Preventing the Trafficking of Youth: A Retrospective Evaluation of kNow MORE! An Educational Program in San Diego, California

ABSTRACT

In 2017, California enacted the Human Trafficking (HT) Prevention Education and Training Act, requiring HT prevention curricula in middle and high schools. Prevention efforts to combat trafficking among vulnerable groups are scarce. Additionally, implemented educational programs tend to lack evaluation. In 2016, in San Diego, California, kNOw MORE!¹

¹ The kNOw MORE! Human Trafficking Prevention Program is copyrighted—2021 Point Loma Nazarene University.

(kM!), a drama-based and student-centered HT prevention curriculum, was developed. It aims to provide education among youth about awareness of HT, traffickers’ strategies of recruitment, identification of victims, and advocacy strategies. This analysis begins to address the current evaluation gap of implemented preventive educational programs. A mixed-method retrospective single-group design was applied. Pre- and post-assessment tools were utilized to collect data throughout a five-year period (2016–2021). Descriptive and inferential statistical analyses of association were performed. Qualitative thematic analysis was conducted to triangulate key findings. The sample comprised predominantly Latinx and Non-Hispanic white students from middle and high schools throughout San Diego, California. The results demonstrated that kM! has proven to increase the knowledge of its participants about HT victimization and how to advocate for themselves and others. The findings of this study provide significant implications for preventive educational efforts locally and nationwide. Future research should include a rigorous evaluation when such preventive educational curriculum is replicated.

KEYWORDS:

• Policy
• California
• preventive efforts
• social justice
• community
• collaboration

Background

Human Trafficking (HT), the exploitation of a person using force, fraud, or coercion for forced labor, commercial sex, or both (Trafficking Victims Protection Act [TVPA], 2000), is recognized as a human rights violation that impacts victims across the globe. The Trafficking Victims Protection Act (TVPA) became the foundation of the U.S. government’s response to human trafficking, which also reflects international efforts represented in the United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children (Office of the High Commission for Human Rights [OHCHR], 2000; Trafficking Victims Protection Reauthorization Act, 2017). In recent years, data from around the suggest an increased number of trafficking victims (International Labor Organization [ILO], 2022; OHCHR, 2000). Evidence points to the inhumane reality that one in four victims of sex trafficking is estimated to be a child, and sex trafficking in the U.S. remains predominantly an issue impacting females (J. A. Reid et al., 2017). Accurately quantifying the number of victims of trafficking in the U.S. remains a challenging goal. Yet, an analysis of more than 32,000 cases of human trafficking documented by Polaris (2007–2016) identified the manifestation of exploitation of 25 typologies of HT. This analysis demonstrates those victimized by trafficking tend to be overrepresented within certain activities, including pornography (61%), outdoor soliciting (50%), domestic work (48%), residential sex trafficking (48%), and fraudulent job offers (43%) (Polaris, 2017).

Through a national report by Polaris Project (2020), risk factors identified include recent migration or relocation (52.4%), unstable housing (8.9%), runaway/homeless status of a youth (8.4%), a mental health concern (7.4%), the experience of sexual abuse or violence (5.2%), and child welfare system involvement (4.9%). Other vulnerabilities include being part of an ethnic or racial minority, belonging to a non-conforming sexual-orientation group, and lacking social support systems (Basson, 2017; Fedina et al., 2016; Fehrenbacher et al., 2020; Franchino-Olsen, 2021; Greenbaum, 2014; Hogan & Roe-Sepowitz, 2020; Landers et al., 2017; J. A. Reid et al., 2017).

HT victimization negatively impacts survivors’ health outcomes and well-being. Survivors of trafficking have reported physical injuries, psychological trauma, chronic physical conditions, substance abuse, and unplanned pregnancies, among other negative consequences (Greenbaum, 2014; J. Reid, 2016). Youth who have experienced trauma and abuse since early childhood are more likely to become victims of HT (Fedina et al., 2016; Hardy et al., 2013; Miller-Perrin & Wurtele, 2017). Understanding victimization and the vulnerabilities that heighten trafficking entrapment provides valuable information for the development of preventive programs that increase awareness and prevent future victimization. Given the extreme chronic trauma of HT victimization, more emphasis on prevention is greatly needed to combat this global and local crime. Although intervention and rehabilitation of survivors of HT are important efforts, prevention is also essential to reduce and eventually eliminate trafficking victimization (Centers for Disease Control and Prevention [CDC], 2004; Richie-Zavaleta et al., 2022; U.S. Department of Education, 2015). Scant studies have focused on evaluating preventive HT educational programming in the U.S. To begin narrowing the current understanding about the effectiveness gaps in understanding the effectiveness of preventive HT educational programs, this retrospective evaluation analysis includes three aims: 1) Analyze the historical policy background on preventive education curriculum development in the context of California; 2) Retrospectively investigate and analyze kM! pre and post-assessment data collected during a five-year period from 2016 to 2021 and 3) Compile evidence-based recommendations for future practice and policy.

The FBI designated San Diego (S.D.), California, as one of 13 cities in the U.S. with the highest rates of commercial sexual exploitation of children (San Diego County District Attorney, 2022). In 2015, a study conducted in S.D. identified up to 8,000 victims of trafficking in the locality. The average age of recruitment was 16 years, and middle and high school campuses were targeted locations, accounting for 30% of the exploitation of minors in S.D (Carpenter & Gates, 2016). Moreover, of all (N = 20) schools that participated in the study, 90% had confirmed cases of sex trafficking victimization among the student population (Carpenter & Gates, 2016; National Center for Homeless Education at SERVE, 2014). Information from the State of California Department of Education Data & Statistics identified 80 schools in S.D. categorized as highest need due to the overrepresentation of homelessness status, housing instability, involvement in the foster care system, and low economic status among its students (California Department of Education, n.d.). Thus, prevention among such students seems to be essential in addressing HT vulnerability.

Prevention of Trafficking Through Education Programming at Schools

Despite the significant number of minor victims caught up in HT, very few efforts have been invested in its prevention through the development of education curriculum and its implementation in K-12 school settings (Rizo et al., 2019; U.S. Department of Education, 2015). Nonetheless, some efforts were initiated in recent years after the U.S. Department of Education mobilized training across the country by appropriating grant funds to support programming in regions designated by the FBI as high-intensity sex trafficking areas. These efforts have focused on the development of HT prevention curricula for elementary, middle, and high school settings (22 U.S.C. §§ 7101, et seq., OHCHR, 2000; Salas & Didier, 2020).

Essential Frameworks, Models & Approaches

School-based prevention efforts are crucial for reaching youth on a large scale (Donohue-Dioh et. al., 2020). Thus, implementing educational curriculum and utilizing public health frameworks to understand the issue has the potential to address trafficking in the short and long term. The CDC (2004) was the first to recommend trafficking prevention education (Richie-Zavaleta et al., 2022; Todres, 2012; Zhu et al., 2020). A public health approach to prevention of trafficking makes sense because it calls for a multidisciplinary collaboration with communities involved in program planning, assessing local strengths and needs, identifying vulnerable populations, evaluating programming, seeking greater community buy-in to support programming implementation and sustainability (Lesak et al., 2021; Richie-Zavaleta et al., 2022; Todres, 2012).

