School Nurse Perspectives and School Policy on Commercial Sexual Exploitation of Children/Domestic Minor Sex Trafficking in Virginia Public Schools

Problem. In the United States (U.S.), commercial sexual exploitation of children (CSEC) is a crime and a public health problem. Girls ages 12 to 18 compose the largest group of CSEC victims. Since most victims attend schools, oftentimes while under their trafficker’s control, U.S. schools have emerged as a promising environment for a variety of CSEC prevention and intervention activities, and school nurses, as healthcare providers in the school setting, are thought to be well-positioned to identify children at risk for or victims of CSEC. In 2017 Virginia policymakers passed legislation aiming at addressing the issue in Virginia’s schools. Nevertheless, many victims go unrecognized and unaided. Consequently, it is crucial to explore if, and if so, how, CSEC is actually addressed in Virginia’s schools. This study aimed to fill this gap 1) by exploring school nurses' perspectives on how identification, response to, and referral of CSEC victims are addressed in Virginia’s schools across the Commonwealth; and 2) by examining policies and regulations addressing identification, reporting, and referral of CSEC victims in Virginia’s schools.
Method. A two-phase exploratory qualitative research design characteristic of policy research was employed. In phase one (corresponding to aim one), new data in the form of individual interviews with 27 school nurses was collected using Richie and Spencer’s framework/index analysis approach. Phase two (corresponding to aim two) was a review of pertinent Virginia’s state and school policies on CSEC and relevant contextual sources informed by Parker’s critical discourse analysis framework.
Findings and Conclusion. Findings from this qualitative policy research study demonstrate that CSEC is ineffectively addressed in Virginia’s schools. Three main intertwined clusters of causes were identified to contribute to this structural failure: (1) An underutilization of the school nurse role; (2) a general lack of understanding and acknowledgement of the larger problem of CSEC; and (3) predominantly underdeveloped and ineffective, or entirely missing, policies on CSEC in Virginia’s schools. CSEC can be addressed more effectively in Virginia’s schools. Policymakers are called to commit to tackling CSEC in Virginia ‘s schools with an unequivocal, specific, and funded mandate. Further recommendations include role-specific training for school nurses, and other school personnel, including school administrators. Appropriate school nurse staffing and inclusion of school nurses as equal members of the school team.