Child Abuse, Sexual, Commercial Sex, Sex Crimes, Sex Offense, Sex Trafficking, Sexual Violence
Conditions
Keywords
Human Trafficking, Sex Trafficking, Sex Crimes, Commercial Sex, Commercial Sexual Exploitation of Children, Prevention
Brief summary
The overall goal of the 5-year project is to conduct both a process and rigorous outcome evaluation of The Set Me Free Projects (SMFP) READY to Stand (RTS) curriculum with an eye toward widespread dissemination to other U.S. communities, if deemed effective.
Detailed description
Detailed Description: The commercial sexual exploitation of children (CSEC) is a public health crisis in the U.S.1-4 Research has documented risk and protective factors across the social ecology for CSEC,2,5-8 that many perpetrators (traffickers, clients, recruiters) of CSEC are peers (e.g., romantic partners) 9-11 and adolescents report opportunities to intervene in situations of peer victimization (although not necessarily specific to CSEC).12-14 Prevention efforts with adolescents that seek to (1) reduce risk for CSEC perpetration; (2) reduce risk for CSEC victimization; and (3) increase positive bystander intervention in situations of CSEC is urgently needed. Thus, the goal of this multi-stakeholder collaboration-that includes researchers, educators, practitioners, and youth-is to conduct both a process and rigorous outcome evaluation of The Set Me Free Project's© (SMFP) READY to Stand (RTS)© curriculum-with an eye toward widespread dissemination to other U.S. communities, if deemed effective. This project is responsive to Research Priority Area 4 (preventing CSEC as a form of CSA) of RFA-CE-22-003. The implementation site includes eight high schools in Des Moines Public Schools (DMPS); students (naïve to the RTS curriculum) are largely racial/ethnic minority (65%) and low-income (76%). DMPS leadership have expressed a growing concern about the CSEC in their district and are eager to partner with researchers to rigorously evaluate the RTS curriculum. The RTS curriculum includes four, 45-minute modules implemented to high school students in mixed gender groups of \ 25 students and provides students with psychoeducation on CSEC, healthy relationship skills training, identification of safe people/resources, and programming components to enhance valuing of self and others. As part of the proposed project, the RTS curriculum will be enhanced with two additional 45-minute modules on bystander intervention training in situations of CSEC and shifting school norms to be intolerant of all forms of violence, including CSEC. Additionally, school personnel participate in an enhanced (from 90 minutes to 120 minutes) training to equip them with skills to effectively respond to students' disclosures of CSEC and to reinforce programming messages. The RTS curriculum may also reduce other forms of violence such as teen dating violence (TDV) given it addresses risk and protective factors for multiple forms of violence. Despite its potential for reducing CSEC, the RTS curriculum has never been evaluated. Specific Aims are as follows: Refinement and Planning Phase (Component A): Convene a Research Advisory Board (RAB) that includes researchers, practitioners, educators, caregivers, and youth who will provide input on all research components of the project (Aim 1a). Conduct focus groups with students (n=80) and school personnel (n=60) to inform the refinement of the RTS curriculum and research procedures for Component B (Aim 1b). Enhance the existing RTS program manual and create a training manual to ensure consistent implementation, produce training manuals for use in subsequent clinical trials and dissemination, and develop fidelity measures (Aim 1c). Develop via cognitive interviews (n=20 youth, n=10 school personnel) and surveys (n=878) with students valid, reliable, and developmentally appropriate measures of CSEC perpetration, CSEC victimization, and CSEC bystander opportunity/action to be used in subsequent research, including Component B (Aim 1d). Conduct an open pilot trial of the RTS curriculum in one of the five traditional high schools and one of the three alternative schools in DMPS with students (n=878) and school personnel (n=78) to gain experience with the recruitment and assessment procedures and administration of the intervention; assess acceptability and safety of the research protocols; document initial trends, effect sizes, and CSEC incidence rates; and refine the intervention and research procedures in preparation for Component B (Aim 1e). Apply for additional funding under Component B and disseminate findings to diverse audiences in collaboration with the RAB (Aim 1f). All procedures for Component B will be ready for implementation by the end of Component A funding. Rigorous Evaluation Phase (Component B): Conduct a quasi-experimental study in which four traditional high schools in DMPS and two alternative high schools (not including the two high schools that participated in Component A) are demographically matched and randomly assigned to treatment or wait-list control conditions. Students (n=7,241) will complete baseline and 6-, 12-, and 18-month follow-up surveys to test the hypothesis that participation in the RTS program will lead to reductions in CSEC perpetration (primary outcome), as well as reductions in CSEC victimization and TDV and sexual violence victimization and perpetration and increases in bystander intervention in CSEC situations compared to participants in the waitlist control condition (secondary outcomes) (Aim 2a). We will assess mediators and demographic moderators of program impact (Aim 2b). Document via program observations of student and school personnel programming (Aim 2c), post-session surveys (n=7,241 students; n=396 school personnel) (Aim 2d), and post-program implementation key informant and stakeholder interviews (n=40: program facilitators \[n=10\], students \[n=20\], school personnel \[n=10\]) (Aim 2e) variations in implementation, unanticipated challenges, lessons learned, and perceptions of program impact. Determine costs associated with the program implementation (both student and school personnel programming) to inform future economic evaluation of the RTS curriculum (Aim 2f). Refine and assess validity and reliability of school personnel's' CSEC prevention related knowledge, attitudes, and skills (Aim 1g). Examine the preliminary impact of the RTS school personnel training curriculum on CSEC prevention related knowledge, attitudes, and skills as well as acceptability and perceptions of impact (Aim 1h).