Moreover, using an interactive and creative model when implementing preventive curricula is essential to increase the understanding of prevention programs’ participants (Rizo et al., 2023). The Theater of the Oppressed (Boal, 1993) aims to raise consciousness of social issues and activate participants’ imaginations. The goal of such a model is to help participants not only become aware of social issues but also identify possible solutions through their participation and interaction in the program. This model empowers participants by raising their awareness of social issues, providing knowledge about important characteristics that help them understand their own vulnerability or that of their friends, and teaching them how to seek help if needed. The kM! curriculum uses the Theater of the Oppressed interactive model. The intent of implementing this approach is to increase the awareness of and understanding of trafficking and strategies for youth to protect themselves from victimization.

Furthermore, U.S. law and experts in the human trafficking field recommend that curricula focus on raising awareness, preventing trafficking, and increasing access to resources (Donohue-Dioh, et. al., 2020; Richie-Zavaleta et al., 2024; Rizo et al., 2023; Trafficking Victims Protection Reauthorization Act, 2017). Comprehensive prevention education should include information on relationships, what trafficking is and how it happens, how to identify safe people, and resources that support leaving exploitation. Other important components include delivering the content in developmentally appropriate ways. Lastly, facilitators delivering the content should be trained not only in presenting and addressing the specific needs of the school but also in identifying signs of distress displayed by students, as these students may be victims of trafficking (Lesak et al., 2021).

California Policy on Prevention Education

California was the first state that introduced laws that incorporated and mandated trafficking prevention education for its students in grades 7–12 through the Human Trafficking Prevention Education and Training Act [HTPETA] (2017)²(HTPETA, 2017; Lemke, 2018; Salas & Didier, 2020). With California’s Assembly Bill 1227, titled the Human Trafficking Prevention Education and Training Act (HTPETA), the State of California officially recognized it was a necessity for implementation of prevention education curriculum across the state of California through school settings (HTPETA, 2017). This state law aimed at reducing the vulnerability to exploitation that California’s children face. Codified in 2017, HTPETA amended existing law to expand comprehensive sexual health educational requirements to include human trafficking prevention education. Preventive curricula were required to include information on the prevalence, nature, and human traffickers’ strategies of entrapment as well as techniques to understand healthy relationships (HTPETA, 2017). The bill also expanded requirements for the training of leaders, administrators, and educators. Moreover, the establishment of protocols for assisting potential victims, once they have been identified, was later required. The trainings are intended to consistently provide updated information on forms of abuse, including human trafficking, and prevention methods. Although it would be beneficial to evaluate the impact of prevention policies, the state mandate did not establish accountability or enforcement of the required curriculum (Pollack Porter et al., 2018). Additionally, this law was unfunded, which means the implementation of the law would not be accomplished especially among the counties that lack many resources to enact such educational programming to fruition (Carpenter & Gates, 2016; San Diego Grand Jury, 2019).

kNow MORE! Beginnings & Goals

In 2015, the kNOw MORE! (kM!) preventive program was developed by local stakeholders and survivors of HT and implemented in schools starting in 2016. At the time of its development, kM! was one of the few preventive educational programs in the country that focused on increasing awareness of trafficking as a pressing issue in the U.S. It provided, and continues to impart specific knowledge about human trafficking at the local and national, identifying perpetrators’ strategies to entrap victims, demonstrating vulnerabilities and risks for victimization, national and local resources, and increasing self-advocacy.

The kM! curriculum is a drama-based program that uses the principles of the Theater of the Oppressed. It depicts the grooming process of a young female high school student named Amanda. Under the eyes of her parent, friends and teacher, Amanda is groomed and exploited for commercial sex by a trafficker, posing as a boyfriend. After the drama is presented, facilitators teach the vulnerabilities of trafficking victimization and the recruitment tactics of traffickers, as well as providing information about what sex trafficking is, where it is happening in San Diego and what vulnerabilities can lead to exploitation. Participants are then invited to watch segments of the drama again, this time with the instruction to stop the program if they see or hear any warning signs of Amanda’s grooming and eventual exploitation. Through the interactive and creative model (Boal, 1993), participants are encouraged to change the outcome of Amanda’s story. These processes that engage participants, raise consciousness, and provide knowledge and tools to interrupt the cycle of exploitation are the essence of kM!. Resources are discussed so participants leave with the knowledge of what steps to take if they experience or witness a similar situation.

Along with the creation of kM!, other anti-trafficking efforts were instrumental, including the San Diego Trafficking Prevention Collective (SDTPC). This collective impact project was privately funded and championed by the San Diego District Attorney, Summer Stephan (San Diego District Attorney, 2022). The purpose of the SDTPC was to provide human trafficking prevention education to as many participants as possible throughout S.D. As a result, three nonprofits agreed that they would carry the baton to implement the educational prevention program. These partners included 3-Strands Global Foundation, the Center for Justice and Reconciliation (CJR) at Point Loma Nazarene University (PLNU), and Project Concern International (now Global Communities) (San Diego Trafficking Prevention Collective [SDTPC], 2022). The partners also worked with the San Diego County Office of Education to develop protocols and processes to implement prevention education and to coordinate reporting of identified victims of trafficking (Center for Justice and Reconciliation [CJR], 2021; SDTPC, 2022).

Although a few other preventive educational programs with similar objectives to kM! have been developed and implemented locally and nationally, all share a common shortfall: they lack evaluation of their effectiveness (Rizo et al., 2019). School-based prevention efforts, with youth-centered curricula that combine research and data collection, are necessary to narrow current gaps in prevention education in the United States (Donohue-Diah et. al., 2020; Richie-Zavaleta et al., 2022).

Method

Participants

S.D. is home to 326,716 youth between the ages of 10–17 (SANDAG, n.d..), and has 95 high schools, 100 middle schools, and 52 K-12 schools. Students between the ages of 10–17 in 247 local educational institutions have an ethnic breakdown of 45.26% Hispanic or Latino, 34.58% White, 8.8% Asian American, 4.98% Biracial, 5.15% African American, 0.45% American Indian/Alaskan Native, and 0.43% Native Hawaiian/Pacific Islander (SANDAG, n.d..). kM! presented to students in 26 different public, private and charter schools throughout S.D. County. The total number of student and non-student participants was 11,968 in a five-year period from 2016 to 2021. Non-student participants included community members who at times participated in the program. This analysis did not include any teachers or school administrators as participants.

Materials

The kM! assessment tools (pre and post evaluation surveys) were developed through a multidisciplinary collaboration of survivors of HT, teachers, governmental officials, law enforcement agents, and nonprofit organizations (CJR, 2021; SDTPC, 2022). The first version contained 16 items in 2016, and in 2021, it evolved to 29 items. This evolution can be divided into two major periods: Version 1 from 2016–2018 and Version 2 from 2018–2021. Version 1 focused on knowledge and awareness constructs. The items included version were True/False items (true was given the value of zero), and open-ended questions were included in the post-assessment only. In 2018, the assessment was converted from paper to an electronic format, allowing for streamlined assessment of the data. This change also allowed the introduction of multiple-choice questions. The assessment tool was translated into Spanish in 2018 and was consistently offered to native Spanish speakers moving forward.

