Appendix B_ACF Responses - Public Comments SYTFC

Appendix B: Survey of Youth Transitioning from Foster Care: Public Comments and Responses (Full original comments begin on page 24)
Comment
Comment
Source
General Comments/ Protocols
Covenant
Recommendation: Treat youth with respect. Explain survey
House
purposes and use of adults. Solicit feedback.

Response
The research team will treat youth will respect and clearly describe the study
purposes. All interviewers will undergo training on field procedures.
Survey questions have been reviewed by three expert consultants (survivor
advocates) who all work directly with trafficking survivors with diverse experiences
and backgrounds.
Interviewers will be from the contracting organization, RTI International; no
interviewers will be familiar to survey respondents. The field interviewers will
follow an IRB-approved distressed respondent protocol which outlines procedures
and available resources should a young person become distressed.

Covenant
House

Recommendation: Interviewer be someone the youth didn’t know.
However, it is important to have someone on hand who can
comfort the youth and provide appropriate referrals if necessary.

Chapin Hall
at the
University
of Chicago

Even as we endorse the prospect of collecting data on transitionage youth (TAY), we respectfully suggest that this information
collection activity might utilize existing infrastructure for the
collection of survey data from TAY who are or were in foster care…
Thus, for practical and burden-reducing purposes, it might make
sense to add questions on human trafficking and other
victimization experiences to the NYTD outcome survey, rather than
to create a separate initiative to sample and survey the same
population.

In the Survey of Youth Transitioning from Foster Care, young people will be asked
questions that will allow ACF to identify the prevalence of human trafficking among
youth transitioning from foster care; the risk and protective factors associated with
increased or decreased risk of trafficking victimization, respectively; and the
context surrounding victimization among youth in foster care. Adding these
questions to the NYTD outcome survey would be time and resource prohibitive. In
addition, this survey will oversample youth at increased risk of trafficking
victimization in order to collect data on a relatively rare event; this would not be
possible with the NYTD sample.

If this addition to the NYTD is infeasible, other strategies to
minimize burden and maximize participation and representation
include automation, the use of financial incentives, and utilizing
existing venues were youth are present (i.e., ensure youth
participation in survey and question design; youth advisory board;
child and family teams).
Regardless of the venue for the survey, we believe and advise that
youth input and expert participation in design are critical to
feasibility, reliability, and validity of all forms, but especially social
validity, which will influence youth response rates and patterns.

Strategies to minimize burden and maximize participation will be used. Expert
consultants (including survivor expert consultants) provided feedback on
recruitment methods to increase participation. Financial tokens of appreciation will
be provided to respondents.

Chapin Hall
at the
University
of Chicago

Expert consultants (including survivor expert consultants) provided feedback on
recruitment methods to increase participation; these expert consultants all work
directly with trafficking survivors with diverse experiences and backgrounds.

1

Comment
Source
Chapin Hall
at the
University
of Chicago

Freedom
Network
USA
(FNUSA)
FNUSA

FNUSA

FNUSA

Children's
Law
Center of
California
(CLC) and
the
National
Center for
Youth Law
(NCYL)

Comment

Response

An additional factor to consider in designing a data collection
strategy is the reality that states have struggled to reach the
federally required response rates for 19 and 21 year olds in the
NYTD survey. In part, this occurs because many of the 19 year-olds
and nearly all of the 21 year-olds are no longer in foster care. Data
collection specifications might detail whether proposed
engagement of youth aged 18 or 19 who were in foster care at age
17 includes both youth in extended foster care and those who
opted out of extended foster care. While it would be considerably
easier to access only those youth still in care, the latter group may
be more likely to be at risk for or have experienced trafficking.
In conducting an evaluation and developing policies and
procedures of these systems, then, it is critical to ensure that the
needs, experiences, and vulnerabilities of immigrant and refugee
youth are included in the development of policies and procedures.
We recommend asking all participants if there are any
accommodations that would assist them in completing the survey
at the beginning of the interview. We have tried to include specific
comments and recommendations regarding these issues, and also
encourage specific review by disability experts to ensure that all
recommendations are inclusive.
We also strongly encourage all interviewers to ensure that they
ask the youth to identify their names and pronouns at the onset of
the interview. And to ensure that they use the correct name and
pronouns throughout the interaction.
It is also important to point out at the onset, and on multiple
occasions during the interview, that the participants can decline to
answer any one or many of the questions.

Young people aged 18 or 19 who were in foster care at age 17 includes both youth
in extended foster care and those who opted out of extended foster care. The
contractor will use strategies to access youth who are not in foster care at the time
of the survey.

We suggest adding language to the survey instrument that
recognizes that some youth engage in commercial sex not at the
behest or coercion of a third party, but in order to meet their basic
needs, such as food, clothing and shelter (otherwise known as
“survival sex”).

Immigrant and refugee youth will be included in the Survey of Youth Transitioning
from Foster Care to the extent they are represented in the child welfare agencies
selected for participation in the study.
At the beginning of the survey, field interviewers will ask respondents if there are
accommodations that would assist them in completing the survey.

At first contact, field interviewers will ask respondents to identify their names and
pronouns.

The consent form will note that respondents can decline to answer any one or all of
the questions in the survey.
Tokens of appreciation will be provided to all respondents, regardless of whether
questions are skipped.
Text will be included in the consent form to clarify the multiple reasons why youth
may engage in commercial sex.

2

Comment
Source
CLC and
NCYL

Comment

We suggest deleting the language stating “You will not get any
personal benefit…” Participants will be receiving financial
compensation; also, some youth may feel personal satisfaction in
being able to tell their story.
CLC and
The second paragraph of the survey instrument currently states
NCYL
that the interviewer or project staff may report the situation if
they believe the participant’s life or health may be in danger.
Please clarify what will happen if the staff believes the participant
is a danger to others. Also, giving examples may be helpful in
illustrating the circumstances where this would come into play.
CLC and
The survey instrument states youth may refuse to participate or
NCYL
stop participating without penalty or loss of benefits. Please clarify
whether participants get to keep the financial compensation if
they do not complete the survey.
Demographics and Health
CLC and
Consider broadening Mexican, Mexican American to Central
NCYL
American, unless there is a specific reason that information about
Mexican nationality or heritage is needed.
CLC and
Include an option for mixed race or allow participants to select
NCYL
multiple races.
FNUSA

While these questions are commonly used in the US to capture
racial and ethnic identities, they do not generally capture the
identities of immigrants and refugees. We recommend asking for
the national origin of the participant to better capture the
identities of participants from immigrant and refugee families.