Interventions
BEHAVIORALREADY To Stand Curriculum
Students will receive the RTS programming over six consecutive school days, spread over two weeks. The program is delivered in mixed-gender groups of 20 to 40 students and includes videos, small and large group discussions, activities, worksheets, and ample opportunities for skill-building. This curriculum is intended to be one piece of comprehensive prevention strategies that has the potential to make immediate and sustained impacts on reducing rates of CSEC perpetration in the lives of youth, including those most vulnerable to this pernicious crime.
Sponsors
The Set Me Free Project
Des Moines Public Schools
Centers for Disease Control and Prevention
University of Nebraska Lincoln
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Two Schools will receive the intervention in addition to pre- and post- surveys. There is no control group.
Eligibility
Sex/Gender
ALL
Age
10 Years to 25 Years
Healthy volunteers
Yes
Inclusion criteria
* For school personnel, participants must be 18 years of age or older and currently employed at Hoover or All Points for the OPT and one of the eight high schools in DMPS for the survey development portion of the study (Aim 1g). We will include anyone working in administration (e.g., principal), teaching (e.g., academic subject matter instructor) or support service (e.g., counselor) capacity within any of the eight high schools encompassed within Des Moines Public School (DMPS) system. * For students, participants must be in Grades 9 through 12 at one of the eight participating high schools in DMPS and be able to understand spoken English. For the OPT (Aims 1e, 1h) this includes Hoover and All Points.
Exclusion criteria
* For school personnel, not being 18 or older or currently employed at Hoover or All Points for the OPT and one of the eight high schools in DMPS. * For students, being in Grades younger than 9 or older than 12 and not being enrolled in participating high school in DMPS.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Commercial Sexual Exploitation Children (CSEC) Perpetration (STUDENT Reported) | 1-month post RTS delivery | For the initial pool of items, we identified existing CSEC perpetration items from The National Study on Adolescent to Adult Health (ADD Health; Franchino-Olsen et al., 2021) and The My Life My Choices evaluation study (Rothman et al., 2021). The scale consists of 21 statements and response options included yes, no, or I do not want to answer this question. A total score is calculated from the sum of the items, with higher scores reflective of a higher sex trafficking perpetration experiences in the past month. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Bystander Readiness to Help (STUDENT Reported) | One-month post RTS delivery | The bystander readiness to help scale was based on the denial subscale of the readiness to help scale (D-RHS; Banyard et al., 2014) to assess students's awareness of and willingness to engage in prevention efforts regarding CSE among high school students in their school district. These items have similarly been adapted for measuring opinions regarding relationship abuse and/or sexual assault among high school students (Edwards et al., 2018). The scale consists of four statements using a 4-point Likert scale (1 = strongly agree to 4 = strongly disagree). A total score is calculated from the average of the items, with higher scores reflective of a greater sense of need and the willingness to engage. |
| Sexual Assault Victimization (STUDENT Reported) | 1-month post RTS delivery | Behaviorally worded items to assess students' self-reports of experiencing past month sexual assault victimization, with items adapted from Cook-Craig et al. (2014). The scale consists of 4 items with response options (1=Yes, 0=No, and -999=I don't want to answer). The original scale has response options ranging from 0-4 (0=0 times, 4=10+ times). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-4. Higher scores indicate more instances of sexual assault victimization having occurred. |
| Sexual Assault Perpetration (STUDENT Reported) | One-month post RTS delivery | Behaviorally worded items to assess students' self-reports of experiencing past month sexual assault perpetration, with items adapted from Cook-Craig et al. (2014). The scale consists of 4 items with response options (1=Yes, 0=No, and -999=I don't want to answer). The original scale has response options ranging from 0-4 (0=0 times, 4=10+ times). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-4. Higher scores indicate more instances of sexual assault perpetration having occurred. |
| Sexual Harassment Victimization (STUDENT Reported) | 1-month post RTS delivery | Behaviorally worded items to assess past month students' self-reports of experiencing sexual harassment victimization. Items adapted from American Association of University Women Educational Foundation (2001, p.21). The scale consists of 2 items with response options (1=Yes, 0=No, and -999=I don't want to answer). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-2. Higher scores indicate more instances of sexual harrassment victimization having occurred. |
| Sexual Harassment Perpetration (STUDENT Reported) | 1-month post RTS delivery | Behaviorally worded items to assess past month students' self-reports of experiencing sexual harassment perpetration. Items adapted from American Association of University Women Educational Foundation (2001, p.21). The scale consists of 2 items with response options (1=Yes, 0=No, and -999=I don't want to answer). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-2. Higher scores indicate more instances of sexual harrassment perpetration having occurred. |
| Stalking Victimization (STUDENT Reported) | 1-month post RTS delivery | Behaviorally worded items to assess students' past month self-reports of experiencing stalking victimization, with items adapted from(Cook-Craig et al. 2014). The scale consists of 3 items with response options (1=Yes, 0=No, and -999=I don't want to answer). The original scale has response options ranging from 0-4 (0=0 times, 4=10+ times). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-3. Higher scores indicate more instances of stalking victimization having occurred. |