Both versions of the tool aimed to measure the following multidimensional constructs: 1) Awareness of HT, 2) Knowledge of HT, 3) Self-Perceived Advocacy Attitudes, and 4) Recommendations for Program Improvement. The assessment tool’s construct on Awareness of Trafficking included five items. The construct was operationalized based on four dimensions: 1) What happens when someone is victimized in the context of sex trafficking, 2) Where HT occurs within S.D., 3) Traffickers’ Characteristics, and 4) Trafficking Vulnerabilities. Both quantitative and qualitative items were included. Quantitative items included True/False, Likert Scales ranging from 1–5 (with 1 being strongly disagree and 5 being strongly agree), and multiple choice with a drop-down menu. Qualitative items were included in the post-assessment tool.

Procedures

Recruitment and Protocols

kM! sought the collaboration of school districts and administrators in order to determine its implimentation throughout San Diego County. The program was free of cost to schools and participants. For school sites, the kM! artistic director contacted school districts to offer the program to middle and high schools. Once a school district agreed to a partnership, the kM! artistic director connected with school administration to arrange initial scheduling and protocol discussions. School administrators received a kM! information package that included details of the presentation and the mandatory and recommended program protocols for hosting the program. Mandatory protocols required schools to provide Commercial Sexual Exploitation of Children (CSEC) 101 training to their staff, presented by San Diego Youth Services, and to adopt the recommended CSEC reporting protocol prior to the performance. In 2018, the San Diego County Office of Education established a uniform CSEC protocol, and this protocol was adopted by kM! in collaboration with partnering schools (HTPETA, 2017). The mandatory program protocol also required schools to obtain opt-out consent forms from the parents/legal guardians of student participants prior to the presentation. The presentation spans up to 3.25 hours and can be presented to 25–100 youth at a time.

Data Design & Dataset

This retrospective mixed-methods evaluation was based on the analysis of kM! data. The dataset was collected from Fall of 2016 to Spring of 2021 by school partners in collaboration with the kM! administrators at the Center for Justice & Reconciliation (CJR) mentioned below.

Analysis

The mixed-methods, retrospective design analyzed a five-year period (2016–2021) of data, based on a single-group pre and post-intervention design; however, the data were not linked to participants’ ID numbers, which prevented paring responses between pre and post-assessments. Quantitative data were analyzed using descriptive and statistical inferential analysis via IBM SPSS Statistics for Mac, version 28 (IBM Corporation, 2021). Descriptive statistics were performed on the different constructs included in both assessment tools, pre and post. These constructs included: a) Participants’ Demographic Characteristics; 2) Awareness of HT; 3) Knowledge of HT; 4) Self-Perceived Advocacy; and 5) Opinions. The Mean (M) and Standard Deviation (SD) were calculated for Likert Scale variables. The statistical inferential analysis utilized was based on Pearson’s Chi-Square Test with a significance alpha set at 0.05. For the inferential analysis, pre and post-assessments were treated as the independent variable, and the pre and post responses as dependent variables. This method allowed for the dichotomous categorical data since the responses were based on a True/False type of question.

Qualitative data from the open-ended items in the post-assessment questionnaire were cleaned, analyzed, and then transferred into a data management software, Nvivo Mac version 12 Pro for further analysis (QSR International Pty Ltd, 2018). The data were analyzed based on a five-step process. This process included reading, coding, displaying, collapsing, and interpreting (Ulin et al., 2005). Prior to uploading the qualitative data into Nvivo, researchers identified key themes through a content-analysis process, done independently from each other (Creswell et al., 2004). Then, researchers met to identify themes, and once themes were established, researchers continued the thematic analysis within Nvivo (QSR International Pty Ltd, 2018). During the software enabled re-coding process, sub-themes were identified. Once the coding was completed, data were displayed and collapsed. These steps allowed for forming important connections within the data. The last step of the qualitative analysis was based on the interpretation of the previous connections made. The main themes identified through the qualitative analysis included: 1) Benefits of Participation, 2) Challenges of Participation, and 3) Recommendations for Improvement of Program.

Safeguards

The dataset was de-identified prior to sharing with researchers. For qualitative data, researchers assigned pseudonyms to quotes. This study was IRB approved by Point Loma Nazarene University (PLNU) for a retrospective evaluation of the dataset.

Results

Sociodemographic Characteristics

Table 1 summarizes the descriptive statistical analysis of kM! and provides a picture of the implementation of the program throughout the County of S.D. during a five-year period from 2016 to 2021. A total of 41 sites throughout S.D. received the drama-based program, primarily face-to-face, with the exceptions of two sites in April and May 2021, when the program was facilitated via online due to COVID-19 restrictions on in-person presentations. The sites where the program was presented included schools, community centers, churches, and alternative schools. More than half of the presentations were done in school settings. Therefore, a majority of kM!’s participants were students, pre-assessment (n = 3912) and post-assessment (n = 2691). Non-students included members of the community which represented less than 10% of total participation in both pre and post-assessment (See Table 1).

Table 1. Sociodemographic Characteristics of kM! Program Participants.

	Pre	Post
Characteristics	N (%)	N (%)
Types of Setting	5334 (100)	3671 (100)
Schools	4,931 (92.44)	3430 (93.3)
Church	133 (2.5)	108 (2.9)
Community Center	193 (3.6)	101 (2.7)
Juvenile Facility	77 (1.4)	32 (0.9)
Type of Participants	4165 (100)	3837 (100)
Students	3,912 (93.9)	2,691 (94.9)
Non-students	253 (6.1)	146 (5.1)
Sex	5334 (100)	3671 (100)
Female	3158 (59.2)	2113 (57.5)
Male	1906 (36.0)	1334 (36.3)
“I don’t want to answer”	210 (4.0)	164 (4.5)
Other	51 (1)	32 (0.9)
Level of Education	3912 (100)	2691 (100)
7^th	612 (14.69)	443 (16.5)
8^th	584 (14.9)	415 (15.4)
9^th	1731 (44.2)	1292 (48.0)
10^th	412 (10.5)	222 (8.2)
11^th	296 (7.6)	151 (5.6)
12^th	277 (7.1)	168 (6.2)
Race/Ethnicity*	4910 (100)	3404 (100)
African American	251 (5.1)	181 (5.3)
Asian/Pacific Islander	284 (5.8)	189 (5.6)
White	1057 (21.5)	794 (23.3)
Middle Eastern	104 (2.1)	55 (1.6)
Native American	18 (0.4)	8 (0.2)
Other	130 (2.6)	77 (2.3)
Biracial/Multiracial	908 (18.7)	690 (20.3)
Hispanic/Latin Origin
Yes	2152 (43.8)	1410 (41.4)

*Participants could select more than one option including Hispanic/Latin Origin.

Both pre- and post-assessments were administered to each student cohort. Females represented more than half of the participants for students and non-students for both pre and post-assessment (n = 3158, 59.0%; n = 2113, 57.5%). Self-described non-White Hispanic/Latinos consisted of less than half of participants, students and non-students, in both pre and post assessments (n = 2152, 40.2%; n = 1410, 38.4%). Almost half of the participants in both pre and post consisted of 9^th grade students (n = 1731, 32.3%; n = 1292, 35.2%).

