Empowering Georgia Healthcare Professionals with Knowledge in Identification and Management of Sex Trafficking Victims using an MobileHealth (mHealth) app Stop SEX Trafficking Now (SSTN): A Grant Proposal to Educate Healthcare Professionals in the Identification and Care of Commercial Sex Exploitation Victims. 公开
Flowers, Lisa (Summer 2019)
Abstract
The US State Department estimates that 26 million individuals worldwide are human trafficking victims. Washington D.C.’s Urban Institute for the U.S. Justice Department reports that between 2003-2007, Atlanta had the largest sex trade revenue of eight major American cities. The violence, abuse, deprivation, physical damage and psychological manipulation experienced by these individuals may cause commercial sex exploitation (CSE) victims to present to the medical community. These victims do not typically self-identify due to shame, fear and close monitoring by the trafficker, leaving it up to the clinician to spot signs suspicious for trafficking. A 2014 survey of CSE victims found that 88 percent had contact with a health care provider at some point while being trafficked. There is very little training for medical professionals in the US, especially among emergency room clinicians, gynecologists, or pediatricians, who are most in contact with these victims. Further, there are no clinically validated screening tools to help medical professionals identify victims in the healthcare setting, or to determine what actions to take once victims actually are identified. This thesis proposes to develop a grant proposal to create and beta test a mobile smartphone app, Stop SEX Trafficking Now (SSTN), designed to educate and better enable clinicians to identify, document and manage CSE victims. Feedback from key informant interviews, in-depth interviews, focus group discussions, and surveys with healthcare professionals, CSE victims and advocacy organizations will be used to inform the design of the app. Once a beta product is designed, it will be piloted among frontline healthcare professionals most in contact with CSE victims (medical staff in the ER, OB/GYN, Pediatric, and Urgent Care clinics). Specifically, this thesis will evaluate the knowledge gain, perceived usefulness of the app, the perceived quality of the content, and the intent to adopt the app among Emergency Medicine clinicians, gynecologists and pediatricians who predominantly provide services to sex trafficking victims and measure increased identification of CSE victims in an Metro Atlanta Safety-net Hospital.
Table of Contents
Chapter I:....................................................................... 1
Introduction......................................................... 1
Defining Sex Trafficking................................. 1
The Magnitude of CSE Victims Worldwide and in the US............................... 1
Missed Opportunities for Identification of CSE Victims by HCPs................................... 2
Significance of the Study................................ 3
Theoretical Framework.................................. 5
Technology Acceptance Model......................... 6
Diffusion of Innovations Theory...................... 6
Chapter II Review of the Literature......................... 8
Magnitude of the Problem............................. 8
CSE Victims Health Consequences and Contact with HCPs........................................... 10
The Strengths and Weaknesses of Current Screening and Training Tools in Educating HCPs in Identification of CSE victims............ 17
Innovation........................................................... 23
Digital Problem-Based Learning in Health Professions.......................................................... 24
Components of the mHealth app for Human Trafficking.......................................... 27
Definition of Terms......................................... 30
Chapter III: Methodology........................................ 31
NoVo Foundation Life Story Grants....... 31
Purpose of the Thesis Project.................... 32
Eligibility for the Grant................................. 34
Study Design....................................................... 34
Qualitative Data Analysis............................. 43
Quantitative data analysis........................... 44
Summary of the Grant Funding Announcement.................................................. 46
Protection of Human Subjects.................. 48
Risks to Human Subjects................................ 48
Human Subjects Sources of Materials.......... 49
Recruitment and Informed Consent – English and Spanish......................................... 50
Protection Against Risks................................. 50
Potential Benefits of the Proposed Research to Subjects and Others.............. 51
Data Safety Monitoring Plan.......................... 52
Participant Safety Data Examination, Monitoring........................................................... 53
Plans for Transmission of Temporary or Permanent Suspension Actions..................... 54
Plans for Protecting Subject Confidentiality................................................... 54
NIH Certificate of Confidentiality........... 55
Plans for Assuring Data Accuracy and Protocol Human Safety Compliance...... 55
Proposed Budget.............................................. 56
External Reviewers for the Grant Proposal................................................................ 58
Chapter IV: Incorporation of Reviewer Comments....................................................................................... 61
Reviewer 1 comments: Kecia Harris, A.M., Ph.D........................................................... 61
Reviewer 2 comments: Sandra Ford MD, MBA........................................................................ 62
Reviewer 3 comments: Nancy Fajman MD, MPH.............................................................. 63
Reviewer 4 comments: Kalinda Woods, MD........................................................................... 63
Chapter V: The Final Version of the Proposal..... 65
Eligibility for the Grant................................. 67
Study Design....................................................... 67
Qualitative Data Analysis............................. 76
Quantitative data analysis........................... 77
Protection of Human Subjects.................. 78
Risks to Human Subjects................................ 78
Human Subjects Sources of Materials.......... 79
Recruitment and Informed Consent – English and Spanish......................................... 80
Protection Against Risks................................. 80
Potential Benefits of the Proposed Research to Subjects and Others.............. 81
Data Safety Monitoring Plan.......................... 82
Participant Safety Data Examination, Monitoring........................................................... 83
Plans for Transmission of Temporary or Permanent Suspension Actions..................... 84
Plans for Protecting Subject Confidentiality................................................... 84
NIH Certificate of Confidentiality........... 85
Plans for Assuring Data Accuracy and Protocol Human Safety Compliance...... 85
Proposed Budget.............................................. 86
Appendix 1: References............................................ 88
About this Master's Thesis
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