Response
Text will be added more fully describe the potential benefits to participating in the
study.

The consent form will be clear about the situations in which a field interviewer or
other study staff may break confidentiality. The only exceptions to the promise of
confidentiality are if a respondent tells the field interviewer that they intend to
seriously harm themselves or someone else, or if a child has been or will be
seriously harmed.
Tokens of appreciation will be provided to all respondents, regardless of whether
questions are skipped or the respondent declines to finish the survey.

Racial and ethnic categories used in the survey are consistent with the standards
on the classification of federal data on race and ethnicity from the Office of
Management and Budget (OMB).
Racial and ethnic categories used in the survey are consistent with the standards
on the classification of federal data on race and ethnicity from the OMB.
Respondents can select one or more races.
Citizenship status may affect youths’ options for education and employment, and
thus their risk of human trafficking, so it is related to the study objectives.
The following items have been added, all drawn from the third cohort of the
National Survey of Child and Adolescent Well-being (NSCAW III):
• “Were you born in the United States? The United States includes the 50 states
and the District of Columbia, but not US territories. (yes/no)”
• (if no) “In what country were you born? (list of 12 countries and
other/specify)”
• “How many years all together have you been living in the U.S.? (years)”
• “Are you a citizen of the United States?
• Yes, born in the United States
• Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern
Marianas
• Yes, born abroad of American parent or parents
• Yes, U.S. citizen by naturalization
• No, not a citizen of the United States”

3

Comment
Source
FNUSA
CLC and
NCYL
FNUSA
FNUSA
CLC and
NCYL

CLC and
NCYL

Comment

Response

Also, it is almost certainly a typo, but White is combined with
Don’t know/Not sure, but should be separate.
Consider separating this into two questions, one asking whether
the participant is enrolled in school and one asking whether the
participant is attending school.
Consider deleting Questions 5 and 7, as Question 6 should get the
same information.
Consider deleting Questions 4-7, and add the options High School
Diploma and GED to the answer options.
Also include the term “community college,” as in some states that
terminology is more commonly used than junior college. If
response to 8 is “yes,” consider asking: What subject area did you
study in college, junior college, or community college?

This typo has been corrected in the Demographics section of the survey.

Following question 10 in this section, or in a separate, additional
section (such as “Educational Experiences and Aspirations”)
consider including questions about the participant’s educational
experiences, school engagement, school supports, and future
educational and career aspirations. Asking such questions would
provide researchers with an opportunity to examine potential
correlations between educational experiences and outcomes for
youth in foster care, and would also provide an opportunity to
identify areas in which child welfare agencies and other service
providers could offer support and resources to youth in planning
for their futures. For example, consider adding questions such as
the following: “Do you plan to continue school after completing
[highest school level attended to date]?”; “What is the highest
level of school you plan to attend?”; “If you plan to attend junior
college, community college, college, and/or graduate school, what
would you like to study?”; and “Once you are done with school,
what type of job would you like to have?

This question has been split into two:
“Are you currently enrolled in school? (yes/no)”
“Are you currently attending school? (yes/no)”
Questions A5 and A7 have been removed from the survey.
Question A4 has been broken into two questions and A5 and A7 have been deleted.
Question 6 has been retained.
“Community college” has been added:
“Have you attended college, community college, or junior college?”
A question around subject of study was not added; this question would add
respondent burden without being key to answering the primary research
questions.
This was considered but ultimately not added; this question would add respondent
burden without being key to answering the primary research questions. Of note,
several sections (e.g., Social Support; Internal Assets) contain related questions on
supports and aspirations.

4

Comment
Source
CLC and
NCYL

CLC and
NCYL

CLC and
NCYL

Comment

Response

In addition, if responses to questions 5 and 7 are “no,” consider
adding a question asking why the participant did not complete
high school, such as: “The reason I did not finish high school was…”
with a response scale listing possible reasons such as “I didn’t like
school,” “I didn’t get the support I needed,” “I dropped out to
work,” “I had to take care of my siblings,” “It was too hard,”
“Other (specify),” “Don’t know / Not Sure,” and “Choose not to
answer.”)

A question was added for youth who report not completing high school. This
question (stem) and majority of response options was drawn from the National
Center for Education Statistics’ High School Longitudinal Study of 2009. Several
additional response options were drawn from a review of reasons why youth leave
high school [Doll, J. J., Eslami, Z., & Walters, L. (2013). Understanding why students
drop out of high school, according to their own reports: Are they pushed or pulled,
or do they fall out? A comparative analysis of seven nationally representative
studies. Sage Open, 3(4), https://doi.org/10.1177/2158244013503834]

Also consider adding a question around school supports, such as:
“When I was in school, I felt like I had the support I needed to
learn…” (response scale: “All of the time,” “Most of the time,”
“Some of the time,” “Never,” “Don’t know / Not sure,” and
“Choose not to answer.”)
Also consider adding a question around school engagement, such
as: “When I was in school, I felt engaged and excited to learn…”
(response scale: “All of the time,” “Most of the time,” “Some of
the time,” “Never,” “Don’t know / Not sure,” and “Choose not to
answer.”)

“Here are some reasons other people have given for leaving high school. Which of
these would you say applied to you? (select all that apply)
• You missed too many school days.
• You couldn’t work and go to school at the same time.
• You did not like school.
• You were getting behind in your schoolwork or getting poor grades.
• You thought it would be easier to get a GED or alternative high school
credential.
• You were suspended or expelled.
• Your friends had dropped out of school.
• You did not feel like you belonged there.
• You didn’t need to complete high school for what you wanted to do.
• You changed schools and did not like the new one.
• You had to take care of or financially support your family.
• You had to financially support yourself.
• You were pregnant.
• You became the father or mother of a baby.
• You wanted to gain early admission to a school that provides occupational
training or a college.”
This was considered but ultimately not added; this question would add respondent
burden without being key to answering the primary research questions.

This was considered but ultimately not added; this question would add respondent
burden without being key to answering the primary research questions.

5

Comment
Source
FNUSA

FNUSA

Comment

Response

The responses are a combination of locations (outside, jail, etc.)
and relationships (with friends). Consider making the two things
separate and allow multiple choices, so that a participant could
choose Home and With Friends (for a participant who is now living
with their friend’s family) or Shelter and With Family (for a
participant who is living with their family at a homeless or
domestic violence shelter).
The question suggests you are asking about feelings of safety only
while sleeping, and specifically excluding feelings of safety while in
the same location but while awake. This may be intentional, in
which case consider adding another question about feelings of
safety during this time period but while awake.