Awareness of Human Trafficking

Victimization of HT

Table 2 summarizes the descriptive and statistical analysis of the Awareness of Trafficking constructs. This construct was operationalized by using five items included in the pre and post-assessment tool. Under the construct of awareness of Victimization of HT, the item asked participants to answer True/False to the question: “Being made to perform a sexual act for financial gain is a type of HT.” For V2, the item was changed to a True/False and read, “If someone forces another person to perform a sexual act for money … ” The inferential statistical analysis established that there was significant association for both variables in V1 and V2, between time of assessment (pre and post) and the participants’ awareness of someone is being made or forced to perform a sexual act for an exchange of some monetary gain being HT; V1, (Χ²(1) = 43.1, p < .001); and V2, (Χ²(1) = 129.3, p < .001) respectively.

Table 2. Awareness & Knowledge of Human Trafficking Among Participants of kM!

Awareness of Human Trafficking	Pre Intervention % (n/N)	Post intervention % (n/N)	Χ2	P-value (0.05)
Victimization of HT
Being made to perform a sexual act for financial gain is a type of HT (True)	90.0 (1669/1854)	96.0 (1404/1462)	43.5	0.001
If someone forces another person to perform a sexual act for money … (True)	85.3 (1442/1690)	97.7 (1227/1256)	129.3	0.001
Location
If you want to avoid getting caught up in sex trafficking, just stay away …(False)	50.7 (1300/2564)	47.7 (907/1901)	3.9	0.048
Trafficking only happens in certain parts of SD (False)	15.3 (303/1980)	11.6 (165/1425)	9.7	0.002
Trafficker Charateristics
Traffickers can be men, women, girls or boys (True)	93.4 (2039/2183)	94.2 (1388/1473)	1	0.312
Vicitim Charateristics
The average age that a girl in S.D. is recruited into sex trafficking is 16 (True)	61.5 (2147/3496)	77.1 (2584/3352)	196.8	0.001
Victims of HT are likely to ask for help. (False)	40.4 (1617/3998)	29.5 (910/3086)	91.1	0.001
Knowledge of Human Trafficking
Traffickers Strategies of recruitment
Traffickers can recruit victims online or through social media (True)	93.3 (2986/3201)	96.3 (2472/2566)	26.1	0.001
Traffickers are unlikely to recruit at schools (False)	78.6 (1240/1578)	84.2 (1143/1359)	14.5	0.001
Victimization Identification
A classmate at schools posts online that his girlfriend is willing to have sex with someone … (Yes, for money & drugs)	82.3 (2628/3191)	91.7 (2286/2494)	109.2	0.001
Resources
National Hotline (True)	95.3 (2916/3060)	97.4 (2522/2590)	16.8	0.001

NOTES:

1. Total numbers did not include “I don’t know” or “Missing” cases.

2. Response inside parenthesis denotes the correct response

3. n=Number of correct responses and N=total number of responses

Location Where HT Happens in S.D

Table 2 also represents the findings on constructs related to location of potential trafficking. The first item included in the analysis was: “If you want to avoid getting caught up in sex trafficking just stay away from those of the city . . .” (false). The inferential statistical analysis demonstrated that there was a significant association between time of assessment (pre and post) and participants’ awareness that avoiding getting caught was only related to avoiding certain locations in the city (Χ²(1) = 3.9, p < .048). For the later V2 of the same item: “Trafficking only happens in certain parts of S.D.” (false). Based on the inferential statistical analysis, it established that there was a significant association between time of assessment (pre and post) in relationship to awareness that trafficking not only happens in certain parts of the city but that could happen anywhere (Χ²(1) = 9.7, p < .002).

Traffickers’ Characteristics

Under the characteristics often demonstrated by traffickers,’ the item “Traffickers can be men, women, girls or boys,” was only included in version 2 of the assessment tool (pre and post). Based on inferential statistical analysis, findings showed that there was no association found between the time of assessment (pre- and post-intervention) and the awareness about trafficker’s characteristics (Χ²(1)≥1.022, p = .312).

Victims’ Attributes

The Awareness construct included two items which measured the attributes of victims of HT. These dimensions included average age and whether victims typically ask for help. The first item was: “The average age that a girl in S.D. is recruited into sex trafficking is 16.” The inferential statistical analysis demonstrated that there was a significant association between time of assessment (pre and post) and awareness of the average age of recruitment (Χ²(1) = 196.8, p < .001). For the second item asking whether “Victims are likely to ask for help,” the inferential statistical analysis demonstrated that there was a significant association between time of assessment (pre and post-intervention) and awareness of victims asking for help (Χ²(1) = 91.1, p < .001). See Table 2.

Knowledge of Human Trafficking

The construct Knowledge of HT, was operationalized by four dimensions. These included: 1) Grooming & Vulnerabilities, 2) Trafficker’s Strategies of Recruitment, 3) Identification of Victimization, and 4) Resources. This construct included six items. Some items were included in both V1 and V2. See Tables 2 and 3.

Table 3. Knowledge of Trafficking Among Participants of kNow MORE!

Grooming & Vulnerabilities	Pre (N = 5334)		Post (N = 3671)		Difference*
	N	%	N	%	%
Version 1
Expensive Possessions	970	18.2	1175	32.0	+13.8
Exposed Bruises	1605	30.1	1263	34.4	+4.3
Frequent Absences	1447	27.1	1216	33.12	+6.0
Have a New Tattoo	562	10.5	1145	32.0	+22.5
Have Two Cell Phones	809	15.2	890	24.2	+9.0
Spending Time with New Friends	490	9.2	529	14.4	+5.2
Eat In Class	89	1.7	100	3.0	+2.3
Loud in Class	82	1.5	200	6.0	+1.3
Watch the Wrong Kind of Movies	281	5.3	187	5.1	−0.2
None of These Actions	89	1.7	34	0.0	−1.7
Not Sure	506	9.5	130	3.5	−6.0
Version 2
Increase Absences and New Expensive Clothes	1279	24.0	1221	33.3	9.3
Seen on Streets & Is from Another Country	328	6.1	91	2.5	−2.6
Talks on the phone & Eats in Class	59	1.1	55	1.5	+0.4
Not Sure	525	10.0	80	2.2	−7.8
Identification of Victimization N = 3463			Post
Post-Assessment Only			N	%
I Can Tell if Someone Is Being Sold**
Disagree			221	6.0
Neutral			889	24.2
Agree			2353	64.1

*Difference of percentages: “+” denotes increase and “-” denotes decrease in post-assessment.

after intervention.

**Values of “Strongly Disagree and Disagree” were combined to “Disagree..”

“Agree” and “Strongly Agree” were combined into “Agree.”

