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Sex trafficking is a worldwide public health concern. U.S. federal law defines trafficking as a form of modern slavery and the exploitation of person(s) for profit through force, fraud, or coercion. Survivors endure high levels of physical and sexual violence, resulting in long-term wellbeing challenges. Minors are particularly vulnerable. Young survivors represent all social classes, races/ethnicities, sexual orientations, and forms of exploitation. Estimates suggest that there could be 2.4 million U.S. survivors of sex trafficking as a minor.
This study’s purpose was to develop in-depth understanding of how survivors define recovery from sex trafficking, and gain their perspectives on the healing process. Scant research centers survivor perspectives, and there is no consensus on the recovery definition. This presentation focuses on challenges and solutions related to recruiting research participants belonging to this vulnerable population, who might be wary based on past harms experienced.
Methods
The study involved collaboration between researchers and a survivor-serving agency, with the goal of engaging 50-80 survivors in focus group interviews. Materials and procedures were developed in an iterative, collaborative process between the researchers and the agency’s leadership and advocates. Procedures were designed with participant reassurance in mind; e.g., incentives were provided immediately after the consent process, prior to beginning interviews, to underscore rights to discontinue.
Participants were to be recruited via advocates in contact with survivors, using purposive sampling. Recruitment launched offering an incentive of a $25 gift card and in-person focus groups scheduled weekday evenings and Saturdays, with English and Spanish options. The agency facilitated attendance in several ways, including arranging transportation.
Results and Adaptations
With over 50 focus group offerings over a period of months, only three survivors participated. Procedures were adjusted during these months, including doubling the incentive, revising recruitment materials, and adding options for individual and virtual interviews. No additional participants were recruited.
Survivor focus groups were paused to adjust the study design and procedures. Adjustments yielded 24 additional survivor participants in one month. Adjustments included: adding survivor surveys and focus groups with advocates prior to resuming survivor recruitment for interviews, additional collaborative revisions of recruitment materials, increasing the frequency of meetings between researchers and agency leadership, and shifting from a set sample size to a saturation goal. Independently, the agency held two survivor focus groups during the data collection pause, facilitated by survivor leaders. The goal was learning what survivors needed from the agency, plus a longer-term goal that survivors would become more comfortable sharing their thoughts, and ultimately increase participation in this study. As data collection restarted, agency leadership provided targeted guidance to advocates on speaking with survivors about potential participation, emphasizing how the research could benefit society and survivors in general.
Conclusions/Implications
The eight-fold increase in participation by survivors signals the value of adjustments made to the research design and procedures. Lesson learned will be detailed with potential implications for future research that requires recruitment through intermediaries, or is with survivors of sex trafficking or other populations or who have been harmed by others.