This question now first asks about location slept, and then the types of
people/relationships the respondent may have ran to or saw when they were
kicked out.

CLC and
NCYL

It is not clear whether this question is referring to physical health,
or mental health, or both. It would be helpful to have separate
questions for physical and mental health.

FNUSA

Consider deleting the phrase, “Because of a physical, mental, or
emotional condition” as this does not seem to add anything to the
question (since it is not limited to diagnosed conditions) but does
seem to add some judgment about having a ‘condition’ which may
discourage affirmative responses.

CLC and
NCYL

The words “you first had” are repeated.

This question intends to focus on feelings of safety while sleeping; this orients
respondents to a clear time period –episodes of at least a night or longer. A
question about perceived safety while awake was considered but ultimately not
added. Youth may spend time in multiple places while awake on any given day, so
that asking about this would require a complex line of questioning, and add
respondent burden.
No changes were made; this question is from an existing, validated measure
recommended by expert consultants:
Hamby, S., Grych, J., & Banyard, V. L. (2015). Life Paths measurement packet:
Finalized scales. Sewanee, TN: Life Paths Research Program.
http://www.lifepathsresearch.org/strengths-measures/
No changes were made; this question is consistent with HHS data collection
standards (see: HHS Implementation Guidance on Data Collection Standards for
Race, Ethnicity, Sex, Primary Language, and Disability Status;
https://aspe.hhs.gov/basic-report/hhs-implementation-guidance-data-collectionstandards-race-ethnicity-sex-primary-language-and-disability-status). According to
the guidance, the items used in the American Community Survey (ACS) is the data
standard for survey questions on disability, and the questions and answer
categories should not be changed.
The repeated words have been removed.

6

Comment
Source
FNUSA

Comment

Response

Question A31- We strongly recommend removing this question
and replacing A31 and A32 with the proposed for Question A32.
Question A32- We strongly recommend restating this question as,
“What is your gender?” as gender is not something one thinks, it
is.

As recommended, wording changes were made to the question stem, guidance
from the HHS Data Council:
“How do you describe yourself? (check one)”

Also, we recommend adding the following options: Agender,
Genderqueer, Gender fluid, Transgender Male, Transgender
Female, Nonbinary, Intersex and Other (allow any answer). We
recommend allowing multiple choices. For more information, see
https://center.dso.iastate.edu/sites/default/files/Documents/Class
room/Asking%20about%20Gender%20and%20Sexuality.pdf.

CLC and
NCYL
FNUSA

Include “non-binary” as an answer option.

CLC and
NCYL

Consider asking a second question about gender of person(s) with
whom you most often engage in sexual activity, if any – such as
male having sex with male, female having sex with male – to
account for sexual behaviors, as distinct from sexual orientation or
identity.

We also strongly recommend adding a question about gender
expression. Youth are often bullied or abused for their gender
expression, which is likely to put them at increased risk of abuse
and exploitation, including human trafficking. We recommend
adding the question, What is your gender expression? With the
answer choices: Masculine, Feminine, Agender, Androgenous,
Nonbinary, Genderqueer, and Gender fluid. We recommend
allowing multiple choices.

The GenIUSS Group (2014). Best Practices for Asking Questions to Identify
Transgender and Other Gender Minority Respondents on Population-Based
Surveys. J.L. Herman (Ed.). Los Angeles, CA: The Williams Institute.
Response options include those from the HHS Data Council, expanded to be
inclusive of the way respondents may identify:
• “Male
• Female
• Transgender male
• Transgender female
• Other (for example, non-binary, genderqueer, gender fluid, or intersex)
• Choose not to answer”
See response above.
Gender expression is distinct from gender identity. Research has shown that
gender nonconforming youth are at increased risk of victimization and negative
behavioral health outcomes. A single item has been added, which is used in the
CDC’s Risk Behavior Surveillance System (YRBSS):
“A person’s appearance, style, dress, or the way they walk or talk may affect how
people describe them. How do you think other people at school would describe you?
• Very feminine
• Mostly feminine
• Somewhat feminine
• Equally feminine and masculine
• Somewhat masculine
• Mostly masculine
• Very masculine”
For this survey, the words “at school” have been deleted from the question.
No changes made; of primary importance to this study are sexual orientation and
identity rather than the gender of the person with whom the respondent engages
in sexual activity.

7

Comment
Source
FNUSA

FNUSA

FNUSA

FNUSA

CLC and
NCYL

Comment

Response

We strongly recommend restating this question as, “What is your
sexual orientation?” as sexual is not something on thinks, it is.
Also, we recommend adding the following options: Asexual,
Pansexual, Queer, Questioning, and Same-Gender-Loving. We
recommend allowing multiple choices. For more information, see
https://center.dso.iastate.edu/sites/default/files/Documents/Class
room/Asking%20about%20Gender%20and%20Sexuality.pdf.

This question has been revised to be consistent with the question stem
recommended by the HHS Data Council and used in the YRBSS:
“Which of the following best describes you?”

Consider combining these into one question asking, “What is your
marital status?” with the answer choices from Question 36, but
add Domestic Partnership, which is a legal status in some states.
Note that someone can be married and dating (Question 34 directs
skipping this question for people who are married).
We recommend combining these questions to simply determine if
they have ever been pregnant, and the number of children they
are responsible for. Asking for the number of pregnancies and the
number of living children is overly intrusive, asks for highly
personal medical information without any clear relation to the
evaluation, and is likely to break any trust developed with the
interviewer.
More clarification is needed as to what is meant by “where you are
a parent or like a parent” and the goal of this question. Would this
include siblings for whom the participant is caring? If the
participant is living with one child of their own, and three other
children (siblings or
otherwise) for whom they are not caring/parenting, how would
they respond?

The response options mirror those used in the National Health Interview Survey,
with an expanded definition of “something else”:
• “Straight, that is, not lesbian or gay
• Lesbian
• Gay
• Bisexual
• Something else (for example, queer, questioning, pansexual, or asexual)
• Don’t know / Not sure
• Choose not to answer”
Domestic partnership has been added as a response option. The questions have
remained separate at the recommendation of a senior survey methodologist.
We recognize that someone can be married and dating; however, our primary
interest is whether someone is married (regardless of other relationships),
therefore, we kept this question as-is.
Questions asking the number pregnancies and living children have been removed
from the survey.