Grooming & Vulnerabilities

The items that measured this dimension were based on the identification of potential signs of Grooming (pre-victimization process) and Vulnerabilities. The item, “Which of the following responses are red flags that a minor may be a victim of trafficking?” was part of the V1 assessment tool. Later, for V2, the item was modified to “Which of these is the most accurate set of red flags that someone is being groomed for sex trafficking?” These items had several choices and participants could select more than one answer. For V1, descriptive analysis demonstrated that in the pre-assessment, the options most selected were “Exposed Bruises” (n = 1605; 17.8%), followed by “Frequent Absence” (n = 1447; 16.0%) and “Expensive Possessions” (n = 970; 10.7%). For the post-assessment, results were similar choices, but percentages differed. Results were comprised of “Exposed Bruises” (n = 1263; 14.0%), followed by “Frequent Absence” (n = 1216; 13.5%) and “Expensive Possessions” (n = 1175; 13.0%). The answer that had a double fold in percentage increase was “Have a New Tattoo,” going from 6.2% in the pre-assessment (n = 562) to 12.7% (N = 1145) in the post-assessment.

The V2 of the item (n = 2191) that measured the Grooming & Vulnerabilities, contained four options for participants. The most selected answer was, “Increase in school absences and new expensive clothes” (n = 1279; 58.4%); followed by “Not sure” (n = 525; 24.0%). For the post-assessment (n = 1447), same answer had the most percentile of responses, “Increase in school absence … ” (n = 1221; 84.4%); increased to almost all participants. See Table 3.

Traffickers’ Strategies of Recruitment

The second dimension of Knowledge of HT focused on traffickers’ strategies of recruitment. There were two items under this dimension. The first item was “Human traffickers can recruit victims online or through social media.” Table 2 again demonstrates these findings. The univariate and bivariate analysis demonstrates that kM! participants increased their knowledge in Traffickers’ Strategies. The inferential statistical analysis demonstrated that there was a significant association between time of assessment (pre and post-prevention) and correct knowledge on traffickers’ strategies of recruitment online and in social media (Χ²(1) = 26.1, p < .001).

For the second item, “Traffickers are unlikely to recruit at schools” descriptive analysis demonstrated an increase from baseline to after implementation of the educational program in their knowledge of location of recruitment of traffickers; specifically, schools. Table 2 also demonstrates the results of the Pearson Chi-Square statistical test. It demonstrated that there was a statistically significant association of distribution between time of assessment (pre and post-prevention) and correct knowledge on traffickers’ strategies in terms of location of recruitment-schools (Χ²(1) = 14.5, p < .001).

Victimization Identification

For this dimension, there were two items included in the assessment, but the second one was only included in the post-assessment. The first item was “A classmate at your school posts online or on social media that his girlfriend is willing to have sex with someone for money or drugs. Is this HT?” Descriptive analysis demonstrates that a majority of kM! participants answered correctly in the pre-assessment (See Table 2). The inferential statistical analysis demonstrated that there was a significant association between time of assessment (pre and post-prevention) and correct knowledge on identification of victims (Χ²(1) = 109.2, p < .001). See Table 2.

The second item included in the post-assessment measured the self-assessed knowledge of a participant’s ability to identify what trafficking is: “I can tell if someone is being sold.” However, there was no pre-assessment data to compare it with to see any change in percentile. Nonetheless, most participants agreed and strongly agreed that they could identify a victim of trafficking. See Table 3.

Resources

Table 2 demonstrates the findings of knowledge about Resources. The item in the assessment tool was written as follows, “There is a national HT hotline for victims, concerned family, friends or anyone who suspects HT is occurring.” The descriptive analysis indicated that almost all participants in the pre-assessment and post-assessment knew the correct answer. The inferential statistical analysis exhibited that there was a significant association between time of assessment (pre and post-prevention) and correct knowledge on the national hotline for HT (Χ²(1) = 16.8, p < .001).

Self-Perceived Advocacy – Willing to Assist Others, Compassion & Moving into Action

Table 4 summarizes the descriptive analysis of this construct. This third construct of the assessment tool measured participants’ perception on their Self-Perceived Advocacy skills, which included three Likert-Scale items. The scale rated answers from “Strongly Disagree” (value of 1) up to “Strongly Agree” (value of 5). The first item included was: “I am willing to take action if I suspect HT.” The descriptive analysis demonstrated that almost two-thirds of respondents strongly agreed with being willing to take action if they suspected victimization of HT (n = 2133; 72.9%; M = 4.33). For the post-assessment, analysis indicated an increase in percentile.

Table 4. Self-Perceived Advocacy – Assisting Others, Compassion & Moving into Action.

	Pre			Post
	N (%)	M (SD)	Median	N (%)	M(SD)	Median
I am willing to act if I suspect human trafficking.	2133 (100)	4.33 (1.182)	5	1391 (100)	4.50 (1.065)	5
1	135 (6.3)			66 (4.7)
3	442 (20.7)			218 (15.7)
5	1556 (72.9)			1107 (79.6)
I feel bad when someone else gets hurt	2147 (100)	4.31 (1.252)	5	1394 (100)	4.36 (1.227)	5
1	178 (8.3)			110 (7.9)
3	383 (17.8)			229 (16.4)
5	1586 (73.9)			1055 (75.7)
I believe all my peers should receive human trafficking education	2135 (100)	4.31 (1.197)	5	1386 (100)	4.51 (1.061)	5
1	141 (6.6)			67 (4.8)
3	455 (21.3)			204 (14.7)
5	1539 (72.1)			1115 (80.4)
	Pre
	N (%)	M(SD)	Median
I understand all the information	3466 (100)	4.65 (0.926)	5
1	118 (1.3)
3	371 (4.1)
5	2975 (32.9)
I learned more about human trafficking	3473 (100)	4.66 (0.938)	5
1	136 (1.5)
3	322 (3.6)
5	3015 (33.4)
The presenter helped me learn about human trafficking	3475 (100)	4.86 (0.900)	5
1	121 (1.3)
3	306 (3.4)
5	3048 (33.7)

A majority of kM! participants who responded agreed with assisting a suspected victim (n = 1391; 79.6%; M = 4.50). For the next item: “I feel bad when someone else gets hurt,” analysis of the pre-assessment tool showed that almost two-thirds of kM! participants felt bad when someone else got hurt (n = 2147; 73.9%; M = 4.31). The univariate analysis demonstrated that a majority of participants in the post-assessment strongly agreed with the statement (n = 1394; 75.7%; M = 4.36). The last item, under this construct, was stated as follows, “I believe all my peers should receive an education in HT.” The descriptive analysis of the pre-assessment tool revealed that more than half of the participants strongly agreed with the statement (n = 2135; 72.1%; M = 4.31). For the post-assessment, a majority strongly agreed (n = 1386; 80.4%; M = 4.51) (see Table 4).

Quality of Program

Table 4 demonstrates the findings on this construct. This construct included the following items: 1) “I understand all the information,” 2) “Presenter(s) [and/or] Facilitators helped me learn about HT,” and 3) “I learned more about Human Trafficking.” The items were based on a Likert Scale range from “Strongly Disagree” (value of 1) to “Strongly Agree” (value of 5). For this analysis, values of “Strongly Disagree” and “Disagree” were combined and given the value of 1. Choices “Agree” and “Strongly Agree” were combined and assigned a value of 3 to create a greater uniform distribution. The descriptive analysis demonstrated that most intervention participants strongly agreed about their understanding of the information shared during the kM! intervention presentation (n = 3466, 86%; M = 4.65). When kM! participants were asked to share whether the presenters or facilitators had assisted them in their learning about HT, a majority strongly agreed (n = 3048, 88%; M = 4.86). Finally, similar findings were demonstrated when participants were asked about whether they had gained knowledge of HT after the intervention, (n = 3473, 87%; M = 4.68), with most post-assessment responders strongly agreeing. Median and Mode had a value of 5, and their Range was 4 for all these three items.