| Stalking Perpetration (STUDENT Reported) | 1-month post RTS delivery | Behaviorally worded items to assess students' past month self-reports of experiencing stalking perpetration, with items adapted from(Cook-Craig et al. 2014). The scale consists of 3 items with response options (1=Yes, 0=No, and -999=I don't want to answer). The original scale has response options ranging from 0-4 (0=0 times, 4=10+ times). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-3. Higher scores indicate more instances of stalking perpetration having occurred. |
| Dating Violence Victimization (STUDENT Reported) | 1-month post RTS delivery | The Measure of Adolescent Relationship Harassment and Abuse (MARSHA; Rothman et al. 2020) was used to assess past month dating violence victimization. The scale consists of two subscales, Physical abuse (7 items) and Isolation (3 items), with response options of 1=Yes, 0=No, and -999=I don't want to answer. A total score is calculated from the counting the nunber of items answers as yes. Higher scores indicate more instances of dating violence victimization having occurred. |
| Dating Violence Perpetration (STUDENT Reported) | 1-month post RTS delivery | The Measure of Adolescent Relationship Harassment and Abuse (MARSHA; Rothman et al. 2020) was used to assess past month dating violence perpetration. The scale consists of two subscales, Physical abuse (7 items) and Isolation (3 items), with response options of 1=Yes, 0=No, and -999=I don't want to answer. A total score is calculated from the counting the nunber of items answers as yes. Higher scores indicate more instances of dating violence perpetration having occurred. |
| Youth Violence (STUDENT Reported) | 1-month post RTS delivery | The Youth Risk Behavior Surveillance System (YRBS; Centers for Disease Control and Prevention, 2019) was used to measure past month physical fights, fear of going to school, and weapon carrying. The scale consisted of 4 items with response options of 1=Yes, 0=No, and -999=I don't want to answer. A total score is calculated from the counting the nunber of items answers as yes. Higher scores indicate more instances of youth violence having occurred. |
| Depression (STUDENT Reported) | 1-month post RTS delivery | The Patient Health Questionnaire (PHQ-9) modified (Johnson et al. 2002) was used to measure past two week depression. The scale consisted of 8 items with response options from Not at all (0) to Nearly every day (3) and I don't want to answer (-999). The toal score is calculated from the average of the items, with higher scores representing higher depression symptoms. |
| Academic & Career Commitment (STUDENT Reported) | 1-month post RTS delivery | Items from Hulsey et al. (2022) were used to measures students intentions on graduating high school/getting a GED as well as having a job/career. The scale consisted of 5 items with response scales from Not at all true of me (1) to Extremely true of me (4) and I don't want to answer this question (-999). The total scores were calculated from the average of the items, with higher scores representing higher academic and career commitment. |
| Commercial Sexual Exploitation of Children (CSEC) Victimization (STUDENT Reported) | One-month post RTS delivery | For the initial pool of items, we identified existing CSEC victimization items from The National Study on Adolescent to Adult Health (ADD Health; Franchino-Olsen et al., 2021) and The My Life My Choices evaluation study (Rothman et al., 2021). The scale consists of 21 statements and response options included yes, no, or I do not want to answer this question. A total score is calculated from the sum of the items, with higher scores reflective of a higher sex trafficking victimization experiences in the past month. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Valuing Self (STUDENT Reported) | 1-month post RTS delivery | The Valuing of Self (e.g., I have value) scales was adapted from measures and conceptualizations of positive youth development (PYD; Bowers et al., 2010; Lerner et al., 2005; Park, 2010) and dignity scales (Bal, 2017; Lebech, 2004; Ziebertz et al., 2018). Prior to the questions, a definition of value was provided. The scale included eight statements. Participants rated statements from strongly disagree (1) to strongly agree (4). Scores were calculated by taking the average of the items with higher scores indicating higher sense of valuing of self. |
| Valuing Other(STUDENT Reported) | 1-month post RTS delivery | The Valuing of Others (e.g., All people have value) scale was adapted from measures and conceptualizations of positive youth development (PYD; Bowers et al., 2010; Lerner et al., 2005; Park, 2010) and dignity scales (Bal, 2017; Lebech, 2004; Ziebertz et al., 2018). Prior to the questions, a definition of value was provided. The scale included eight statements. Participants rated statements from strongly disagree (1) to strongly agree (4). Scores were calculated by taking the average of the items with higher scores indicating higher sense of valuing of other. |
| Perceptions of Social Norms of Prevention of CSEC (STUDENT Reported) | 1-month post RTS delivery | The Social Norms scale (Waterman et al., 2022) (adapted from prior work; Waterman et al., 2022) is composed of four subscales that gauges personal beliefs, perceptions of friends, perceptions of other high school students in this district, and perceptions of school personnel in the district regarding their beliefs on sex trafficking. Participants rated all statements on a scale from strongly disagree (1) to strongly agree (4). An option of I don't want to answer was also provided. Subscale scores were calculated from the average of the items, with higher scores representing social norms less supporting of sex trafficking, including personal beliefs, perceptions of friends, other high school students, and school personnel. |
| Prevention-related Communication With School Personnel (STUDENT Reported) | 1-month post RTS delivery | We adapted items created by Edwards et al. (2021, 2022). The eight statements focused on things school personnel had discussed with students, including general items such as how to have healthy relationships and their futures, as well as CSE items, including sex trafficking, sexual assault, and dating and/or domestic violence, and to what extent they agreed with each statement (1 = strongly disagree to 4 = strongly agree). The final score was the average of the scale items, with higher values indicating more engagement between students and school personnel. |