It is possible that a respondent is living with children (e.g., siblings) for whom they
are not responsible. Use of the phrase, “like a parent” increases the likelihood that
a respondent will be thinking about children (including siblings) for which they are
responsible.

8

Comment
Source
CLC and
NCYL

Comment

Following question 39 in this section, consider including several
additional questions about pregnancy and birth control. The
following four questions come from the Youth Transitions to
Adulthood Studies that Chapin Hall implemented in California,
Iowa, Illinois and Wisconsin:
Thinking of your most recent pregnancy, did you want/ intend to
get pregnant by partner? Definitely no; Probably no; Neither
wanted nor didn't want; Probably yes; Definitely yes.
Thinking of your most recent pregnancy, what was the month of
pregnancy you first saw a doctor? month 1; month 2; month 3;
months 4-6; months 7-9; did not receive prenatal care.
Frequency of birth control use during past year? None of the time;
Some of the time; Half of the time; Most of the time; All of the
time.
Frequency of condom use during past year? None of the time;
Some of the time; Half of the time; Most of the time; All of the
time.
System Involvement
FNUSA
Note that case closure ages vary by state, some allow youth who
entered the system prior to 18 to continue services for several
years.

Response
These questions were considered but ultimately not added; questions on
pregnancy and child-bearing are limited to those that are key to answering the
primary research questions.

Yes; this is recognized in the inclusion of two separate questions, allowing the
possibility that a young adult would still have an open case and be receiving child
welfare services.

9

Comment
Source
CLC and
NCYL

Comment

Response

More clarification is needed regarding what is meant by “most
recent time” and “same time in foster care.” For example, does
this refer to stays in out-of-home placement that are separated by
a return home, a stay in detention, a runaway/absent without
leave incident, or other interruption? In addition, this question
appears duplicative of question # 7.

The questions in this section have been re-organized. Questions no longer refer to
the “same time” in foster care.
These questions now read/are ordered:
“How old were you the very first time you were placed in foster care?”
“Throughout your life, what type of foster care placements have you had? Select all
that apply.
• With foster parent(s) who are unrelated to me
• With relatives who were also my foster parents
• In a group home or residential program
• In a foster care emergency shelter
• In an independent living apartment
• Placed somewhere else (specify)
• Don’t know / Not sure
• Choose not to answer”
“[for each kind of foster care placement selected]
• How many homes have you been in with foster parents unrelated to you?
Count every home or address you have lived in with unrelated foster parents.
• How many foster homes have you been in with relatives? Count every home or
address you have lived in with relatives.
• How many foster care group homes or residential programs have you been in?
• How many foster care emergency shelters have you been in?
• How many independent living apartments have you been in?
• How many (other specify) have you been in?”
“[if more than one type of placement selected)
Some young people stay in one foster care placement for a long time, and others
may stay for a short time or move between different homes or types of placements.
You said you have lived in (fill total number) (fill type of placements). Which kind of
placement did you stay in for the longest amount of time?”

FNUSA

FNUSA

Note that participants may not have met with the caseworker
after the placement. Consider adding an option that reflects this,
such as: “There was no opportunity to talk to the caseworker.”
This seems to overlap with Question A11. Consider deleting this
question.

“Altogether, how much time have you spent in foster care?”
Response option added, “I never met (in person, or remotely, such as on the
phone) my last caseworker.”
We are retaining both questions. One question is specific to foster care and the
other is not.

10

Comment
Source
CLC and
NCYL
FNUSA

CLC and
NCYL

Comment

Response

We support and encourage the inclusion of more questions of this
nature which get at the subjective experiences of individual youth
with system actors, such as their caseworkers.
Consider adding “current” before “caseworker” as the participant
may have had several caseworkers. Unless you mean to refer to all
of their caseworkers, in which case indicate that.
Distinguish between # of different foster homes and # of times in
foster care. Ask how many different foster care placements.

Questions capturing the subjective experiences of young adults with system actors
(e.g., caseworkers) were carried into the final version of the survey.
“Current” added:
“How well do you feel that your current caseworker or social worker understands
you and your situation? Would you say...”
The questions in this section have been re-organized; a question is now included
that asks about the number of different foster care placements respondents have
had:
“Throughout your life, what type of foster care placements have you had? Select all
that apply.
• With foster parent(s) who are unrelated to me
• With relatives who were also my foster parents
• In a group home or residential program
• In a foster care emergency shelter
• In an independent living apartment
• Placed somewhere else (specify)
• Don’t know / Not sure
• Choose not to answer”
“[for each kind of foster care placement selected]
• How many homes have you been in with foster parents unrelated to you?
Count every home or address you have lived in with unrelated foster parents.
• How many foster homes have you been in with relatives? Count every home or
address you have lived in with relatives.
• How many foster care group homes or residential programs have you been in?
• How many foster care emergency shelters have you been in?
• How many independent living apartments have you been in?
• How many (other specify) have you been in?”

11

Comment
Source
FNUSA

CLC and
NCYL

FNUSA

Comment

Response

Question B13- Note that participants may have had multiple
placements and/or been in foster care multiple times. Consider
clarifying this question or adding a second question to address
multiple placements, which are likely to be a risk factor for abuse
and exploitation.

The questions in this section have been re-organized; a question is now included
that asks about the number of different foster care placements respondents have
had:
“Throughout your life, what type of foster care placements have you had? Select all
that apply.
• With foster parent(s) who are unrelated to me
• With relatives who were also my foster parents
• In a group home or residential program
• In a foster care emergency shelter
• In an independent living apartment
• Placed somewhere else (specify)
• Don’t know / Not sure
• Choose not to answer”

The terms “illegal or delinquent offense” may be confusing.
Consider switching to “violating a law or a court order.” In
addition, in some places, youth may be taken into custody for
behavior that does not violate a specific law or is a status offense,
such as violating curfew, missing school, “running away” or leaving
care without permission, or for their own protection. If those types
of arrests or custodial situations are meant to be included in this
question and the following questions
(through # 21), more clarification is needed.
Question B15- Consider deleting the phrase. “for an illegal or
delinquent offense” if you are asking about all arrests, or clarify
what type of arrest you are excluding. It is likely that participants
have been arrested or taken into custody when they feel that they
did not do anything wrong. I suspect that you want to capture
these arrests, but this wording might make the participants feel
defensive or they may not count arrests that they felt were unfair.

