Obtaining Exposure and Depth of Field: School Nurses “Seeing” Youth Vulnerability to Trafficking

Abstract

Trafficking of youth is a growing phenomenon. How commercially exploited youth present in schools is multifaceted and poorly understood. Like other providers, school nurses are on the frontlines, yet can misunderstand youth who are commercially exploited. Using Grounded Theory, we employed theoretical sampling with school nurses and survivors of trafficking to generate a theory that explains (a) the factors that increase the risk of youth being trafficked and (b) how school nurses might identify youth at risk of being trafficked. The emerging theory developed from the data was Obtaining Exposure and Depth of Field: School Nurses "Seeing" Youth Vulnerability to Trafficking. Voices of school nurses and survivors illuminated the invisibility of youth in schools who are victims of trafficking and the magnified lens of exploiters who see their vulnerability. The lens of school nurses can be refocused to "see" youth who are victims of trafficking presenting at school.

Risk Factors and Indicators for Commercial Sexual Exploitation/Domestic Minor Sex Trafficking of Adolescent Girls in the United States in the Context of School Nursing: An Integrative Review of the Literature

“…A mixed-methods study with 40 CSEC survivors (Reid, 2014) reported that girls successful in school were also victimized to CSEC, but that exploitation had ceased by adulthood among two third of those who had completed high school. Several other studies, however, found a low-level educational achievement or dropping out of school significantly correlated to CSEC victimization (Chohaney, 2016; Edinburgh et al, 2015; Fedina et al, 2019; Fraley & Aronowitz, 2019). For example, in Chohaney’s (2016) study ( N = 328), one third of participants dropped out of school before their involvement in sex work ( OR = 2.14, 95% CI [1.31, 3.49], p < .002).…”

“…Research identified that many CSEC victims were enrolled in school (Cecchet & Thoburn, 2014; Fraley & Aronowitz, 2019; Kenny et al, 2020; Reid, 2014; Shaw et al, 2017). For example, of 56 confirmed CSEC victims in a study by Kenny and colleagues (2020), 60% were enrolled in school.…”

“…A qualitative study of CSEC survivors ( N = 25) reported chronic absence of student CSEC victims with one survivor stating,The busiest time for me and my work [being trafficked] was the lunch period, and so I would go for a few hours in the morning and then I would leave [lunch] because I had to go work [trafficking]…sometimes I did not make it back. (Fraley & Aronowitz, 2019, p. 12)Vulnerability to CSEC victimization may also manifest in a child’s disengagement and deviant behavior, as evidenced by a study of CSEC victims ( N = 25) that revealed suspensions from school for more than half of the participants (Shaw et al, 2017). Landers and colleagues (2017; N = 87) support these findings; more than two thirds of CSEC victims exhibited moderate to severe behavior problems in school, thus risking expulsion, and about one third missed at least 2 days of school per week on average.…”

“…The busiest time for me and my work [being trafficked] was the lunch period, and so I would go for a few hours in the morning and then I would leave [lunch] because I had to go work [trafficking]…sometimes I did not make it back. (Fraley & Aronowitz, 2019, p. 12)…”

“…Most studies found an association between dysfunctional home and family environments and increased risk for CSEC (e.g., see Cecchet & Thoburn, 2014; Chohaney, 2016; Cimino et al, 2017; Fedina et al, 2019; Fraley & Aronowitz, 2019; Naramore et al, 2017; O’Brien et al, 2017; Perkins & Ruiz, 2017; Reid et al, 2015, 2017; Varma et al, 2015). Family environmental factors spanned a broad spectrum from lack of more general parental or guardian supervision to neglect or abuse as well as domestic violence, parental substance use, family members or peers trading sex, and poverty.…”