Qualitative Results

Table 5 summarizes the findings of the content analysis for kM! The qualitative findings were based on three identified main themes including: Benefits of Participation, Challenges of Participation, and Recommendations for Improvement. These findings also contained sub-themes that were embedded throughout all the main themes. These sub-themes presented a cohesiveness throughout the content data analysis. The sub-themes emerged from the qualitative data analysis, including: Gained New Knowledge, Self-Perceived Advocacy, Unwanted Emotions, Resources, Reporting, and Safety, among others. The following section expands on the qualitative analysis of the kM! data.

Table 5. Qualitative Findings: Benefits, Challenges, and Recommendations.

Benefits of Participation
Gained New Knowledge	”.. I thought the drama was very effective and realistic. It really showed, not told, what trafficking might look like for us. I think having discussions and more information content in between the acting helped guide our understanding.”
Engagement	“Yes! I really enjoyed it. Even though it was online, I found it very engaging, thorough, and helpful. Honestly, the online transition looked very nice. I would recommend this course to teachers and students. I really liked how speakers were talking while sharing the slides. This made it easy to follow and understand the content being spoken about. The videos were of good quality and there were no noticeable technical difficulties. The program was engaging throughout, and I never felt bored or that it was too long.”
Self-Advocacy	“I liked how they really showed us how to identify the victims and to be an up stander if anything happens and not just sit around like you didn’t see anything.”
Challenges of Participation
Lack of Understanding	Make it a little better at explaining to people who don’t know a lot of English or simply don’t understand.
	… Information is presented in a very abstract manner and our students need information presented in a very concrete manner.
Unwanted Emotions	Maybe make it less stressful, it was almost scary to be a part of, and if there can be a way for it to be more relaxed but still have the same seriousness that would be good.
Recommendations for Improvement
Modification of Curriculum	The program can be improved by giving more information, and different sex trafficking scenarios. Like, show different situations about human trafficking.
	I feel like the program was very well done; however, I feel as though there should have been more examples of trafficking. Instead of just being someone meeting another person online, it could be other things too.
Resources, Reporting and Safety	You can improve by letting us know more about the subject and providing resources for helping [others].
Modification of Delivery & Engagement	Una manera de mejorar es que los estudiantes de todos los grados puedan tener este taller y ver los testimonios de sobrevivientes para que sepan como se combierte alguien en victima[Translation: To improve the program have access to attending workshops [on this topic–trafficking] to students from all different grades so they can testimonies from survivors so theycan learn more about how victims get trapped].

Benefits of Participation

Most participants who provided a content-response to the post-assessment survey stated their appreciation of the program and cited new knowledge gained after participation. They expressed enjoyment, not because the topic was enjoyable, but because they had the opportunity to learn something important that could help them know how to prevent or intervene in a trafficking situation. Most of them also commented that the presentation was engaging even when presented in an online format. Additionally, some respondents revealed the program encouraged action and taught them how to protect themselves and assist others.

A majority of participants who shared their reflections on the kM! program relayed positive feedback. Participants felt that the program was educational and included important information about the risks of trafficking, citing specific examples. Rebecca commented, “The program was educational, and I think it is important that I know about human trafficking. The actors did a good job of showcasing a scenario of human trafficking and teaching us about it.”

Lola also shared the following:

There is nothing to improve, it was great, and I loved it! You guys provided useful information and informed us what was important to know. There was nothing that was included that was unneeded, I felt everything that was introduced was necessary.

Caitlynn explained, “I believe that every single student learned about this and did not take it as a joke. I think that every person needs to know the risk and how to see the red flags of human trafficking.” Participants also shared that kM! was engaging. Mia indicated her thoughts about the program:

Yes! I really enjoyed it. Even though it was online, I found it very engaging, thorough, and helpful. Honestly, the online transition looked very nice. I would definitely recommend this course to teachers and students. I really liked how speakers were talking while sharing the slides. This made it easy to follow and understand the content being spoken about. The videos were of good quality and there were no noticeable technical difficulties. The program was engaging throughout, and I never felt bored or that it was too long.

Self-Perceived Advocacy

An important sub-theme that surfaced throughout the three main themes was Self-Perceived Advocacy. This idea surfaced as the understanding of the ability to be an active participant to prevent and possibly intervene in a trafficking scenario. Analynn shared, “Yes, I liked how they really showed us how to identify the victims and to be an upstander if anything happens and not just sit around like you didn’t see anything.”

Thomas wrote, “Yes, I thought the drama was very effective and realistic. It really showed, not told, what trafficking might look like for us. I think having discussions and more information content in between the acting helped guide our understanding.” Participants expressed the idea that the content was important, and they were satisfied that they knew how to respond when danger is perceived.

Challenges Faced During Participation

Although most participants who responded to the qualitative content appreciated learning about the topic of HT in general, some did not. The main reasons why program participants expressed their dislike of the presentation was based on challenges faced during the presentation. The range of challenges included not understanding the drama’s content, being uncomfortable due to the subject matter, the presentation within the online format, and some concerns about language used by the actors during the scene.

Lack of Understanding

Many of the challenges focused on not completely understanding terms, gestures or vocabulary used by the actors who presented the drama and feeling uncomfortable with the content. Lauren commented, “Make some things clearer like try to make the drama a little clearer on what they are trying to say.” Some students may not be completely fluent in English so a drama that is presented in English only could create a lack of clarity of the curriculum content. Anna shared, “Make it a little better at explaining to people who don’t know a lot of English or simply don’t understand.” Ms. Smith commented, “ … Information is presented in a very abstract manner and our students need information presented in a very concrete manner.” Ms. Johnson stated the following:

I think that the contemporary moments that all the actors did on stage should either be a different move or be cut from the play because unfortunately my class wasn’t mature enough to handle it and they all started laughing at the gestures.

In other instances, the challenges were not based on the content of the program, but the format or mode of dissemination. For those who participated via online, the speed seemed faster than desired. Others felt that the content online needed an introduction or more information prior to the video being shown. Some others shared a desire for the video format to mirror the in-person performance’s pauses to allow participants to engage with the content of the video and allow time to identify red flags. For example, Mario offered the following suggestion:

I know in other kNOw MORE [in-person] performances, they pause the performance and ask students and spectators if they noticed any red flags. I know we discussed red flags and vulnerabilities, but I feel like it would be cool to stop the video and ask right there and then if the audience noticed any red flags/what they would do different.

