RCT to evaluate Bystander-informed See it Stop it (BiSiSi) to Prevent Child Sex Trafficking in Kentucky Middle Schools

随机对照试验评估旁观者知情的 See it Stop it (BiSiSi) 预防肯塔基州中学儿童性贩运

• 批准号: 10820144
• 负责人: Ann L Coker
• 金额: $ 1万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10820144
• 关键词: RCT; evaluate; Bystander; informed; See

The strongest risk factor for child sexual exploitation and trafficking (CSE/T) is a dysfunctional family environment characterized by violence and parental substance use. In Kentucky, familial sex trafficking is the more common form of CSE/T. Kentucky leads the nation with the highest rates of sexual violence (SV) and partner violence and we rank 4th in opioid overdose deaths. Based on Kentucky’s need, we propose a clustered randomized controlled trial (RCT), in response to Priority area 4 preventing CSE/T, using a bystander-informed intervention among middle school staff as interventionists. As highlighted by CDC’s STOP- SV, bystander programming shows promise to reduce SV. Our research team conducted a 5-year high school- based RCT that identified Green Dot as an effective bystander program to reduce multiple forms of SV including two forms, sexual coercion and substance use facilitated sex, strongly correlated with CSE/T risk. Given the effectiveness of Green Dot in high schools, we propose a rigorous evaluation of a novel Bystander- informed See it Stop it (BiSiSi) program designed to be electronically delivered to middle school staff with the goal of reducing CSE/T risk in children. Our multi-disciplinary research team has the opportunity to leverage ongoing county-level activities addressing substance use and child sexual abuse prevention. 32 Kentucky counties will be randomized to BiSiSi intervention or attention control conditions; the randomized condition will be applied to recruited middle schools within counties. Given the strong links between opioid use and CSE/T risk, county selection will reflect those with higher opioid overdose rates (included in HEALing Communities RCT). This recruitment strategy allows an investigation of two, potentially complimentary, interventions to address two highly correlated public health problems: CSE/T and opioid use. Specific Aim 1: To evaluate the effectiveness of BiSiSi training to change middle school staff 1a) knowledge of CSE/T, 1b) attitudes towards CSE/T (stigma), 1c) willingness and efficacy to intervene, 1d) use of ‘bystander’ actions to thwart CSE/T risk, and 1e) use commercial sexual exploitation –identification tool (CSE-IT) screening, referral and reporting. Aim 2: To evaluate the effectiveness of BiSiSi training to increase CSE/T screening and reporting in the short term (from Years 0-2) and begin to reduce CSE/T rates in the longer term (Year 3) by condition, with BiSiSi implementation, at the school & county level, adjusting for school and county ‘climate’. This RCT will be appropriately powered (≥80% with ~40 staff in each of 64 middle schools, in 32 counties with high and lower opioid overdose rates). General estimating equation (GEE) and structural equation modeling will be used to prospectively evaluate how BiSiSi training affects middle school staff’s CSE/T knowledge, attitudes, efficacy and intervention actions to reduce CSAET (Aim 1). Linear mixed models and GEE will be used to evaluate the effectiveness of BiSiSi to change CSE/T screening and reports, measured at the county level. Anticipated results: Identification of complementary prevention strategies to reduce child sexual exploitation and trafficking.

儿童性剥削和贩运（CSE/T）的强大风险因素是功能失调的家庭 以暴力和父母的使用为特征的环境。在肯塔基州，家庭性贩运是 CSE/T的更常见形式。肯塔基州的性暴力率最高（SV）和 伴侣暴力，我们在阿片类药物过量死亡中排名第四。根据肯塔基的需要，我们提出了一个 响应优先区域4防止CSE/T的聚类随机对照试验（RCT），使用A 旁观者在中学工作人员中为干预者提供干预。正如CDC的停止所强调的那样 SV，旁观者编程显示有望减少SV。我们的研究团队进行了5年的高中 - 将绿点确定为有效旁观者计划的基于RCT，以减少多种形式的SV 包括两种形式，性胁迫和药物使用促进性别，与CSE/T风险密切相关。 鉴于绿点在高中的有效性，我们提出了对新型旁观者的严格评估 通知看到它阻止了它（BISISI）计划，该计划旨在以电子方式交付给中学工作人员 降低儿童CSE/T风险的目标。我们的多学科研究团队有机会利用 正在进行的县级活动，以解决药物使用和预防儿童性虐待的活动。 32肯塔基 县将被随机分为Bisisi干预或注意力控制条件；随机条件将 可应用于县内的招募中学。鉴于阿片类药物使用与CSE/T之间的牢固联系 风险，县选择将反映那些阿片类药物过量率较高的人（包括在治愈社区中 RCT）。这种招聘策略允许投资两项，可能是免费的，可能是免费的干预措施 解决两个高度相关的公共卫生问题：CSE/T和阿片类药物使用。特定目的1：评估 BISISI培训以改变中学人员1A的有效性1A）CSE/T，1B）参加 CSE/T（污名），1C）愿意和效率干预，1D）使用“旁观者”行动来挫败CSE/T风险， 和1E）使用商业性剥削 - 识别工具（CSE-IT）筛查，推荐和报告。目的 2：评估BISISI培训的有效性以在短期内增加CSE/T筛查和报告 （从0-2年开始），并从长远（3年级）开始降低CSE/T率，而Bisisi 在学校和县一级实施，调整了学校和县的“气候”。这个RCT将是 适当的动力（≥80％，在64所中学中的每位工作中约有40名员工，在32个县高和较低的县 阿片类药物过量率）。一般估计方程（GEE）和结构方程模型将用于 前瞻性评估了BISISI培训如何影响中学工作人员的CSE/T知识，吸引力，有效性 以及减少CSAET的干预措施（AIM 1）。线性混合模型和GEE将用于评估 Bisisi在县一级进行的更改CSE/T筛查和报告的有效性。预期 结果：确定完全预防策略，以减少儿童性剥削和贩运。