PHS 2018-02 Omnibus Solicitation of the NIH, CDC, and FDA for Small Business Innovation Research Gra

摘要 每天都有成千上万的美国儿童被迫从事商业性行为，包括卖淫， 色情和脱衣舞虽然人们往往认为，商业性贩运和剥削妇女 未成年人（CSTEM）是一个城市问题，越来越多地发生在美国各地的农村社区。 在农村社区往往看不到这种情况，部分原因是缺乏具体的贩运或剥削数据 由于农村地区的CSTEM与城市地区的CSTEM有很大不同， 导致认识不足。在这些地区，许多儿童被家庭成员或家庭朋友贩卖 在自己的社区或附近，60%的家庭贩运发生在农村地区。最常见的 家庭贩运的动机是为非法药物使用提供资金，从而导致阿片类药物危机的悲剧 这也导致农村地区的CSTEM增加。虽然CSTEM的影响越来越大，但公共卫生 应对措施的重点是城市地区，对遭受贩运的农村地区的重视和资助， 没有跟上步伐。与城市地区不同的是，绝大多数与有风险的青年接触的专业人员， 农村地区的CSTEM，包括教育工作者和医疗保健提供者，往往只有有限的培训或根本没有培训， 使他们能够识别或应对遭受性剥削的青年的经验。独特的介绍， 农村地区的CSTEM和农村提供者的具体培训需求造成了严重的差距， 解决美国的CSTEM问题。SBIR项目第一阶段将通过开发和测试 应用程序提供了关于识别和报告农村青年商业性性剥削的培训 设置（CSTEM农村）。CSTEM农村是一个定制的应用程序交付的互动多媒体培训， 为教育和保健领域的农村专业人员提供资源，以协助他们确定和应对 向农村地区的受害者和面临CSTEM风险的人提供援助。第一阶段将通过以下方式测试可行性： （2）为县级卫生部门人员开发两个通用课程模块; 3)开发和测试移动的和桌面应用程序的产品原型， 为卫生领域的人员提供一套多媒体交互式培训单元， （c）资源中心，提供一套资源，协助对边缘青少年作出回应 这将满足他们的需要，包括按地域转介受害者援助;以及4）进行试点 公共卫生部门工作人员使用原型进行评估，以评估原型对 CSTEM技能、知识和态度。第二阶段将完成卫生部的发展轨道， 完整的教育课程轨道;完整的资源数据库与来自美国各地的资源 并对整个产品的有效性进行大规模的评估研究， 查明和转介正在遭受性剥削和性贩运的农村青年或可能遭受性剥削和性贩运的农村青年。

ABSTRACT Every day thousands of children in the United States are coerced into commercial sex, including prostitution, pornography, and stripping. While the perception is often that commercial sexual trafficking and exploitation of minors (CSTEM) is an urban problem is increasingly happening in rural communities across the U.S. CSTEM often remains unseen in rural communities, due in part to a lack of specific trafficking or exploitation data recorded in rural communities, and because CSTEM in rural settings looks very different than in an urban setting, contributing to under-recognition. In these areas, many children are trafficked by a family member or family friend in or near their own community, with 60% of familial trafficking occurring in rural areas. The most common motivator for familial trafficking is the funding of illicit drug use and consequently, the tragedy of the opioid crisis has also caused an increase in CSTEM in rural areas. While the impact of CSTEM is growing, the public health response has focused on urban areas and the emphasis and funding for rural areas experiencing trafficking has not kept pace. Unlike urban areas, the vast majority of professionals who come into contact with youth at risk for CSTEM in rural areas, including educators and healthcare providers, often have limited or no training or experience that prepares them to identify or respond to sexually exploited youth. The unique presentations of CSTEM in rural areas and the needs for specific training for rural providers have created a critical gap in addressing CSTEM in the U.S. This Phase I SBIR project will address this critical gap by developing and testing App­Delivered Training to Identify and Report the Commercial Sexual Exploitation of Youth in Rural Settings (CSTEM Rural). CSTEM Rural is a customized app-delivered interactive multimedia training and resource for rural professionals in education and healthcare fields to assist them in identifying and responding to victims and those at risk of CSTEM in their rural areas. Phase I will test feasibility by: 1) conducting formative research interviews; 2) developing two modules of a general curriculum for county health department personnel; 3) developing and testing product prototypes of a mobile and desktop app that provide a visually engaging multimedia interactive set of training modules for those in the health field with curriculum customization by profession/position; and (c) a resource center that provides a set of resources to help respond to at risk youth that will meet their including geographically specific referrals for victim assistance; and 4) conducting a pilot evaluation in which the prototype is used by public health department staff to assess impact of the prototype on CSTEM skills, knowledge and attitudes. Phase II will complete development of the health department track, add the complete education curriculum track; complete the resource database with resources from across the United States; and implement a large scale evaluation study of the effectiveness of the entire product on increasing identification and referral of rural youth who are or who are at risk of sexual exploitation and sex trafficking.