Although this was not a majority of the participants, some participants did share that the content of the presentation created some unwanted emotions due to past experiences or the intensity of the topic. Others felt that the content of the presentation made them feel awkward or uncomfortable due to past experiences. Maya shared, “Maybe not talk about the personal experiences because people could get triggered, if they have gone through something similar.” Zoe also commented, “Maybe make it less stressful, it was almost scary to be a part of, and if there can be a way for it to be more relaxed but still have the same seriousness that would be good.” Embedded in the participants’ reflections was discomfort with the unwanted emotions that the drama evoked. Also, at times, participants given their limited fluency in English, did not comprehend all the content presented through the drama.

Recommendations for Improvement

In addition to sharing challenges, participants commented on recommendations for the improvement of the program. These recommendations included modifying content and increasing specificity about safety and other areas of HT prevention and resources. Additionally, some recommendations about format delivery were included. The following section presents these qualitative findings of this last main theme and the identified sub-themes.

Modification of Curriculum

Program participants shared the desire for the curriculum to provide more in-depth information on how people may behave if they are being trafficked and specific case studies that illustrate those behaviors. Claire explained, “You can give more examples of how people may act if they’re being trafficked.” Alonso commented, “The program can be improved by giving more information, and different sex trafficking scenarios. Like, show different situations about human trafficking.” Monica also shared, “I feel like the program was very well done; however, I feel as though there should have been more examples of trafficking. Instead of just being someone meeting another person online, it could be other things too.” Others recommended using simple language and defining the words actors used throughout the presentation could improve the program.

Moreover, some participants suggested adding some context so there is a smoother transition from beginning to end of the presentation. Ms. Miller shared the following:

Talk about what sex trafficking is at the beginning of the presentation. Teach students what is going to be presented on the videos and then play the videos and have students look for the things that you just talked about and have then talk about it at the end of the video. Better explain what many of the vocabulary terms you were using. Many of these words and terms are new to our students and they don’t frequently ask questions!

In providing context, a few other participants suggested including a trigger warning to audiences about the nature of the content and material they would be encountering through their participation. Malia shared, “Provide a trigger warning to audience.”

Lastly, students and other participants suggested omitting certain content from the curriculum and recommended modifying the ways it was presented with the goal of making it clearer for all participants. Esli commented, “Try to censor out explicit content [and] make it less uncomfortable…making feel a little less awkward for the students.”

Amy shared the same sentiment and said, “[Take] out the inappropriate words and making it feel a little less awkward for the students. You can improve the program by telling the actors not to say bad words.”

Resources, Reporting, and Safety

Most recommendations centered on self-perceived advocacy attitudes, either to assist someone else or to keep themselves safe if they were in danger. Participants would like to see more detailed information on how to seek help if they saw someone involved in trafficking. Additionally, they wanted to learn more about available resources on how to be safe when reporting. Lastly, program participants recommended kM! provide more education on how to access the hotline and the other options to report a potential case. For example, some participants recommended providing greater insights on how to be safe online. Others shared the desire to obtain more resources so they could assist others or themselves if needed. Luke commented, “You can improve by letting us know more about the subject and providing resources for helping [others].” Likewise, Sabana shared her thoughts below:

The only thing that I can really think of that would help to improve the program itself is to make it so that when teaching that students about it to make the assembly more focused on ways to talk to people, because I felt it lacked resources on which to act on the claims.

In terms of safely reporting a potential identified case, Riley commented, “We could discuss more about warning signs and the different methods of reporting. Often, it’s hard to resist peer pressure, fear of being labeled as a snitch, or not knowing enough about the help hotline.” For their own safety, some students commented on the desire to learn more specifics on how to be safe online. Connie offered her thoughts as follows:

Maybe give more advice on social media about trafficking. It felt more as if the program was just saying be safe online which most kids hear a lot from teachers and adults in their lives and that’s when kids and teenagers stop listening. Showing the signs of who to look out for online and not just warning people not to talk to strangers may be a better approach because a lot of teenagers have online friends who they’re very close with that are around their own age.

Modification of Delivery & Engagement

Moreover, others suggested changing the format of the delivery of the content with the goal of increasing engagement. Other suggestions also focused on the length of programming and possible ways to continue the training and make it more diverse. Sara shared, “Change the format, like, include more workshops, more discussions, bring speakers to the presentations” presentations”, and Martha offered a suggestion on how to improve the program.

Una manera de mejorar es que los estudiantes de todos los grados puedan tener este taller y ver los testimonios de sobrevivientes para que sepan como se combierte alguien en victima. [Translation: A way to improve the program is for students from all grades to have the workshop and see a survivor speak to know how to victims are trapped]

In terms of engaging participants, Marcos shared, “Have kids in the drama so they pay more attention to the program.” Others recommended adding tools such as questionnaires that do not include human trafficking to better assess if they can identify danger when they see it. Mrs Romero offered the following thoughts:

Acknowledge that those skills to identify a perpetrator, are universal: they are not exclusive to human trafficking. To get your money’s worth, make up scenarios or questionnaires that does not involve human trafficking, with a dangerous scenario involving a perpetrator. If they could identify them, then they can most certainly do it to recruiters.

Other suggestions provided by several participants were based on the idea of increasing interaction and involvement from the audience during the performance. Johny shared, “Maybe get more kids into it by making it more interactive, kind of like when we could say ‘pause and change things.” Also, Alexis commented, “More interaction between the audience and the speaker and play.” Bella also shared, “Have more inclusive activities so that students can participate fully. For example, include more time for questions, and make sure all students understand [the content].”

The findings of this analysis indicated that kM! was effective in increasing awareness of human trafficking in areas of understanding human trafficking victimization, the potential location of where trafficking can occur, and some of the victims’ characteristics. In terms of knowledge, this study demonstrated that kM!’s participants gained knowledge on traffickers’ recruitment strategies, potential signs of victimization, and the national resource hotline. Additionally, qualitative findings also highlighted both benefits of participation and recommendations for the program’s curriculum modification.

Discussion

Recently, the development of human trafficking preventive curricula has slowly emerged. Yet, evidence-based research of their effectiveness is scant (Rizo et al., 2019). To the best of the authors’ knowledge, this retrospective evaluation represents one of the few assessments conducted on human trafficking preventive programs in San Diego, California (Richie-Zavaleta et al., 2024). In addition to analyzing California’s laws mandating the development and implementation of trafficking prevention education curricula in middle and high schools, this study also assessed one of the first human trafficking prevention programs in the city of San Diego (CJR, 2021). The findings of this analysis highlight that implementing a human trafficking prevention program that utilizes the public health framework and the principles of the Theater of the Oppressed model has the potential to engage youth in learning about trafficking victimization, understanding strategies used by traffickers for entrapment, recognizing red flags and vulnerabilities, and acquiring tools to reach out for help if needed (Boal, 1993; CJR, 2021).

Findings of this analysis demonstrated high levels of Awareness of HT before the presentation and after the presentation. Moreover, the inferential statistical analysis indicated that most of the dimensions of Awareness of HT were statistically significant except one dimension – traffickers’ characteristics. Within the construct of Knowledge of HT, kM! participants increased their knowledge in three dimensions – Traffickers’ Strategies of Recruitment, Victimization Identification, and Resources. These three dimensions were statistically significant. Descriptive analysis of Self-Advocacy demonstrated some increase of percentage in participants’ willingness to act when comparing pre and post responses. These findings begin confirming the efficacy of kM!. Overall, most participants agreed that they have learned about the topic and understood information presented through the drama-based program. Moreover, these findings indicate that kM! was effective at increasing the awareness of HT, knowledge of traffickers’ strategies of recruitment, and victimization identification. However, kM! presentations need to emphasize traffickers’ characteristics more to improve participant understanding and provide more than one case-scenario of trafficking (Lesak et al., 2021).