“[for each kind of foster care placement selected]
• How many homes have you been in with foster parents unrelated to you?
Count every home or address you have lived in with unrelated foster parents.
• How many foster homes have you been in with relatives? Count every home or
address you have lived in with relatives.
• How many foster care group homes or residential programs have you been in?
• How many foster care emergency shelters have you been in?
• How many independent living apartments have you been in?
• How many (other specify) have you been in?”
These items were minimally adapted from a survey that is a major source of
comparable data (National Longitudinal Survey of Youth [NLSY]). Clarifying
language has been added:
“Have you ever been arrested by the police or taken into custody for an illegal or
delinquent offense? That is, for violating a law or court order? Please do not
include arrests for minor traffic violations.”

See response above.

12

Comment
Source
FNUSA

CLC and
NCYL
FNUSA

CLC and
NCYL
CLC and
NCYL

Comment

Response

Question B16- Consider combining this with Question 15 by
reframing as, “How many times have ever been arrested” with the
first option being Never or Zero.
Add prostitution or related offenses (ex. solicitation), given that in
approximately half of U.S.
states, youth under 18 may still be arrested for prostitution.
Consider adding the following optional responses: Other sex
offenses, Prostitution-related offenses, Domestic Violence,
Stalking, Child Abuse, Violation of a Protective Order, Gang-related
offenses.

These items were minimally adapted from a survey that is a major source of
comparable data (NLSY). To retain ability to compare to NLSY, these items have not
been combined.
A response option for prostitution has been added:
“Prostitution or a related offense, such as soliciting or loitering”

Clarify what is meant by “that time.”

In some cases, youth may be under the custody of the dependency
system (child welfare) and the delinquency system (juvenile
justice) at the same time. It therefore may be difficult or
impossible for a youth to distinguish when an out-of-home
placement was through the juvenile justice system rather than the
child welfare system. For youth involved in both systems
simultaneously, the questions regarding placement through the
child welfare system (#3-14) may overlap or produce duplicative
information with the later questions regarding placement through
the juvenile justice system (#37-41). In addition, more clarification
may be needed to distinguish between questions asking about
time spent in a juvenile detention facility due to a sentence (#3032) and out-of-home placement through the juvenile justice
system (#37-41).
FNUSA
Consider also asking if the participant is a registered sex offender,
which would also limit many of their options for housing,
education, and employment.
FNUSA
Also consider asking about the participants’ feelings about their
interactions with the legal system, was it fair?, were they properly
represented?, did they understand what was happening?, were
they abused by police officers or officers of the court or
corrections officials? Perceptions of fairness can affect the impact
of the experience and cause participants to engage in either more
or less criminal activity.
Social Support

The following response options have been added:
• “Prostitution or a related offense, such as soliciting or loitering”
• “Domestic violence or stalking”
• “Violation of a protective order”
• “Gang-related offense”
• “Child abuse”
“That time” has been deleted.
It is possible that youth may not be able to distinguish when an out-of-home
placement was through the juvenile justice system rather than the child welfare
system. However, the item has been revised to be clearer (increasing the likelihood
that a respondent will answer about a placement through the juvenile justice
system):
“Before you were eighteen, were you ever placed out of home by [juvenile justice
agency] in a group home, that is a community placement for young people who had
committed delinquent offenses?”

This was considered but ultimately not added; this question would add respondent
burden without being key to answering the primary research questions.
These questions were considered but ultimately not added; these questions would
add respondent burden without being key to answering the primary research
questions.

13

Comment
Source
FNUSA

FNUSA

CLC and
NCYL

CLC and
NCYL

Comment

Response

Consider changing Brother or sister to Sibling, husband or wife to
Spouse, and Boyfriend/girlfriend to Dating Partner to be inclusive
of all genders. Consider adding Pastor, priest, imam, or other
religious figure, and Boss or Coworker to the options.

Revisions have been made to be more inclusive: all instances of brother/sister have
been changed to sibling; husband/wife to spouse; and boyfriend/girlfriend to
partner.

Consider collapsing these questions together. It seems unlikely
that the responses to these questions would be completely
different.
In response scale, consider broadening the option “Teacher,
counselor or coach” to “Teacher, counselor, school staff member,
or coach.” Also, should “counselor” in this option be “school
counselor”? “Counselor” is also included in the following option,
“Therapist, counselor or doctor,”
which may be confusing.
The methods of communication listed are not exhaustive. Consider
revising to, “During the past 3 months, since [REFERENCE DATE]
how often have you communicated with your parents, brothers or
sisters, or other people related to you by birth or adoption, for
example by speaking to them, texting, emailing, or visiting?”

FNUSA

Question C10- Consider changing brother or sister to sibling to be
inclusive of all genders.
External Assets
CLC and
Include Supervised Independent Living Placement (SILP) payments.
NCYL
FNUSA
Consider adding domestic violence or other emergency shelter to
homeless shelter. Also consider adding runaway and homeless
youth shelters.

CLC and
NCYL

Change spouse to partner or add partner to list.

Also added as response options are “pastor, priest, rabbi, imam or other religious
figure”; and “boss and coworker.”
Separate questions have been retained; it is possible that respondents may have
more support in one area of their lives (e.g., lending financial support) rather than
others (e.g., talking about something private).
Revisions have been made; response options now include:
“Teacher, school counselor, school staff member, or coach”

Revisions have been made to be more inclusive to the various modes of
communication:
“During the past 3 months, since [REFERENCE DATE] how often have you
communicated with your parents, siblings, or other people related to you by birth or
adoption, by – for example – speaking, texting, emailing, messaging or posts on
social media, or visiting?”
All instances of brother/sister have been changed to “sibling.”

Supervised Independent Living Placement (SILP) payments have been added.
Runaway has been added to the item on homeless shelters:
“During the past 12 months, did you spend at least one night in a runaway or
homeless shelter?”
An item was added about domestic or other emergency shelter:
“During the past 12 months, did you spend at least one night in a domestic violence
or other emergency shelter?”
This item has been revised to read:
“During the last three months, have you received…Financial help from a relative,
friend, partner or spouse?”

14

Comment
Source
CLC and
NCYL

Comment

This is an opportunity to capture information about potential
trafficking or exploitation. For example, if a youth considers their
trafficker to be their boyfriend, they may indicate that they are
receiving financial help from that person. Although this may be
captured later in the section on Human Trafficking, if the
participant does not consider their situation to be one of
trafficking or victimization, including questions in other parts of
the survey may provide insight or information that would not
otherwise be captured.
Community Services
CLC and
Provide clarification about who the participant tried to get help
NCYL
from. If this is focused on community resources only, that should
be specified. It may also include a family member, a friend, a
system actor (such as a social worker), a trafficker, or others.

