A nurse intervention program that helps sexually exploited runaway girls re-connect to family, school and health care reduces trauma and restores healthy behaviors, according to a new study led by University of British Columbia researcher Elizabeth Saewyc and Children's Hospitals and Clinics of Minnesota nurse practitioner Laurel Edinburgh.
The study, published online this month in the Journal of Adolescent Health, and due out in print later this year, examined the effects of the Runaway Intervention Program (RIP) at Children's Hospital in St. Paul, Minnesota. Girls and their families reported significant improvements in family and school relationships, self-esteem and grades after participating in RIP. The researchers also found significant reductions in emotional distress, substance use, suicide attempts, and risky sexual behaviors.
"Runaways often become isolated from supportive family and school relationships, which are important for healthy development," says Saewyc, a professor in UBC's School of Nursing who also holds a Canadian Institutes of Health Research (CIHR) Public Health Chair in Youth Health. "When they are also sexually assaulted or exploited, where can they turn for help in coping with the trauma? RIP was designed to reintroduce protective relationships back into young girls' lives and help them heal."
Through the intervention program, nurses worked beyond the clinic to support girls and their families with home and school visits. In addition to providing health exams and health education, they used creative problem-solving strategies to improve communication between family members, help girls stay in school, and find the support they need to be healthy.
"Remarkably, by six and 12 months into the program, the girls had improved so much that in most areas they were indistinguishable from girls in school who had never been abused," says Saewyc, who is also a scientist at the Child & Family Research Institute at BC Children's Hospital.
Edinburgh attributes the program's success to the individualized approach to health care, which may include interfacing with law enforcement and community services.
"Every runaway girl has a unique set of circumstances, issues and needs and therefore require individualized intervention in order to restore a supportive environment that would help them heal," says Edinburgh. "These could range widely from working with the school's police officer to make the school a safe environment, free from threats of gang members to helping find free piano lessons as a reward for ongoing school attendance.
"A vital element of the program is utilizing the specialized training of nurses to bring well-rounded health care to these girls, identifying their unique issues and working with each girl - and their support networks, including family, school and the community - to address them head on."
"CIHR understands the importance of helping sexually exploited runaway girls reconnect with family members and return to school to ensure positive and healthy development," says Dr. Joy Johnson, Scientific Director of CIHR's Institute of Gender and Health, which helped fund the study. "Abuse has a devastating effect on people's lives, so it is essential to invest in programs that give victims an equal chance of success and hope for the future."
About Children's Hospitals and Clinics of Minnesota
Serving as Minnesota's children's hospital since 1924, Children's Hospitals and Clinics of Minnesota is the seventh-largest pediatric health care organization in the United States, with 332 staffed beds at its two hospitals in St. Paul and Minneapolis. An independent, not-for-profit health care system, Children's of Minnesota provides care through more than 14,000 inpatient visits and more than 200,000 emergency room and other outpatient visits every year. Children's is the only Minnesota hospital system to provide comprehensive care exclusively to children, and in 2008 was ranked among the best pediatric hospitals by U.S. News & World Report.
About the Canadian Institutes of Health Research
The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health-care system. Composed of 13 Institutes, CIHR provides leadership and support to more than 13,000 health researchers and trainees across Canada. www.cihr-irsc.gc.ca