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Background: Runaway, sexually victimized adolescents require evidence-based interventions focused on reducing trauma symptoms, fostering healing, and promoting healthy development. The Runaway Intervention Program (RIP), a nurse designed and led intervention, aims to support runaway adolescents (≤ 17 years) who have experienced sexual violence, including sexual exploitation. The program is theoretically informed by developmental traumatology, resilience theory, and positive youth development. Although previous studies have demonstrated evidence of the RIP’s effectiveness, its theoretical framework has not been tested. Aim: This dissertation aimed to test the RIP theoretical framework. Methods: Ten years of administrative and questionnaire data from RIP participants (N = 666) were analyzed using growth curve and parallel process models. These models examined: 1) changes in participants’ protective factors (maternal support, school connectedness, other caring adults) and health outcomes (emotional distress, substance use) from program entry up to 24 months; 2) relationships between intervention elements (nurse visits, nurse case management, parent visits, empowerment group sessions) and participants’ protective factors; 3) whether increases in protective factors contributed to improvements in health outcomes; and 4) whether the theoretical framework functioned similarly for sexually exploited and non-sexually exploited adolescents. Results: The emotional distress parallel process models showed that increases in the growth rate of each protective factor contributed to decreases in the growth rate of emotional distress, and three intervention elements (nurse visits, empowerment group sessions, parent visits) contributed to increases in protective factors. The substance use parallel process models showed similar patterns. The growth rates of school connectedness and other caring adults contributed to decreases in the growth rate of substance use, and the same three intervention elements contributed to increases in protective factors. Despite sexually exploited participants having statistically significantly higher emotional distress and substance use and lower protective factors at program entry, the theoretical framework functioned similarly for sexually exploited and non-sexually exploited adolescents. Conclusion: The analyses consistently reproduced the RIP’s theorized mechanisms of effect; providing provisional support for the RIP theoretical framework. Sexually exploited adolescents may need longer interventions to meet their unique needs. Parallel process modelling served as a rigorous approach for testing this complex theoretical framework. |
