Recipient Organization
AUBURN UNIVERSITY
108 M. WHITE SMITH HALL
AUBURN,AL 36849
Performing Department
Human Development and Family Studies
Non Technical Summary
Human trafficking is the exploitation of a person or persons for sex or labor. Recent statistics show that millions of people are victims of human trafficking each year. Human trafficking is occurring across the United States, including in the state of Alabama. Among people who are victims of human trafficking, sex trafficking survivors represent a diverse group of people whose health outcomes are influenced by environmental, developmental, cultural, and trauma-specific factors, as well as characteristics of the individual survivors. Research is lacking on sex trafficking survivors in the United States. The current set of studies will address this gap by identifying distinct health profiles within a sample of adult sex trafficking survivors; examining differences in help-seeking attitudes and intentions; and exploring trafficking victimization community size (i.e., rural, urban, suburban). Furthermore, this project will include investigation of the course of post-traumatic stress disorder (PTSD) and depression over time, as well as determine how anxiety symptoms and biological, psychological, social, and trauma history matter for differing responses to a residential recovery program. The long-term goal is to develop and test the efficacy of a treatment model that is informed by the unique needs of sex trafficking survivors.
Animal Health Component
50%
Research Effort Categories
Basic
50%
Applied
50%
Developmental
(N/A)
Goals / Objectives
Although there are service programs striving to help survivors recover from the adverse outcomes associated with sex trafficking victimization, they are sparse and often incompatible with or insufficient to meet the manifold needs of this population. 25,26,27,28 Moreover, there are significant limitations in the research needed to inform the development of empirically-based intervention models. Previous studies with sex trafficking survivors have typically relied on small samples to explore health outcomes in the aggregate with variable-centered (e.g., simple frequencies, mean comparison, regression) rather than person-centered analyses (i.e., statistical techniques that identify clusters of participants within a sample based on meaningful similarities and differences). These findings offer a foundation for understanding the trafficking crisis, but they have limited generalizability. For example, the first and only study to date using the person-centered latent class analysis technique, Iglesias-Rios et al. 29 found differences in violence and coercion tactics used against survivors of human trafficking in Cambodia, Thailand, or Vietnam. In female survivors, they identified two distinct classes of violence and coercion experiences: one with severe sexual and physical violence and coercion (class 1; 20%), and the other with sexual violence and coercion (class 2; 80%). In males, they also found two distinct classes of violence and coercion experiences, but these were delineated by severe physical violence and coercion (41%) in class 1, and personal coercion only in class 2 (59%). Moreover, they found that females who experienced severe sexual and physical violence and coercion (class 1) had a two-fold increase in the odds of reporting anxiety and PTSD compared with females in class 2. These findings highlight the limits of variable-centered analyses by uncovering previously unidentified nuance in the violence and coercion experiences of human trafficking survivors. Understanding heterogeneity in the sex trafficking survivor population is critical to developing effective intervention tools.Sex trafficking survivors represent a diverse population whose post-victimization health outcomes are influenced by disparate characterological, environmental, developmental, cultural, and trauma-specific factors. Research investigating nuances in biopsychosocial health with other trauma- exposed populations has found that survivors have distinct symptom profiles. 30,31,32,33,34,62,63,64,65 However, only preliminary efforts 29 have been made to investigate such heterogeneity in the victimization experiences and health outcomes of sex trafficking survivors; and no studies have examined these questions among survivors in the United States. This is a critical gap in the literature as inattention to the nuance of individual health needs limits the scope and efficacy of intervention initiatives.Our long-term goal is to develop and test the efficacy of a treatment model that is informed by the unique needs of sex trafficking survivors. Our overall objectives for the hatch proposal, which are the first steps in pursuit of that goal, are to (1) identify discrete polyvictimization and biopsychosocial health profiles in a large, diverse national sample of adult sex trafficking survivors in the United States, and their associated differences in help-seeking attitudes and intentions; and, (2) investigate the longitudinal trajectory of PTSD symptoms in sex trafficking survivors taking part in a multi-phase residential recovery program.