| CSEC Knowledge (SCHOOL PERSONNEL Reported) | 1-month post RTS delivery | Consistent with other measures of sexual violence/teen dating violence knowledge for youth (Edwards et al., 2019), questions (e.g., most victims are trafficked by strangers) are True/False. We provide youth a definition of CSE, specifically, sex trafficking. We created nine items to assess school personnel's general knowledge about CSE and the roles school personnel can play in its prevention. The respondents are asked if they believe the statements to be true or false. Items are scored based upon whether they were answered correctly (1) or incorrectly (0). The scores were then averaged to create a cumulative score that reflects the proportion of statements answered correctly |
| Bystander Readiness to Help (SCHOOL PERSONNEL Reported) | 1-month post RTS delivery | The bystander readiness to help scale was based on the denial subscale of the readiness to help scale (D-RHS; Banyard et al., 2014b) to assess school personnel's awareness of and willingness to engage in prevention efforts regarding CSE among high school students in their school district. These items have similarly been adapted for measuring opinions regarding relationship abuse and/or sexual assault among high school students (Edwards et al., 2018). The scale consists of four statements using a 4-point Likert scale (1 = strongly agree to 4 = strongly disagree). A total score is calculated from the average of the items, with higher scores reflective of a greater sense of need and the willingness to engage. |
| Perceptions of Social Norms of Prevention of CSEC (SCHOOL PERSONNEL Reported) | 1-month post RTS delivery | The Social Norms scale (Waterman et al., 2022) (adapted from prior work; Waterman et al., 2022) is composed of four subscales that gauges personal beliefs, perceptions of friends, perceptions of other high school students in this district, and perceptions of school personnel in the district regarding their beliefs on sex trafficking. For school personnels, three out of the four subscales were included (i.e., personal belief, perceptions of high school students in this district, and perceptions of school personnel in the district). Participants rated all statements on a scale from strongly disagree (1) to strongly agree (4). An option of I don't want to answer was also provided. Subscale scores were calculated from the average of the items, with higher scores representing social norms less supporting of sex trafficking, including personal beliefs, other high school students, and school personnel. |
| Prevention-related Communication With School Personnel (SCHOOL PERSONNEL Reported) | 1-month post RTS delivery | We adapted items created by Edwards et al. (2021, 2022). The eight statements focused on things school personnel had discussed with students, including general items such as how to have healthy relationships and their futures, as well as CSE items, including sex trafficking, sexual assault, and dating and/or domestic violence, and to what extent they agreed with each statement (1 = strongly disagree to 4 = strongly agree). The final score was the average of the scale items, with higher values indicating more engagement between students and school personnel. |
| Cultural Humility (SCHOOL PERSONNEL Reported) | 1-month post RTS delivery | The Cultural Humility scale was based on The Multicultural Teaching Competency Scales (Spanierman et al., 2011). The scale consists of 16 statements using a 5-point Likert scale (1 = strongly disagree to 5 =strongly agree). The total score is calculated from the average of the items, with higher scores reflective of a higher sense of cultural humility. |
| Efficacy (STUDENT Reported) | 1-month post RTS delivery | Author created items to assess confidence in resistance to being a victim of CSEC. Two statements asked how confident the participant is in recognizing sex trafficking (i.e., If someone tried to force you into sex trafficking, how confident are you that you would recognize it?), and keeping it from happening (i.e., If someone tried to force you into sex trafficking, how confident are you that you would be able to keep it from happening?). Participants rated the statements using the four options: Not at all confident (1), Somewhat confident (2), Very confident (3) , and I don't want to answer this question (-999). Total score was calculated into a mean with higher scores indicating higher efficacy. |
| CSEC Knowledge (STUDENT Reported) | 1-month post RTS delivery | Consistent with other measures of sexual violence/teen dating violence knowledge for youth (Edwards et al., 2019), questions (e.g., most victims are trafficked by strangers) are True/False. We provide youth a definition of CSE, specifically, sex trafficking. We created six items to measure adolescents' knowledge of CSE. The respondents are asked if they believe the statements to be true or false. Items are scored based upon whether they were answered correctly (1) or incorrectly (0). The scores were then averaged to create a cumulative score that reflects the proportion of statements answered correctly (Min=0, Max=6). |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| RTS Intervention-School Personnel RTS intervention will include a total of one 120-minute session of programming delivered to school personnel. There are five components in this intervention that school personnel will receive: 1) Psychoeducation on CSEC, 2) Healthy relationship skills training, 3) Programming components to enhance valuing of self and others, 4) Bystander intervention skills, and 5) Social norms for both students and school personnel. Students will additionally receive programming on Identification of safe people and resources, while school personnel will receive programming on Responding to Student Disclosures, and Cultural Humility. | 68 |
| RTS Intervention-Students RTS intervention will include six, 45-minute sessions (total = 4.5 hours) for students. There are five components in this intervention that students will receive: 1) Psychoeducation on CSEC, 2) Healthy relationship skills training, 3) Programming components to enhance valuing of self and others, 4) Bystander intervention skills, and 5) Social norms for both students and school personnel. Students will additionally receive programming on Identification of safe people and resources, while school personnel will receive programming on Responding to Student Disclosures, and Cultural Humility.
