Sex-Trafficking Survivor Intervention and Services Research: A Review and Recommendations for Innovation

Background: Sex-trafficking is a horrific problem affecting many communities globally (U.S. Department of State, 2014). As awareness of trafficking has grown, there are increasing numbers of non-governmental programs providing services aimed at promoting survivors’ resilience and preventing their revictimization. Unfortunately, services for sex-trafficked persons have out-paced research on best practices, and many services being delivered to survivors currently are untested (Macy & Johns, 2010). Nonetheless, formative evaluations of trafficking services exist, and a systematic summary of all such studies will guide future research to develop evidence-based practices. Thus, we sought to (a) identify and synthesize existing studies concerned with intervention research and service evaluations for trafficking survivors; and (b) develop a compendium of standardized tools/indicators to promote rigorous studies of such programs among both practitioners and researchers.

 Methods: We conducted a review to identify intervention research and service evaluations for sex-trafficking survivors using 11 electronic databases. For inclusion, studies were required to (a) collect/analyze data between 2000-2014, (b) be published in English, (c) be peer-reviewed, (d) include data from trafficking victims/survivors, (e) focus on interventions or services for trafficking victims/survivors, and (f) include details of data collection strategies (i.e., standardized measures, instruments, indicators, and questions). Database searches yielded 1397 articles. After title/abstract review, 83 articles potentially met inclusion criteria. Following additional scrutiny, 33 studies fully met inclusion criteria. Backwards searches of the 33 studies’ reference lists identified 7 additional articles meeting inclusion criteria. For each article, we systematically extracted, analyzed, and synthesized data on (a) study aims, (b) sample details, (c) location of data collection, (d) data collection and analysis, and (e) specific questions, indicators, and standardized measures used in the research.

 Results: Among the 40 studies, 22 named specific standardized tools used for data collection. These 22 studies identified 31 distinct instruments assessing various areas of survivors’ well-being (i.e., coping, mental and physical health, substance use, and trauma/abuse). Eighteen studies reported using unstandardized questions to gather information regarding survivors’ outcomes and well-being (i.e., physical, sexual, and mental health; experiences of trauma and abuse; activities engaged in while trafficked that increase health-related risks; and substance use). During the presentation, we will provide a compendium of tools/indicators/instruments based on the review results to help inform attendees’ future research with sex-trafficking survivors.

 Implications: Thus far, the intervention and service evaluation research is strongly focused on survivors’ physical/mental health needs and outcomes, with few studies focusing on comprehensive and holistic views of survivors’ well-being (e.g., education, economic stability, housing, language, legal, spirituality). Review results also show that the standardized tools used in existing studies are often borrowed from other research areas and have not been tested with survivors for acceptability, relevance, and reliability. Based on review findings, with the aim of improving intervention research on and services for survivors’ resilience and community reintegration, we offer attendees recommendations for (a) testing standardized tools with this population, (b) employing a broad focus for holistic assessments of survivors’ needs and outcomes, and (c) developing tailored assessment/outcome tools for sex-trafficking survivors, services and research.