzanne M., 2019. "Combustible cigarette smoking and alternative tobacco use in a sample of youth transitioning from foster care," Children and Youth Services Review, Elsevier, vol. 96(C), pages 231-236.
    15. Xiaoxia Huang & Hao Di, 2020. "Uncertain portfolio selection with mental accounts," International Journal of Systems Science, Taylor & Francis Journals, vol. 51(12), pages 2079-2090, September.
    16. Huaqiong Zhou & Pamela Roberts & Satvinder Dhaliwal & Phillip Della, 2016. "Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services – an integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(21-22), pages 3113-3130, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Power, Luke & Hardy, Mark, 2024. "Predictors of care leavers’ health outcomes: A scoping review," Children and Youth Services Review, Elsevier, vol. 157(C).
    2. McCauley, Erin, 2021. "Differential risks: How disability shapes risk in the transition to adulthood for youth who age out of foster care," Children and Youth Services Review, Elsevier, vol. 131(C).
    3. Prévost-Lemire, Madeleine & Paquette, Geneviève & Lanctôt, Nadine, 2021. "Trauma symptoms as factors associated with early motherhood among young women who had contact with child protective services," Children and Youth Services Review, Elsevier, vol. 126(C).
    4. Sílvia Alves & Mariana Lucas Casanova & Manuela Sanches-Ferreira & Sérgio Costa Araújo & Luiza Nobre Lima & Clara Cruz Santos, 2025. "A Systematic Review of Residential Care for Children and Young People with Disabilities: Towards the Development of Quality Indicators," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 18(1), pages 241-271, February.
    5. Kelly, Berni & Webb, Paul & Davidson, Gavin & Pinkerton, John & McShane, Theresa, 2022. "Raising the profile of care leavers with mental health and/or intellectual disabilities: A contribution from Northern Ireland," Children and Youth Services Review, Elsevier, vol. 136(C).
    6. Ross, Christina & Kools, Susan & Laughon, Kathryn, 2020. "“It was only me against the world.” Female African American Adolescents’ perspectives on their sexual and reproductive health learning and experiences while in foster care: Implications for positive y," Children and Youth Services Review, Elsevier, vol. 118(C).
    7. Karki, Suyen & Ryynänen, Olli-Pekka & Salokekkilä, Pirkko & Häggman-Laitila, Arja, 2023. "Bayesian analysis of the factors explaining the disruptive behaviour of care leavers: A retrospective document analysis," Children and Youth Services Review, Elsevier, vol. 155(C).
    8. Braciszewski, Jordan M. & Colby, Suzanne M. & Franklin, Michael J. & Stout, Robert L. & Vose-O’Neal, Adam & Bock, Beth C., 2025. "Perspectives on a technology-based smoking cessation intervention among youth exiting foster care," Children and Youth Services Review, Elsevier, vol. 173(C).
    9. Liang, Alicia & Lashewicz, Bonnie & Mitchell, Jennifer & Smith, Walter, 2021. "Mixed perceptions of self-determination: Struggles facing youth with disabilities transitioning from foster care," Children and Youth Services Review, Elsevier, vol. 121(C).
    10. Blakeslee, Jennifer E. & Kothari, Brianne H. & Miller, Rebecca A., 2023. "Intervention development to improve foster youth mental health by targeting coping self-efficacy and help-seeking," Children and Youth Services Review, Elsevier, vol. 144(C).
    11. Li, Bo & Zhang, Ranran, 2021. "A new mean-variance-entropy model for uncertain portfolio optimization with liquidity and diversification," Chaos, Solitons & Fractals, Elsevier, vol. 146(C).
    12. Wojcicki, Anna V. & George, Priya E. & Palzer, Elise F. & Brearley, Ann M. & Gustafson, Kimara L. & Eckerle, Judith K., 2020. "Vitamin D deficiency in a Minnesota-based foster care population: A cross sectional study," Children and Youth Services Review, Elsevier, vol. 119(C).
    13. John Fowler & Mark Zachry & David W. McDonald, 2023. "Policy Recommendations from an Empirical Study of an Online Foster Care Community," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 16(5), pages 2033-2054, October.
    14. Matthew Stagner & Lisa Klein Vogel & Emily Knas & Nickie Fung & Julie Worthington & M. C. Bradley & Angela D'Angelo & Andrew Gothro & Courtney Powers, "undated". "Reducing Homelessness Among Youth with Child Welfare Involvement: An Analysis of Phase I Planning Processes in a Multi-phase Grant," Mathematica Policy Research Reports 531bb7c43cab48a2a9d82410e, Mathematica Policy Research.
    15. Cheatham, Leah P. & Randolph, Karen A. & Boltz, Laura D., 2020. "Youth with disabilities transitioning from foster care: Examining prevalence and predicting positive outcomes," Children and Youth Services Review, Elsevier, vol. 110(C).
    16. van Breda, Adrian D., 2025. "Enablers and barriers to acquiring and maintaining employment among care leavers in South Africa," Children and Youth Services Review, Elsevier, vol. 171(C).
    17. Tyler, Kimberly A. & Schmitz, Rachel M., 2013. "Family histories and multiple transitions among homeless young adults: Pathways to homelessness," Children and Youth Services Review, Elsevier, vol. 35(10), pages 1719-1726.
    18. Dominick, Gregory M. & Saunders, Ruth P. & Friedman, Daniela B. & Hussey, James R. & Watkins, Ken W., 2015. "Factors associated with provision of instrumental social support for physical activity in a foster parent population," Children and Youth Services Review, Elsevier, vol. 52(C), pages 1-7.
    19. Canha, Lúcia & Owens, Laura & Simões, Celeste & Rodrigues, Ricardo & João Gonçalves, Maria, 2024. "Youth with disabilities in residential care in the community: Perceptions and experiences in the transition period," Children and Youth Services Review, Elsevier, vol. 161(C).
    20. Lee, Jane Jiyoun, 2024. "Cross-informant agreement between caregivers and teachers for prosocial behavior across child welfare settings," Children and Youth Services Review, Elsevier, vol. 157(C).

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:cysrev:v:173:y:2025:i:c:s0190740925002002. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/childyouth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.