Photo courtesy of Ami Mitchell
Society harbors many myths about human trafficking, including a perception that, when in public, victims will actively seek help. Instead, studies show that even in healthcare settings, where providers are well-positioned to connect victims with services and may have specialized training to recognize signs of abuse, both disclosure and detection of human trafficking are rare. The same is true for victims of domestic violence and intimate partner violence (DV/IPV). Victims of abuse are often trapped in a vicious cycle of fear, shame, and distrust that prevents them from revealing their true circumstances. thermal stickers
Last spring, students enrolled in the course Communication Strategies for Public Health (SB806) at the School of Public Health collaborated with the Tennessee Department of Health (TDH) to address this problem. At the invitation of the course instructor Jacey Greece, clinical associate professor of community health sciences, Ami Mitchell, South Central regional director at TDH, challenged the students to develop strategies to encourage individuals who might be experiencing abuse to confide in health department staff.
Over the course of the 14-week semester, the students assumed the role of real-world public health consultants, says Greece. They spoke with clinic staff to better understand clinic operations, attended educational seminars on human trafficking in Tennessee, and conducted interviews with key stakeholders. The students’ efforts culminated in proposals so promising that Mitchell adopted some of their ideas and implemented them at all the local health departments in her 12-county region.
One particularly notable intervention is a simple, new disclosure process that TDH calls Red Dot to Disclose (RDD). Signs hung in specimen collection restrooms explain that patients can place a red dot sticker on their specimen cup before placing it in the collection window. The sticker will indicate to healthcare providers that the patient: a) does not feel safe in their current relationship, b) is being hurt or threatened, and/or c) is being forced to do something sexual. Providers then ensure the patient is escorted to the exam room alone and receives the appropriate assessments and referrals.
The process leverages an already private space and a common clinical procedure to give patients the utmost discretion in their decision to disclose, says Aubree McMahon (SPH‘23), who together with classmates Carly Batt (CAMED’23,’27, SPH’23), Annesta Batuwangala (SPH‘23), Hannah Knapp-Broas (SPH‘24), and Kira Levenson (SPH‘24) proposed the idea underlying RDD. The students originally titled their project DISCLOSE to stand for “discrete information sharing,” McMahon says. DISCLOSE also called for patients to write their initials in red marker to initiate the disclosure process, however, when TDH translated the intervention into practice, the marker became a sticker.
“But I like Red Dot to Disclose,” says McMahon. “It is a little catchier.”
This past summer, Mitchell rolled out RDD across the South Central Region, a mainly rural area that also encompasses the city of Chattanooga. If a year-long pilot there proves successful, she says, TDH plans to expand the initiative state-wide.
“I have been fortunate to be able to collaborate with students in [Greece’s] SB806 class several times over the years,” says Mitchell, who first met Greece at a workshop Greece held on practice-based teaching at the American Public Health Association Annual Meeting in 2019. “It has been a real asset to the local health departments I work with to apply the ingenuity of her students to real-world problems. Having the students as consultants on the challenges facing rural Tennessee [and] in our work to implement public health programs has proven incredibly powerful.”
Greece, who worked as a public health consultant herself before transitioning to academia, has long been a major proponent of practice-based teaching. She recalls a moment 10 to 11 years ago when she was reading her students’ assignments and the thought occurred to her, ‘These are phenomenally written—they are really innovative—but they are all theoretical and they are sitting on my computer for a grade for a class. Wouldn’t it be amazing if I could take the classroom, turn it into a consulting firm and allow organizations and communities the benefit of receiving these products, the deliverable to these assignments, that the students have to do for class?’
In 2020, Greece and James Wolff, associate professor of global health, created Collaborate.Health to facilitate and showcase partnerships between community organizations and classrooms that tackle pressing real-word public health problems, such as the collaboration between SB806 students and TDH.
“Having that experience in this class was really formative,” says McMahon, who is now a doctoral student in public health at the University of Pittsburgh. As part of her coursework this spring, she says she plans to use the materials that she and her classmates developed in SB806 to conduct a comprehensive evaluation plan for RDD. She hopes to continue collaborating with Mitchell to look at the fidelity of RDD’s implementation and changes in the attitudes and knowledge among patients and clinic providers exposed to the intervention.
McMahon says that while experiential learning can sometimes feel chaotic—she notes SB806 was one of the most challenging courses she has ever taken—she aims to include it in her own teaching practices as future faculty at a school of public health.
“The passion and ideas that we had are going to do something, and as a student, that is something we do not always necessarily think about—the idea of something that we contributed to theoretically and conceptually ever touching someone’s life,” says McMahon. “It has definitely changed the energy with which I approach my work.”
Red Dot to Disclose: Students Inform Intervention to Help Victims of Abuse
Megan Jones is the writer and editor focusing on school news at the School of Public Health. Profile
Boston University moderates comments to facilitate an informed, substantive, civil conversation. Abusive, profane, self-promotional, misleading, incoherent or off-topic comments will be rejected. Moderators are staffed during regular business hours (EST) and can only accept comments written in English. Statistics or facts must include a citation or a link to the citation.
Your email address will not be published. Required fields are marked *
order cardboard boxes Get the latest from Boston University School of Public Health