READY To Stand Curriculum: Students will receive the RTS programming over six consecutive school days, spread over two weeks. The program is delivered in mixed-gender groups of 20 to 40 students and includes videos, small and large group discussions, activities, worksheets, and ample opportunities for skill-building. This curriculum is intended to be one piece of comprehensive prevention strategies that has the potential to make immediate and sustained impacts on reducing rates of CSEC perpetration in the lives of youth, including those most vulnerable to this pernicious crime. | 177 |
| Total | 245 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Absent from school | 0 | 38 |
| Overall Study | Chose not to participate | 0 | 42 |
| Overall Study | Lack of time | 21 | 0 |
| Overall Study | Other commitments (e.g., sports) | 0 | 25 |
Baseline characteristics
| Characteristic | RTS Intervention-School Personnel | RTS Intervention-Students | Total |
|---|---|---|---|
| Age, Continuous | 44.5714 years STANDARD_DEVIATION 11.28582 | 15.93 years STANDARD_DEVIATION 1.62 | 28.03 years STANDARD_DEVIATION 15.7 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 4 Participants | 35 Participants | 39 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 22 Participants | 126 Participants | 148 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 42 Participants | 16 Participants | 58 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 23 Participants | 23 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 64 Participants | 65 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 19 Participants | 19 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 3 Participants | 3 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 45 Participants | 16 Participants | 61 Participants |
| Race (NIH/OMB) White | 22 Participants | 51 Participants | 73 Participants |
| Sex/Gender, Customized Declined to answer or Unknown | 43 Participants | 5 Participants | 48 Participants |
| Sex/Gender, Customized Man | 5 Participants | 74 Participants | 79 Participants |
| Sex/Gender, Customized Other | 0 Participants | 19 Participants | 19 Participants |
| Sex/Gender, Customized Woman | 20 Participants | 79 Participants | 99 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 68 | 0 / 212 |
| other Total, other adverse events | 0 / 68 | 212 / 212 |
| serious Total, serious adverse events | 0 / 68 | 0 / 212 |
Outcome results
Primary
Commercial Sexual Exploitation Children (CSEC) Perpetration (STUDENT Reported)
For the initial pool of items, we identified existing CSEC perpetration items from The National Study on Adolescent to Adult Health (ADD Health; Franchino-Olsen et al., 2021) and The My Life My Choices evaluation study (Rothman et al., 2021). The scale consists of 21 statements and response options included yes, no, or I do not want to answer this question. A total score is calculated from the sum of the items, with higher scores reflective of a higher sex trafficking perpetration experiences in the past month.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| RTS Intervention-Students | Commercial Sexual Exploitation Children (CSEC) Perpetration (STUDENT Reported) | No | 79 Participants |
| RTS Intervention-Students | Commercial Sexual Exploitation Children (CSEC) Perpetration (STUDENT Reported) | Yes | 11 Participants |
| RTS Intervention-Students | Commercial Sexual Exploitation Children (CSEC) Perpetration (STUDENT Reported) | Declined to answer or Unknown | 17 Participants |
Secondary
Academic & Career Commitment (STUDENT Reported)
Items from Hulsey et al. (2022) were used to measures students intentions on graduating high school/getting a GED as well as having a job/career. The scale consisted of 5 items with response scales from Not at all true of me (1) to Extremely true of me (4) and I don't want to answer this question (-999). The total scores were calculated from the average of the items, with higher scores representing higher academic and career commitment.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Academic & Career Commitment (STUDENT Reported) | 2.8762 score on a scale | Standard Deviation 0.6024 |
Secondary
Bystander Readiness to Help (STUDENT Reported)
The bystander readiness to help scale was based on the denial subscale of the readiness to help scale (D-RHS; Banyard et al., 2014) to assess students's awareness of and willingness to engage in prevention efforts regarding CSE among high school students in their school district. These items have similarly been adapted for measuring opinions regarding relationship abuse and/or sexual assault among high school students (Edwards et al., 2018). The scale consists of four statements using a 4-point Likert scale (1 = strongly agree to 4 = strongly disagree). A total score is calculated from the average of the items, with higher scores reflective of a greater sense of need and the willingness to engage.
Time frame: One-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Bystander Readiness to Help (STUDENT Reported) | 2.7857 score on a scale | Standard Deviation 0.54988 |
Secondary
Commercial Sexual Exploitation of Children (CSEC) Victimization (STUDENT Reported)
For the initial pool of items, we identified existing CSEC victimization items from The National Study on Adolescent to Adult Health (ADD Health; Franchino-Olsen et al., 2021) and The My Life My Choices evaluation study (Rothman et al., 2021). The scale consists of 21 statements and response options included yes, no, or I do not want to answer this question. A total score is calculated from the sum of the items, with higher scores reflective of a higher sex trafficking victimization experiences in the past month.