Runaway or Experiences being Kicked Out
FNUSA
Title of the section should be changed Runaway and Homelessness
Experiences (as ‘Throw out’ has a negative connotation and could
make the participants feel defensive and disinclined to continue
the survey.)
CLC and
Add an option for “feeling dissociated, or like you were outside of
NCYL
your own body.” This is a common traumatic stress reaction that
many youth experience both during and after severe trauma,
such as trafficking.
CLC and
Add “in the home” – Someone in the home hit, kicked or beat you.
NCYL
CLC and
Change “my” to “your.”
NCYL
FNUSA
Change ‘my parents’ to ‘your parents’

Response
An additional question was considered but ultimately not added; victimization is
captured in another section of the survey.

These items have been revised to all focus on community resources. The lead-in to
the questions reads:
“The next set of questions about trying to get help for various reasons. Here, think
about trying to get help from community resources. In this survey, community
resources mean organizations that serve a particular area or group of people by
providing help and tools to help the community grow and improve the quality of life
for people in that community.
When you answer these questions, think about trying to get help from
organizations – for example, calling a homeless or runaway shelter, trying to get
services at hospital or other community health or mental health organization, and
talking with someone at or filling out an application for a social service program like
TANF (financial assistance program) or SNAP (food supplement program).”
Respondents will not see the title of each section.
All instances of the phrase “thrown out” have been replaced with “kicked out or
told to leave,” following consultation with survivor expert consultants.
These items were retained as-is; items are from a validated scale, the PTSD
Checklist – Civilian Version, 6-item version (PCL-C).

This item was retained as-is; the violence is not specific to inside the home.
This change has been made.
This change has been made.

15

Comment
Source
FNUSA

CLC and
NCYL

CLC and
NCYL

Comment

Response

Consider adding:
You wanted to make money.
You joined a religious or cultural group that took you in.
Your home was not a safe place.
You wanted to be with your family members.
You were forced to work.
You were not allowed to go to school or work.
You were forced to follow religious practices you did not agree
with.
Your neighborhood was not safe/you fled a gang or religious
group.

The suggested options have been added:
• “You wanted to make money
• Your home was not a safe place
• You were forced to work
• You were not allowed to go to school or work
• You were forced to follow religious practices you did not agree with
• Your neighborhood was not safe
• Someone threatened to hurt you or told me you that you would be in
trouble if you did not run away.
• You refused to do something your family wanted you to do (for example,
sell your body, have sex with someone you did not want to) (kicked out
only)”
• Your family hurt you and you tried to stop them or fight back (kicked out
only)”
The following option has been added:
“Someone threatened to hurt me or told me I would be in trouble if I did not run
away.”

Add option for “someone threatened to hurt me or told me I
would be in trouble if I did not run away.” Youth who are
experiencing exploitation may cycle in and out of the exploitative
situation, moving from home or care to the trafficker/exploiter or
the “life,” multiple times. In some cases, youth are encouraged or
threatened by a trafficker/exploiter to leave home or care.
This is an opportunity to capture information about familial
trafficking or abuse. Consider adding an option such as “You
refused to do something your family wanted you to do (ex. sell
your body, have sex with someone you did not want to),” or
something more direct, such as “Your family abused you or hurt
you and you tried to stop them or fight back.”

The following options have been added:
“You refused to do something your family wanted you to do (for example, sell your
body, have sex with someone you did not want to)”
“Your family hurt you and you tried to stop them or fight back.”

16

Comment
Source

CLC and
NCYL
CLC and
NCYL

Comment

Response

Same comments as # 22 d-f. Also, add an option for being
encouraged or threatened by a trafficker/exploiter to leave home
or care. In addition, some youth leave care for short periods of
time if they are triggered and need a break, or to engage in
developmentally appropriate behaviors,
such as taking a walk to calm down or hanging out with friends
after school, that are not allowed under the rules of the out-ofhome placement. Consider adding options to capture those
behaviors.
Also, in some places, short “breaks” (where a youth is away for
only hours or a day or two) are recorded as runaways or absences
from placement without leave. Consider adding a separate
question regarding the length of time away from placement to
better understand whether the behaviors are short or longer term.

The following option has been added:
“Someone threatened to hurt me or told me I would be in trouble if I did not run
away.”

Consider adding alternative language to “thrown out.” In some
places, this will be considered a placement change; it may also be
known as a “7-day notice” or “14-day notice” or other terms.
Consider adding option such as, “You were accused of encouraging
other youth to engage in negative or risky behaviors, or considered
a bad influence on others” to account for youth who are removed
from placement or home because of perceived recruitment of
others into trafficking situations or other risky behavior. This same
comment may also apply to youth being thrown out of their
homes.

A question has been added asking the longest period of time for which the
respondent ran away or was kicked out or told to leave. Parallel questions for
running/kicked out from home and from foster care. Response options pulled from
the National Runaway Safeline (https://www.1800runaway.org/runawaystatistics/crisis-hotline-online-services-statistics/)
“What is the longest time you spent away from home because you ran away or you
were kicked out or told to leave? Think about a single episode, or a single time you
spent away before you went back home or someone else made you go back (e.g.,
parent, police).
• 1 – 3 days; 4 to 6 days; 1 to 3 weeks; 1 to 2 months; 3 to 6 months; Longer
than 6 months; Don’t know / not sure; Choose not to answer”
“What is the longest time you spent away from a foster care placement because
you ran away or you were kicked out or told to leave? Think about a single episode,
or a single time you spent away before you went back to your foster care placement
or someone else made you go back (e.g., foster parent, caseworker, police).
• 1 – 3 days; 4 to 6 days; 1 to 3 weeks; 1 to 2 months; 3 to 6 months; Longer
than 6 months; Don’t know / not sure; Choose not to answer”
All instances of the phrase “thrown out” have been replaced with “kicked out or
told to leave,” following consultation with survivor expert consultants.
This option will be captured in “other specify.”

