Administrative Supplement: RCT to Evaluate Bystander-informed See it Stop it (BiSiSi) to Prevent Child Sex Trafficking in Kentucky Middle Schools

We are herein requesting an additional $100,000 in funds to support our Cooperative Agreement (CE003394) MPI Coker & Sprang. As directed, we seek these funds to extend both of our aims as follows. Our current aims are: Aim 1. Evaluate the reach and potential effectiveness of a mass-media CST awareness intervention, in 25 of 50 Kentucky counties randomized to the intervention versus control condition, to increase community awareness of CST as measured by 1) community-level views of our See it to Stop It billboards and reports of hearing radios ads or seeing print or online ads for CSTOP Now! as documented by visits to our CSTOP Now! website (cstopnow.com) and 2) middle school level reports of hearing or seeing CSTOP Now! ads, billboards or information about CSTOP Now! within their school or counties. With this administrative supplement, we seek additional funds to expand the reach of Aim 1 by covering the cost of placing previously developed billboard images in new locations. This will occur in October 2023, concurrent with the launch of our online bystander-based training for middle school staff. This additional mass media launch in Kentucky counties randomized to the intervention, meets the goals of this administrative supplement by a) promoting equity and b) enhancing sustainability. Specifically, we will focus placing billboards in rural and lower income Appalachian counties in KY, some of the areas most affected by substance use (opioids and methamphetamines), which is a major risk factor for CST. The cost for covering billboards ,in Fall 2023 specifically in Appalachian KY counties $$6,096. Aim 2: Evaluate the effectiveness of a novel, online, bystander-informed, CST training, delivered as randomized and relative to an attention-control, alone or in combination with mass media campaign exposure, to begin to change CST risk by changing middle school staff: a) knowledge of CST, b) attitudes or stigma toward CST, c) willingness and efficacy to intervene, d) use of ‘bystander’ actions to reduce CST risk (at child and family levels), and e) use of CST screening tools and make referrals, as appropriate, within schools or to child and family support services or Kentucky Department of Community Based Services (DCBS) reports. With this administrative supplement, we will create an additional online training module for existing mental health professionals within Kentucky schools. Middle school staff who receive our existing CSTOP Now! Training isis directed to refer students screened for CST concern to school or district mental health staff. While school mental health staff have received trauma-informed care training, we would like to provide specific training for mental health staff to prepare them to receive and respond to CST referrals. This online training will provide school mental health staff with best practice approaches on 1) how to conduct a trauma-informed assessment on youth referred for CST risk, and 2) ways to assess and support LGBTQ+ youth who are involved in CST because of their disproportionate risk of experiencing CST. Additionally, psychoeducational materials will be developed for students and their families who identify as LGBTQ+ and screen positive for CST concern or risk. This expanded aim meets the goals of the administrative supplement by a) promoting equity and b) enhancing sustainability by focusing on LGBTQ+ youth and ensuring mental health staff are adequately prepared to receive and respond to CST referrals. Specifically, this administrative supplement will cover the cost of staff to design online training for mental health staff in Kentucky schools and psychoeducational materials for youth and families. These staff (J Willard and Dr. Gusler) will work with the current research team to design the additional materials. All training will be provided free to interested Kentucky schools after the RCT is completed and effectiveness is determined. Notably, while not addressed in this administrative supplement request, the study team has requested a Diversity Supplement which directly responds to this supplement’s mission to enhance measurement considerations. Specifically, our Diversity Supplement applicant, Michael Brienzo, will perform psychometric testing on study variables to help establish their reliability and validity and improve our knowledge in the area of CST prevention. Timeline for proposed activities Month Aim 1 expanding mass media Aim 2 (currently funded) Aim 2 supplemental training 10/2023 Launch 2nd wave of billboards and Create online training for mental social media campaign in Launch RCT with health professionals in middle 11/2023 Appalachian KY; track media Intervention and Attention schools (Research team + J 12/2023 metrics Control training and Willard and Dr. Gusler) 1/2024 evaluation “ 2/2024 “ “ “ “ 3/2024 “ “ Content testing with school 4/2024 mental health staff 5/2024 Continue to track media metrics “ “ 6/2024 “ Production with voice over artists Continue to track media metrics Review/edits of above 7/2024 Production in learning 8/2024 Continue to track media metrics “ management System (Talent 9/2024 “ LMS) Continue to track media metrics “ Continue to track media metrics “ “ Production test of training Measure metrics in Intervention “ Launch training with school and Attention Control counites by mental health staff region and schools to include staff recruitment rates “ “