Time frame: One-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| RTS Intervention-Students | Commercial Sexual Exploitation of Children (CSEC) Victimization (STUDENT Reported) | No | 12 Participants |
| RTS Intervention-Students | Commercial Sexual Exploitation of Children (CSEC) Victimization (STUDENT Reported) | Yes | 6 Participants |
| RTS Intervention-Students | Commercial Sexual Exploitation of Children (CSEC) Victimization (STUDENT Reported) | Declined to answer or Unknown | 89 Participants |
Secondary
Dating Violence Perpetration (STUDENT Reported)
The Measure of Adolescent Relationship Harassment and Abuse (MARSHA; Rothman et al. 2020) was used to assess past month dating violence perpetration. The scale consists of two subscales, Physical abuse (7 items) and Isolation (3 items), with response options of 1=Yes, 0=No, and -999=I don't want to answer. A total score is calculated from the counting the nunber of items answers as yes. Higher scores indicate more instances of dating violence perpetration having occurred.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Dating Violence Perpetration (STUDENT Reported) | 0.1429 score on a scale | Standard Deviation 0.35274 |
Secondary
Dating Violence Victimization (STUDENT Reported)
The Measure of Adolescent Relationship Harassment and Abuse (MARSHA; Rothman et al. 2020) was used to assess past month dating violence victimization. The scale consists of two subscales, Physical abuse (7 items) and Isolation (3 items), with response options of 1=Yes, 0=No, and -999=I don't want to answer. A total score is calculated from the counting the nunber of items answers as yes. Higher scores indicate more instances of dating violence victimization having occurred.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Dating Violence Victimization (STUDENT Reported) | 0.4286 score on a scale | Standard Deviation 1.27904 |
Secondary
Depression (STUDENT Reported)
The Patient Health Questionnaire (PHQ-9) modified (Johnson et al. 2002) was used to measure past two week depression. The scale consisted of 8 items with response options from Not at all (0) to Nearly every day (3) and I don't want to answer (-999). The toal score is calculated from the average of the items, with higher scores representing higher depression symptoms.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Depression (STUDENT Reported) | 1.0342 score on a scale | Standard Deviation 0.84775 |
Secondary
Sexual Assault Perpetration (STUDENT Reported)
Behaviorally worded items to assess students' self-reports of experiencing past month sexual assault perpetration, with items adapted from Cook-Craig et al. (2014). The scale consists of 4 items with response options (1=Yes, 0=No, and -999=I don't want to answer). The original scale has response options ranging from 0-4 (0=0 times, 4=10+ times). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-4. Higher scores indicate more instances of sexual assault perpetration having occurred.
Time frame: One-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Sexual Assault Perpetration (STUDENT Reported) | 0.0333 score on a scale | Standard Deviation 0.181 |
Secondary
Sexual Assault Victimization (STUDENT Reported)
Behaviorally worded items to assess students' self-reports of experiencing past month sexual assault victimization, with items adapted from Cook-Craig et al. (2014). The scale consists of 4 items with response options (1=Yes, 0=No, and -999=I don't want to answer). The original scale has response options ranging from 0-4 (0=0 times, 4=10+ times). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-4. Higher scores indicate more instances of sexual assault victimization having occurred.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Sexual Assault Victimization (STUDENT Reported) | 0.0833 score on a scale | Standard Deviation 0.3814 |
Secondary
Sexual Harassment Perpetration (STUDENT Reported)
Behaviorally worded items to assess past month students' self-reports of experiencing sexual harassment perpetration. Items adapted from American Association of University Women Educational Foundation (2001, p.21). The scale consists of 2 items with response options (1=Yes, 0=No, and -999=I don't want to answer). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-2. Higher scores indicate more instances of sexual harrassment perpetration having occurred.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Sexual Harassment Perpetration (STUDENT Reported) | 0.1774 score on a scale | Standard Deviation 0.4625 |
Secondary
Sexual Harassment Victimization (STUDENT Reported)
Behaviorally worded items to assess past month students' self-reports of experiencing sexual harassment victimization. Items adapted from American Association of University Women Educational Foundation (2001, p.21). The scale consists of 2 items with response options (1=Yes, 0=No, and -999=I don't want to answer). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-2. Higher scores indicate more instances of sexual harrassment victimization having occurred.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Sexual Harassment Victimization (STUDENT Reported) | 0.4677 score on a scale | Standard Deviation 0.6457 |
Secondary
Stalking Perpetration (STUDENT Reported)
Behaviorally worded items to assess students' past month self-reports of experiencing stalking perpetration, with items adapted from(Cook-Craig et al. 2014). The scale consists of 3 items with response options (1=Yes, 0=No, and -999=I don't want to answer). The original scale has response options ranging from 0-4 (0=0 times, 4=10+ times). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-3. Higher scores indicate more instances of stalking perpetration having occurred.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Stalking Perpetration (STUDENT Reported) | 0.1833 score on a scale | Standard Deviation 0.53652 |
Secondary
Stalking Victimization (STUDENT Reported)
Behaviorally worded items to assess students' past month self-reports of experiencing stalking victimization, with items adapted from(Cook-Craig et al. 2014). The scale consists of 3 items with response options (1=Yes, 0=No, and -999=I don't want to answer). The original scale has response options ranging from 0-4 (0=0 times, 4=10+ times). A total score is calculated from taking a count of items with a response of yes, with scores ranging from 0-3. Higher scores indicate more instances of stalking victimization having occurred.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Stalking Victimization (STUDENT Reported) | 0.3115 score on a scale | Standard Deviation 0.6962 |
Secondary
Youth Violence (STUDENT Reported)
The Youth Risk Behavior Surveillance System (YRBS; Centers for Disease Control and Prevention, 2019) was used to measure past month physical fights, fear of going to school, and weapon carrying. The scale consisted of 4 items with response options of 1=Yes, 0=No, and -999=I don't want to answer. A total score is calculated from the counting the nunber of items answers as yes. Higher scores indicate more instances of youth violence having occurred.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Youth Violence (STUDENT Reported) | 0.1833 score on a scale | Standard Deviation 0.50394 |
Other Pre-specified
Bystander Readiness to Help (SCHOOL PERSONNEL Reported)
The bystander readiness to help scale was based on the denial subscale of the readiness to help scale (D-RHS; Banyard et al., 2014b) to assess school personnel's awareness of and willingness to engage in prevention efforts regarding CSE among high school students in their school district. These items have similarly been adapted for measuring opinions regarding relationship abuse and/or sexual assault among high school students (Edwards et al., 2018). The scale consists of four statements using a 4-point Likert scale (1 = strongly agree to 4 = strongly disagree). A total score is calculated from the average of the items, with higher scores reflective of a greater sense of need and the willingness to engage.