Project Methods
Study 1: This study is the product of a Community-Based Participatory Research (CBPR)initiative. CBPR is defined by the equitable integration of community members, service organizations, and researchers in all aspects of the research process. Establishing community partnerships through CBPR enables researchers to access vulnerable and traditionally difficult to reach populations. Traditionally, CBPR programs are localized in a shared geographic community. We adapted this framework to engage a network of stakeholders in the anti-trafficking community - survivors, clinical service providers, non-profit program staff, medical professionals, law enforcement officials, and researchers - across the country. These individuals collaborated on the aims and design of the present study.As in the original OSDNFA study, participants will be recruited by professional referral sampling (i.e., recruiting through community organizations and service providers). In the prior round of data collection, we established partnerships with 29 community organizations who provide support services to sex trafficking survivors across 19 different states. These organizations will again serve as recruitment sites for the proposed study. To ensure the collection of a diverse sample with regard to gender, race, and nationality, we will also target sample potential participants from additional organizations that predominately work with male survivors, racial minorities, and individuals trafficked into the United States from foreign countries. This is a feasible goal as existing data from 175 survivors was gathered in three months without the use of target sampling, which is expected to greatly improve the diversity of the participant pool. Additionally, there were no survivors from Alabama who participated in the previous round of data collection. To ensure Alabama trafficking survivors are represented in the final sample, we will target sample potential participants from three new community partner organizations in the state (located in Montgomery, Birmingham, and Monroeville). The target recruitment goal is 325 participants; this plus the original sample of 175 would bring the total sample to 500 survivors.Staff members at the recruitment sites will disseminate study advertisements to individuals who fulfill the inclusion criteria. Recruitment flyers will direct potential participants to the study website where they can read the informed consent and access the online survey. Data will be gathered online via Qualtrics. Participants will have access to the study survey at their convenience in a location of their choice. When possible, the community referral partners will make their organization's computer labs, laptops, and/or wireless internet available to potential participants who need these resources to take part in the study. Participants' survey responses will be completely anonymous; we will not gather any identifying information. After completing the survey, participants will have the option to claim remuneration in the form of a $30 Visa gift card for time spent participating in this study by providing a mailing address for distribution. To preserve the anonymity of their survey responses, those who choose to provide this information will be securely redirected to a separate survey that in no way describes the original study purpose. Participants will simply enter their name and mailing address and this information will be un-linkable to their initial survey data.Study 2:This open cohort longitudinal study will assess the use, utility, and impact of a multi-phase residential recovery program designed to promote biopsychosocial well-being among adult female sex trafficking survivors. Once admitted to the program, participants will complete all baseline assessments (see Table 5). Thereafter, follow-up assessments will be conducted approximately every 4 months for one year (or until the participant leaves the program, if this occurs during the first year).All participants will take part in the WellHouse multi-phase intervention program for the duration of the study. The WellHouse program combines safe residential housing with an integrated, trauma-informed 3-phase rehabilitation program. Phase one of the program is the immediate shelter (8 beds). This 90-day phase focuses on helping survivors meet their immediate needs (e.g., clothing, shoes, hygiene items, medical care, dental care, and psychiatric care). Program staff work with survivors to develop an individualized care plan which includes specific service referrals as needed and restoration of vital identification documents (e.g., social security card, birth certificate). Phase two of the program - Next Steps to Freedom (NSF) - is a long-term program (16 beds) focused on recovery and future-planning. Survivors transition to a new building and begin working with staff to expand their individualized care plan with future-oriented goals and objectives (e.g., life skills classes, intensive job skills training, educational opportunities, community service). In this phase, survivors receive intensive trauma-focused and substance abuse counseling, both individual and in group settings. After Approximately 9 to 12 months, survivors enrolled in advanced education and/or who have obtained employment may be referred to phase three of the program - Next Steps to Independence (NSI). In this phase, survivors transition from the group-living environment to one of ten independent apartments on-site. They continue having access to all program resources (e.g., counseling, classes, case management, etc.), but the focus of this phase is helping survivors transition to full independent living. Survivors receive free medical care, counseling, and housing throughout the program.