17

Comment
Comment
Source
Victimization
CLC and
After # 10 – Consider adding questions to account for different
NCYL
forms of trafficking, such as:
• “Before you turned 18, did anyone force you to do sexual things
with someone else? If so, did you receive any money, drugs, or
anything else of value? Did the person who forced you receive any
money, drugs, or anything else of value?”
• “Before you turned 18, did you trade sexual acts with anyone to
get something you needed, like food, clothing, drugs, or a place to
stay?”
CLC and
Change to “another parent, their
NCYL
spouse/partner/boyfriend/girlfriend.”
FNUSA

FNUSA

FNUSA

Generally- Why are Relationship Violence and Human Trafficking
separate from this section? Why are they not included in
Victimization? Given that they are later in the survey, it seems that
sexual assault and sex trafficking are given prioritization and there
may be drop off before participants get to the Relationship
Violence and Human Trafficking sections. We recommend
consolidating those questions into this section. There are also
some redundancies between these sections and the Age at First
Sexual Experience section. Combining the Victimization sections
would allow you to consolidate some of these questions and avoid
the redundancies, which are likely to make the participants feel
self-conscious about their experiences and less likely to either
answer truthfully or complete the survey.
Consider adding questions about bullying that was short of
physical assault, including bullying by kids or by adults. These are
common experiences for this population and are likely to put them
at higher risk of abuse and exploitation, including human
trafficking.
Consider adding questions about abuse by law enforcement, or
sexual actions demanded to avoid arrest. This is reported as a
common occurrence, especially by LGBTQ kids and those trading
sex and are likely to put them at higher risk of abuse and
exploitation, including human trafficking.

Response
The suggested questions are captured in another section of the survey that
assesses trafficking experiences, the Human Trafficking Screening Tool-Short Form
(HTST-SF).

The item has been made more inclusive:
“Before you turned 18, did you see or hear a parent get pushed, slapped, hit,
punched, or beat up by another parent, or by their spouse or partner?”
These sections have been reviewed carefully and there are no longer redundancies.
The last section of questions around trading sex were moved to earlier in the
survey (to follow the Victimization questions).
In general, survey break offs are relatively rare and are typically the result of a
respondent needing to get to an appointment or similar. In the contracting firm’s
experience with the National Survey of Child and Adolescent Well-being (NSCAW),
once rapport is built and respondents are answering questions, they tend to
complete the survey.

This was considered but ultimately not added; these questions would add
respondent burden without being key to answering the primary research questions

This was considered but ultimately not added; these questions would add
respondent burden without being key to answering the primary research questions

18

Comment
Source
FNUSA

Comment

Response

Consider adding questions about exposure to familial sexual
abuse, sex work, drug use, or gang involvement. These are
common experiences for this population and are likely to put them
at higher risk of abuse and exploitation, including human
trafficking.

The following item has been added (which parallels an existing question about peer
engagement in commercial sex):
“How many members of your family have traded sexual acts or used sexual acts to
earn food, clothing, money, shelter, favors, or other things they need?
• None of them
• Very few of them
• Some of them
• Most or all of them
• Don’t know/ Not Sure
• Choose not to answer”

Substance Use
CLC and
Consider adding questions regarding reasons for substance use
NCYL
and intersection with exploitation/trafficking, rather than only the
prevalence of drug use. This is especially important because drug
and alcohol use is common among youth and adults impacted by
trafficking and exploitation as a way to avoid and/or cope with
symptoms of trauma and to escape or dissociate from difficult
situations. Example questions include:
• Did you ever use alcohol or drugs to help you deal/cope with
feelings of sadness, fear, depression, anger, or other feelings
about what has happened to you in the past?
• Did you ever use drugs or alcohol to escape something difficult
that was happening to you in the moment, like having sex with
someone you did not want to have sex with, or getting hurt or
abused by someone?
• Were you ever forced to use drugs or alcohol by someone else?

These questions were considered but ultimately not included; these questions
would add respondent burden without being key to answering the primary
research questions. Substance use is already assessed in another section.

19

Comment
Source
CLC and
NCYL

Comment

Response

Consider revising for clarity: “Have you ever used a prescription
medication in any way, or in any amount, that a doctor did not
direct you to use it?”

Item revised to be consistent with the National Survey of Drug Use and Health
(NSDUH), which provides direction regarding amounts.
“The next question asks about using prescription pain relievers and other
prescription medicines in any way a doctor did not direct you to use them.
When you answer this question, please think only about your use of the drug in any
way a doctor did not direct you to use it, including:
• Using it without a prescription of your own
• Using it in greater amounts, more often, or longer than you were told to
take it
• Using it in any other way a doctor did not direct you to use it
Have you ever, even once, used any prescription pain reliever in any way a doctor
did not direct you to use it?” Please do not include “over-the-counter” pain relievers
such as aspirin, Tylenol, Advil, or Aleve.

CLC and
NCYL

Consider revising for clarity: “How old were you the first time that
you used a prescription medication in a way, or in an amount, a
doctor did not direct you to use it?”
Clarify what “a lot of time” means.

CLC and
NCYL
Sexual Experiences
FNUSA
Consider changing “force you to do sexual things” to “do sexual
things to you,” as the term force implies physical force which
participants may be reluctant to disclose.

Have you ever, even once, used any other prescription medicines in any way a
doctor did not direct you to use it?”
No changes; the question as-is is consistent with the NSDUH.

No changes; these items are from a validated scale, the GAIN-SS.

The series of items on first sexual experience have been revised following
consultation with experts. The word “force” is no longer used; instead, lead-in text
now reads:
“Sometimes sex happens even though you might not have consented, you changed
your mind, or you may have had mixed feelings. Sometimes people choose to have
sex, but the situation is complicated.”

Relationship Violence
FNUSA
See comments in Victimization section, above. Consider moving all
of these questions into Section H. Victimization.
FNUSA

Consider adding additional forms of relationship abuse including:
name calling, emotional abuse, threatening to out people, revenge
porn, and financial abuse.
Human Trafficking

Response in Victimization section addressed concerns about grouping of
questions to minimize survey breakoffs. Ordering of survey topics may vary
from what is shown here in order.
No changes; these items are from a validated scale (ARC-3), recommended by an
expert consultant.

20

Comment
Source
FNUSA
Covenant
House

Comment

Response

See comments in Victimization section, above. Consider moving all
of these questions into Section H. Victimization.
Recommend that whenever possible a nonjudgmental lead-in
should be added to relevant trafficking questions.

This comment is addressed above in the Victimization section.

For example, asking “Did you ever have sex for money or drugs or
a place to stay?” will frequently lead to false negatives. Therefore,
we changed the question to: “Sometimes young people who are
homeless or who are having difficulties with their families have
very few options to survive or fulfill their basic needs, such as food
and shelter. Sometimes they are exploited or feel the need to use
their sexuality to help them survive. Have you ever received
anything of value, such as money, a place to stay, food, drugs, gifts
or favors, in exchange for performing a sexual activity?”