Time frame: 1-month post RTS delivery
Population: School Personnel from all high schools within the district
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Bystander Readiness to Help (SCHOOL PERSONNEL Reported) | 3.379 score on a scale | Standard Deviation 0.412 |
Other Pre-specified
CSEC Knowledge (SCHOOL PERSONNEL Reported)
Consistent with other measures of sexual violence/teen dating violence knowledge for youth (Edwards et al., 2019), questions (e.g., most victims are trafficked by strangers) are True/False. We provide youth a definition of CSE, specifically, sex trafficking. We created nine items to assess school personnel's general knowledge about CSE and the roles school personnel can play in its prevention. The respondents are asked if they believe the statements to be true or false. Items are scored based upon whether they were answered correctly (1) or incorrectly (0). The scores were then averaged to create a cumulative score that reflects the proportion of statements answered correctly
Time frame: 1-month post RTS delivery
Population: School Personnel from all high schools within the district
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | CSEC Knowledge (SCHOOL PERSONNEL Reported) | 0.947 score on a scale | Standard Deviation 0.067 |
Other Pre-specified
CSEC Knowledge (STUDENT Reported)
Consistent with other measures of sexual violence/teen dating violence knowledge for youth (Edwards et al., 2019), questions (e.g., most victims are trafficked by strangers) are True/False. We provide youth a definition of CSE, specifically, sex trafficking. We created six items to measure adolescents' knowledge of CSE. The respondents are asked if they believe the statements to be true or false. Items are scored based upon whether they were answered correctly (1) or incorrectly (0). The scores were then averaged to create a cumulative score that reflects the proportion of statements answered correctly (Min=0, Max=6).
Time frame: 1-month post RTS delivery
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | CSEC Knowledge (STUDENT Reported) | 0.8711 score on a scale | Standard Deviation 0.2001 |
Other Pre-specified
Cultural Humility (SCHOOL PERSONNEL Reported)
The Cultural Humility scale was based on The Multicultural Teaching Competency Scales (Spanierman et al., 2011). The scale consists of 16 statements using a 5-point Likert scale (1 = strongly disagree to 5 =strongly agree). The total score is calculated from the average of the items, with higher scores reflective of a higher sense of cultural humility.
Time frame: 1-month post RTS delivery
Population: School Personnel from all high schools within the district
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Cultural Humility (SCHOOL PERSONNEL Reported) | 4.0444 score on a scale | Standard Deviation 0.5901 |
Other Pre-specified
Efficacy (STUDENT Reported)
Author created items to assess confidence in resistance to being a victim of CSEC. Two statements asked how confident the participant is in recognizing sex trafficking (i.e., If someone tried to force you into sex trafficking, how confident are you that you would recognize it?), and keeping it from happening (i.e., If someone tried to force you into sex trafficking, how confident are you that you would be able to keep it from happening?). Participants rated the statements using the four options: Not at all confident (1), Somewhat confident (2), Very confident (3) , and I don't want to answer this question (-999). Total score was calculated into a mean with higher scores indicating higher efficacy.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| RTS Intervention-Students | Efficacy (STUDENT Reported) | Recognizing Sex Trafficking | 2.47 score on a scale | Standard Deviation 0.66 |
| RTS Intervention-Students | Efficacy (STUDENT Reported) | Keeping it from Happening | 2.37 score on a scale | Standard Deviation 0.72 |
Other Pre-specified
Perceptions of Social Norms of Prevention of CSEC (SCHOOL PERSONNEL Reported)
The Social Norms scale (Waterman et al., 2022) (adapted from prior work; Waterman et al., 2022) is composed of four subscales that gauges personal beliefs, perceptions of friends, perceptions of other high school students in this district, and perceptions of school personnel in the district regarding their beliefs on sex trafficking. For school personnels, three out of the four subscales were included (i.e., personal belief, perceptions of high school students in this district, and perceptions of school personnel in the district). Participants rated all statements on a scale from strongly disagree (1) to strongly agree (4). An option of I don't want to answer was also provided. Subscale scores were calculated from the average of the items, with higher scores representing social norms less supporting of sex trafficking, including personal beliefs, other high school students, and school personnel.