The analysis of qualitative data provided triangulation of the quantitative findings and a deeper understanding of participants’ ideas and suggestions for the improvement of the program (Creswell et al., 2004). Qualitative findings highlighted the desire of kM! participants to deepen their comprehension of the complexities and different typologies of trafficking. They also provided several ideas on how to improve the program’s curriculum and how to increase engagement. kM!’s participants also desired to gain deeper knowledge about self-advocacy, including how to safely report a potential case, to recognize the diversity of cases of how trafficking could occur, and to obtain more resources to assist others or to find help, if needed. These findings are essential for kM!’s program director(s) and administrators to consider when updating its curriculum and implementation.

Additionally, in terms of their Self-Perceived Advocacy, both types of data and analysis demonstrated that participants are willing to assist others if they identify a potential victim of trafficking. These could be very important steps in the context of secondary prevention, meaning the identification of potential victims (Richie-Zavaleta et al., 2022). There was a strong agreement among participants of their compassionate attitudes, willingness to assist others if they witnessed victimization, and their enthusiasm for their peers to learn about HT in both the quantitative and qualitative analysis. These attitudes reflect the impact of an educational preventive programming when it is based on a model that seeks to move participants to a more proactive status in protecting themselves of future victimization or identifying current potential victimization. In other words, it moves participants toward social action (Boal, 1993; Rizo et al., 2023; Scott et al., 2019). Nonetheless, school plans for preventive programs, like kM!, need resources in place and trained educators and administrators when implementing them to adequately support potential survivors of trafficking and prevent future victimization (Lesak et al., 2021).

The qualitative findings also provide areas of improvement for the type of information needed for youth and others to be successful at advocating for themselves or others, which represents the aims of the Theater of the Oppressed framework (Boal, 1993; Edward et al., 2022; Zhu et al., 2020). Although the evaluation design only allowed capturing short-term outcomes, this is an important step in establishing a scientific understanding of trafficking prevention and evidence-based practice.

Limitations

This study is not without limitations. Data collection through pre and post-assessments was inconsistent with the number of participants who viewed the program. Additionally, over the course of the five-year period the assessment tools were modified two times. The methodology employed did not pair the answers of participants for pre and post assessments; therefore, it limits the depth of the analysis and contributes to its limitations. Finally, there continues to be a need to assess kM!’s participants’ retention over a longer period and better understand if they are able to use the gained knowledge and tools.

Nonetheless, this study possesses strengths. One strength of this analysis was the qualitative data, which provided a deeper understanding of participants’ thoughts, ideas, and recommendations. Qualitative findings also allowed for triangulation of data. The long-term length of the data collection was also a strength. It provided records of the preventive process as well as a long-term assessment of participation. Thus, this research begins to lay the foundation of evaluative evidence on prevention of human trafficking among youth in the San Diego region and within the state. Moreover, this evaluation begins to narrow the current gap of research in educational preventive curriculum for youth in trafficking and has begun building an evidence-based approach for trafficking prevention education programming for youth and others (Rizo et al., 2019).

Recommendations

At the programming level, it is evident that kM! still has many more schools to reach throughout S.D. Therefore, exploring possible partnerships in areas of high-risk where the program is yet implemented is a high priority (Richie-Zavaleta et al., 2024). Developing an online curriculum could facilitate the expansion of the program beyond S.D. as well as reduce logistical limitations of in-person presentations. Furthermore, there is a need to ensure the consideration of past trauma in every presentation; for example, trigger warnings should be part of every performance. The curriculum content should also include different typologies of HT, including labor trafficking (Polaris Project, 2020; Rizo et al., 2023). Students should also be referred to simplified and centralized resources; for example, a webpage that provides a range of information from where to go if a victim is identified, to counseling and so forth.

There is scarcely any literature on the effectiveness of HT prevention programs amongst youth. The field has not developed sufficient evidence to point toward best practice or evidence-based approaches. One way to address this research gap is by conducting more robust-design evaluations of the existing programs to make appropriate and educated developments based on findings. For example, a longitudinal study should be a goal for future evaluations. The creation of validated assessment tools should also be part of the evaluation process. Lastly, assessing the reliability of the kM! assessment tool can ensure all participants are understanding the questions in the same manner (Cutbush et al., 2021).

The findings of this analysis have provided a realization that paramount efforts are still needed at the county level to ensure all S.D. youth understand the dangers of trafficking and have the necessary tools to avoid entrapment. The statewide policy should support local efforts of prevention through financial support of agencies and community stakeholders throughout the state to create, evaluate and prevent trafficking (Rizo et al., 2023). Prevention programs fill a need that is legally required by the state of California for public schools. These programs should continually be funded at the state and local levels to meet this societal need.

Conclusion

Given the great need to evaluate anti-trafficking preventive programs, this study sought to assess kM!’s short-term outcomes of participants’ understanding of sex trafficking victimization awareness and their willingness to advocate for others and themselves. Data was collected over a five-year period. These recommendations are essential to update kM! and maximize future impact. Moreover, the findings of this analysis can inform the current state-law mandate, HTPETA, and narrow current gaps to meeting the legislation’s intent at the state and local-levels. Some of these gaps include the lack of funding for implementation and robust evaluation designs of preventive anti-trafficking efforts.

Acknowledgments

The authors of this study would like to thank Drs. Janna Ataiants, Ahmand Khanijahani and Qi Yongyue for their invaluable expertise and feedback in the analysis process of this evaluation. Appreciation is also given to Dr. Shanti S. Kandala for her support in the qualitative data processing. They also want to extend their thankfulness to the subject-matter experts who first dreamt of the kNOw MORE! (kM!) Human Trafficking Prevention Program and brought it to life, including Dr. Jamie Gates and Catherine Schrock. Appreciation goes to the UBS Optimus Foundation and the Office of the San Diego District Attorney, Summer Stephan, for their support in founding the San Diego Trafficking Prevention Collective, which helped the kM! program gained a firm foundation in our community. To the survivors who continue to tell their story to help youth understand the risks of trafficking, they extend their deepest appreciation. And to the actors and facilitators who bring the program into the classroom and interrupt exploitation, they salute you! Last, but not the least, great appreciation is given to all the participants who provided their feedback through the kM! assessment tool.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The funding for this research project includes funds from private foundations and donors, the UBS Optimum Foundation # PCI-1402-SG-4002-00, and the County of San Diego.

Notes

¹ The kNOw MORE! Human Trafficking Prevention Program is copyrighted—2021 Point Loma Nazarene University.

² A previous state bill (S.B. No. 1165) was introduced and passed in 2014. However, this law only included sex abuse and sex trafficking into the prevention curricula of the “Health Framework of California Schools”