Covenant
House

If a new or non-validated assessment tool is being used in the
proposed study, we recommend that the screening tool undergo a
pilot process. If that is not possible, it would be helpful to have
subject matter experts (including some young people who have
personally survived CSE/trafficking experiences) review all study
questions.

The lead-in to the trafficking questions is from the Human Trafficking Screening
Tool - Short Form (HTST-SF). It has been revised slightly based on feedback from
survivor expert consultants; in particular, inclusion of the phrase, “for the purposes
of this survey”:
“The next questions are about work or other activities you may have done in
exchange for money, food, housing, drugs, or anything else, or things that enabled
you to earn money for someone else. For the purposes of this survey, work can be
something like cooking in a restaurant or cleaning houses, or something like selling
drugs or trading sex. Work can include things that are legal or not, and things you
may do for someone else even though you didn’t want to or had mixed feelings
about it (part of you was OK with it and part of you was not).”
Survivor expert consultants recommended not to use a definition that
encompasses only survival sex, as trafficking victimization can occur among young
people who are exploited for reasons other than needing to meet basic needs.
The trafficking screener used is the Human Trafficking Screening Tool - Short Form
(HTST-SF). See: Dank M., Yu L., Vasquez-Noriega C., Gelatt J., Pergamit M. (2017).
Pretesting a Human Trafficking Screening Tool in the child welfare and runaway and
homeless youth systems. Available online:
https://www.urban.org/research/publication/pretesting-human-traffickingscreening-tool-child-welfare-and-runaway-and-homeless-youth-systems
This tool was developed and tested by the Urban Institute under contract to the US
Department of Health and Human Services (HHS), Office of the Assistant Secretary
for Planning and Evaluation (ASPE), in partnership with the Administration on
Children, Youth and Families (ACYF) and the Office of Planning, Research and
Evaluation (OPRE).
Three human trafficking subject matter experts/survivor-advocates reviewed the
follow-up questions relevant to trafficking and as a result, some wording changes
were made to the trafficking follow-up questions:
“The first time this/any of those things happened, did someone give you a phone,
computer or other resources (for example, a VISA gift card) so that you could set up
your own dates?”

21

Comment
Source
Covenant
House

FNUSA

Comment

Response

In new screening tools, we believe it would be best to leave the
term ‘work’ out entirely. In versions of our screening tool, we
added a definition of the word ‘work’ that explained that ‘work’
could include any activity where something was traded for
something of value and could include both legal and illegal activity.

The trafficking screener used is the Human Trafficking Screening Tool - Short Form
(HTST-SF). This tool uses the term “work.” Researcher expert consultants in
addition to three human trafficking survivor expert consultants reviewed the
definition of “work.”

FNUSA

Generally, add an explanation that ‘work’ includes any services
done for any form of payment, which may include unlawful
activities such as transporting drugs or sex work.
Consider adding: Agriculture, Factory work, and Elder care.

FNUSA

Consider adding “With the employer/pimp/trafficker.”

CLC and
NCYL

Add option for staying with the trafficker/exploiter, such as “At the
home of the person who was
setting up dates for me.”
Consider adding:
You were embarrassed/ashamed?
You didn’t want the other person to get into trouble?
While much of the content here is critically important and worth
separating out from other topics, consider incorporating some
questions/content earlier in the survey (as suggested above)
because participants may be fatigued by the time they reach this
section of the survey, or may be triggered or resistant to framing
their experiences as “human trafficking.”

FNUSA

CLC and
NCYL

As noted, the wording has been revised slightly based on feedback from survivor
expert consultants; in particular, inclusion of the phrase, “for the purposes of this
survey”:
“The next questions are about work or other activities you may have done in
exchange for money, food, housing, drugs, or anything else, or things that enabled
you to earn money for someone else. For the purposes of this survey, work can be
something like cooking in a restaurant or cleaning houses, or something like selling
drugs or trading sex. Work can include things that are legal or not, and things you
may do for someone else even though you didn’t want to.”
Human trafficking survivor expert consultants (in addition to researcher expert
consultants) reviewed the definition of “work.” See above for definition used.
The suggested response options have been added: agriculture, factory work, and
elder care.
The following response option has been added:
“At the home of a pimp or someone who worked for a pimp.”
The following response option has been added:
“At the home of a pimp or someone who worked for a pimp.”
Option has been added:
“You didn’t want the other person to get in trouble”
The phrase “human trafficking” is not used in the survey (the section headings will
not be shown to participants). The last section of questions around trading sex
were moved to earlier in the survey (to follow the Victimization questions).

22

Comment
Source
CLC and
NCYL

FNUSA

FNUSA

Comment

Response

In addition, consider adding questions to better understand the
source of coercion from
others, such as “What was the reason that you engaged in XX type
of work for another
person?” with options such as “I needed the money/clothing/place
to stay,” “they forced me
to do it,” “they hurt me or threatened to hurt me if I did not do it,”
“they told me that they
loved me and would take care of me if I did it,” “they told me I
needed to contribute to the
household.”
Consider adding questions about dangerous or exploitive work
experiences that tend to put people at risk of exploitation, such as:
Were you working but not able to pay your bills?
Were you not provided necessary protective gear or equipment by
your employer?
Were you required to work in exchange for housing/drugs/food?
Were you not provided sufficient training to do your job
safely/accurately?
Were you working to pay off a debt, either yours or someone
else’s?
Were you charged for housing costs by your employer?
Consider asking questions about financial knowledge and
understanding which can be exploited, such as:
Did you have access to a bank account?
Did you ever receive training or education on personal finance,
banking, credit cards?
Were you ever forced to use credit cards/ anyone take out a credit
card in your name?
Did anyone ever force you to break a lease?

Additional questions were considered but ultimately not included. These are
nuanced situations; for many young people, there may be many sources of
coercion. Questions such as these are better suited to a qualitative survey rather
than a quantitative one.

Suggested items addressing exploitive labor conditions are not key to our primary
research questions and would add respondent burden. However, in light of
numerous reports of debt bondage resulting from excessive charges by employers
(as implied by the last suggestion), we have added an additional item within the
human trafficking screener questions, to be analyzed separately:
“Did someone you work for ever keep most or all of your pay in exchange for
housing, transportation, or food?”

This was considered but ultimately not added; these questions would add
respondent burden without being key to answering the primary research
questions.

23