Time frame: 1-month post RTS delivery
Population: School Personnel from all high schools within the district
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| RTS Intervention-Students | Perceptions of Social Norms of Prevention of CSEC (SCHOOL PERSONNEL Reported) | Personal Beliefs | 3.74375 score on a scale | Standard Deviation 0.520378 |
| RTS Intervention-Students | Perceptions of Social Norms of Prevention of CSEC (SCHOOL PERSONNEL Reported) | Perceptions of Students | 2.923611 score on a scale | Standard Deviation 0.49215 |
| RTS Intervention-Students | Perceptions of Social Norms of Prevention of CSEC (SCHOOL PERSONNEL Reported) | Perceptions of School Personnel | 3.618421 score on a scale | Standard Deviation 0.502483 |
Other Pre-specified
Perceptions of Social Norms of Prevention of CSEC (STUDENT Reported)
The Social Norms scale (Waterman et al., 2022) (adapted from prior work; Waterman et al., 2022) is composed of four subscales that gauges personal beliefs, perceptions of friends, perceptions of other high school students in this district, and perceptions of school personnel in the district regarding their beliefs on sex trafficking. Participants rated all statements on a scale from strongly disagree (1) to strongly agree (4). An option of I don't want to answer was also provided. Subscale scores were calculated from the average of the items, with higher scores representing social norms less supporting of sex trafficking, including personal beliefs, perceptions of friends, other high school students, and school personnel.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| RTS Intervention-Students | Perceptions of Social Norms of Prevention of CSEC (STUDENT Reported) | Personal Beliefs | 3.4063 score on a scale | Standard Deviation 0.5248 |
| RTS Intervention-Students | Perceptions of Social Norms of Prevention of CSEC (STUDENT Reported) | Perceptions of Friends | 3.1908 score on a scale | Standard Deviation 0.59479 |
| RTS Intervention-Students | Perceptions of Social Norms of Prevention of CSEC (STUDENT Reported) | Percceptions of HS Students in their district | 3.0784 score on a scale | Standard Deviation 0.66649 |
| RTS Intervention-Students | Perceptions of Social Norms of Prevention of CSEC (STUDENT Reported) | Perceptions of School Personnel in their district | 3.4286 score on a scale | Standard Deviation 0.65544 |
Other Pre-specified
Prevention-related Communication With School Personnel (SCHOOL PERSONNEL Reported)
We adapted items created by Edwards et al. (2021, 2022). The eight statements focused on things school personnel had discussed with students, including general items such as how to have healthy relationships and their futures, as well as CSE items, including sex trafficking, sexual assault, and dating and/or domestic violence, and to what extent they agreed with each statement (1 = strongly disagree to 4 = strongly agree). The final score was the average of the scale items, with higher values indicating more engagement between students and school personnel.
Time frame: 1-month post RTS delivery
Population: School Personnel from all high schools within the district
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Prevention-related Communication With School Personnel (SCHOOL PERSONNEL Reported) | 3.28 score on a scale | Standard Deviation 0.501 |
Other Pre-specified
Prevention-related Communication With School Personnel (STUDENT Reported)
We adapted items created by Edwards et al. (2021, 2022). The eight statements focused on things school personnel had discussed with students, including general items such as how to have healthy relationships and their futures, as well as CSE items, including sex trafficking, sexual assault, and dating and/or domestic violence, and to what extent they agreed with each statement (1 = strongly disagree to 4 = strongly agree). The final score was the average of the scale items, with higher values indicating more engagement between students and school personnel.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Prevention-related Communication With School Personnel (STUDENT Reported) | 2.8483 score on a scale | Standard Deviation 0.55481 |
Other Pre-specified
Valuing Other(STUDENT Reported)
The Valuing of Others (e.g., All people have value) scale was adapted from measures and conceptualizations of positive youth development (PYD; Bowers et al., 2010; Lerner et al., 2005; Park, 2010) and dignity scales (Bal, 2017; Lebech, 2004; Ziebertz et al., 2018). Prior to the questions, a definition of value was provided. The scale included eight statements. Participants rated statements from strongly disagree (1) to strongly agree (4). Scores were calculated by taking the average of the items with higher scores indicating higher sense of valuing of other.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Valuing Other(STUDENT Reported) | 3.1601 score on a scale | Standard Deviation 0.60016 |
Other Pre-specified
Valuing Self (STUDENT Reported)
The Valuing of Self (e.g., I have value) scales was adapted from measures and conceptualizations of positive youth development (PYD; Bowers et al., 2010; Lerner et al., 2005; Park, 2010) and dignity scales (Bal, 2017; Lebech, 2004; Ziebertz et al., 2018). Prior to the questions, a definition of value was provided. The scale included eight statements. Participants rated statements from strongly disagree (1) to strongly agree (4). Scores were calculated by taking the average of the items with higher scores indicating higher sense of valuing of self.
Time frame: 1-month post RTS delivery
Population: Students from two public Midwestern high schools (one traditional and one alternative)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| RTS Intervention-Students | Valuing Self (STUDENT Reported) | 3.2432 score on a scale | Standard Deviation 0.57972 |