Sex Trafficking and Substance Use: Identifying High-Priority Needs Within the Criminal Justice System.

Substance use disorder (SUD) is common among victims of sex trafficking. Traffickers may exploit individuals' existing opioid use or other SUDs to coerce them into sex trafficking, or they may facilitate substance use to keep trafficking victims from exiting. Additionally, trafficking victims may use substances to cope with trauma. The intersections of sex trafficking and SUD complicate both legal responses and victim advocate responses to sex trafficking cases. Victim SUD can lead to challenges for law enforcement and prosecutors in developing cases against traffickers. On the provider side, traditional victim services are often insufficient for victims of trafficking with SUDs, who face substantial barriers to accessing services. A better understanding of the nexus between sex trafficking and SUDs is critical for implementing victim-centered and trauma-informed responses to this vulnerable population. In this article, the authors describe an online panel, convened in April 2021 by RTI International and the RAND Corporation on behalf of the National Institute of Justice, in which subject-matter experts and criminal justice practitioners discussed how SUDs and sex trafficking complicate the identification and screening of victims and victims' ability to access treatment and legal remedies. The panel participants identified 21 high-priority needs to support a better understanding of sex trafficking and SUDs and a variety of solutions for addressing these intertwined issues.

Collaborative efforts to improve system response to families who are experiencing child maltreatment and domestic violence.

The Greenbook demonstration initiative provided federal funding and other support to six communities to establish collaborations to plan and implement policy and practice changes in systems that serve families who are experiencing domestic violence and child maltreatment or child exposure to domestic violence. The demonstration sites established and organized collaborative groups in accordance with the Greenbook foundational principles and recommendations, including representation from multiple levels within the primary partner systems and other organizations, as well as the community. The sites struggled with how to engage consumers of the primary systems, however, and devoted a great deal of time to understanding and addressing organizational differences among the partners. Other salient collaborative influences included leadership, resources, trust, and commitment. The stakeholders noted that the collaborative relationships required a great deal of work but were ultimately one of the main successes of the initiative.

Changing policy and practice in the child welfare system through collaborative efforts to identify and respond effectively to family violence.

The Greenbook provides a roadmap for child welfare agencies to collaborate and provide effective responses to families who are experiencing co-occurring child maltreatment and domestic violence. A multisite developmental evaluation was conducted of six demonstration sites that received federal funding to implement Greenbook recommendations for child welfare agencies. Surveys of child welfare caseworkers show significant changes in several areas of agency policy and practice, including regular domestic violence training, written guidelines for reporting domestic violence, and working closely and sharing resources with local domestic violence service providers. Case file reviews show significant increases in the level of active screening for domestic violence, although this increase peaks at the midpoint of the initiative. These findings, coupled with on-site interview data, point to the importance of coordinating system change activities in child welfare agencies with a number of other collaborative activities.

Predictors of the decision to adopt motivational interviewing in community health settings.

The purpose of this study is to concurrently examine the impact of individual and organizational characteristics on the decision to adopt the evidence-based practice (EBP) motivational interviewing (MI) among directors and staff (n = 311) in community health organizations (n = 92). Results from hierarchical linear modeling indicated that, at the individual level, attitudes toward EBPs and race each predicted directors' decisions to adopt, while gender predicted staff's decisionmaking. At the organizational level, organizational climate was inversely associated with both staff's and directors' decisions to adopt MI. Organizational barriers to implementing EBPs and use of reading materials and treatment manuals were related to directors' decision to adopt. Type of organization and staff attributes were associated with staff's decision to adopt. These findings underscore the need to tailor dissemination and implementation strategies to address differences between directors and staff in the adoption of EBPs.

Evaluation of a randomized intervention to increase adoption of comparative effectiveness research by community health organizations.

This randomized controlled trial examined the influence of two strategies (informational packets alone and in conjunction with Webinars) aimed at increasing the adoption of motivational interviewing (MI), a patient-centered behavioral health practice supported by evidence from comparative effectiveness studies, among community health organizations responsible for delivering mental and behavioral health services. Data were obtained from 311 directors and staff across 92 community organizations. Hierarchical linear modeling was used to examine changes in decision to adopt MI. The mediating effects of multiple contextual variables were also examined. Results showed that both strategies positively influenced the decision to adopt. The positive impact on decision to adopt was significantly greater among individuals that received informational packets in conjunction with Webinars. Baseline attitudes toward evidence-based practices and pressures for change appeared to mediate this effect.