Transcript EBC Final Prostitution

About this presentation
• These slides present interim findings from a review of the
evidence undertaken in workshop conditions at Evidence Base
Camp 2013/14.
• The findings from the review are not exhaustive. Due to time
constraints not all available bibliographic databases have been
searched, and books and longer reports were excluded from our
synthesis sessions.
• The findings have not been peer reviewed or quality assured
in the same way as a formal research publication.
• The College of Policing Research Analysis and Information Unit
(RAI) plans to turn this review of the evidence into a full Rapid
Evidence Assessment Report in due course.
What interventions have been shown
to be effective in responding to
prostitution?
Delegates:
Naomi Eales – NCA
Dani Matthews – College
Syed Hussain – ACPO TAM
Ian Henderson – College
Debbie Edon-Hayhurst – College
Michael Black – Nottinghamshire
Nicky Davey - Wiltshire
Emma Rees – Sussex
Delegates:
Jenny Hyams – Derbyshire
Nary Lou – Met
Melanie Morrison – South Yorkshire
College of Policing:
Nicky Miller - Research
Jo Wilkinson - Research
Lynn O’Mahony – National Police
Library
How did we answer the question?
• Using a Rapid Evidence
Assessment (REA)
• REAs follow a systematic
process to identify and
appraise evidence…
• …but make compromises
given available time and
resources
• Pragmatic and transparent
approach
• Ensure best possible
coverage of literature in
the time available
The process
(in a nutshell)
1. Draft search terms
2. Draft sift criteria
3. Sift received abstracts
4. Request relevant papers
5. Read and ‘grade’ papers
6. Write it up (‘synthesis’)
Developing search terms
What interventions have been shown to be effective in
responding to prostitution?
Tier Area
Synonyms include…
1
Prostitution
Prostitution; hooker; hustler; sex worker;
rent boy; kerb crawling; call girl; pimp; sex
tourism; stripper; brothel; sex tourism
2
Intervention
Response; stop; reduce; decrease; prevent;
tackle; control; deter; cut
3
What Works
Systematic review; rapid evidence
assessment; trial; RCT; experiment;
evaluation; effective; assessment; “What
works”; impact; success.
Search outcomes
Our search
identifies studies
that mention all
three of our areas:
Prostitution,
Intervention and
‘What Works’…
Prostitution
Intervention
What Works
979 potentially
relevant studies
identified.
Searches find all potentially relevant studies…
Returned by the prostitution search…
Anonymous Learn the secrets to solving the clear skin riddle, GIRLS' LIFE, Apr,
2000, at64.
Abstract: Attack! It's often said in sports that the best offense is a good defense.
That's true when it comes to clean skin, too. Having the right skin care routine is
really the only effective treatment for breakouts. "By the time you see blackheads
or whiteheads, the damage is done and there isn't much you can do," says Dr.
Larry Green, assistant professor of dermatology, George Washington University
School of Medicine. "The key is stopping pimples before they start." Take that!
Say you follow this regimen and still have whiteheads, blackheads, pustules or
papules. The key to getting rid of them is using the right treatment product. Pick
the wrong one and things'll get worse. Dr. Green advises, "Use salicylic acid on
blackheads and whiteheads and benzoyl peroxide on pustules and papules."
Peroxide does nothing for blackheads or whiteheads because it primarily attacks
swelling. And salicylic acid only makes redness and inflammation of pustules and
papules worse. Again, start with the gentlest formulas and work your way up. The
big cover up. While everyone breaks out at some point, there's no need to walk
around advertising. "Redness is a tough problem for regular makeup to handle,"
says Michael Criscuolo, celebrity makeup artist and on-line beauty advisor for
www.pimpleportal.com. "Look for `corrective' makeup (typically in a light green
or yellow shade) that takes redness out of your skin."
Sifting our abstracts identifies the truly relevant literature. Sift criteria
is used so that we are consistent and transparent in our sifting.
Sifting – inclusion criteria
Q1.
Question
Answer
Action
Is the paper directly
related to:
No
Exclude
Yes
Go to Q2
Unclear
Exclude
Prostitution?
Q2.
Q3.
Does the paper focus on: No
Exclude
Interventions/responses to
tackle prostitution?
Yes
Go to Q3
Unclear
Exclude
Does the paper include:
No
Exclude
Empirical data/ methods?
Yes
Include
Unclear
Can’t exclude
Sifting – flow of papers
Searches of two
online databases
(Proquest and
EBSCO)
N=979
Abstrac
t and
title
screene
d
N=979
Full
text
screene
d
N=87
Reports meeting
inclusion criteria &
mapped
N= 47
Papers excluded: Total N= 40/87
Papers sifted out: N=892
Reasons for exclusion:
• Did not meet sift criteria.
Reasons for exclusion:
• Language (not English)
n= 2
Other exclusions:
• Publication not available
• Duplicates
•Too long for EBC
n= 25
n= 2
n = 11
Our initial search identified 979 papers, but only 87 (9%) were actually relevant to our
research question. Our findings are drawn from xx studies that we have reviewed over
the last two days.
• We searched two of the main databases available to the National Police Library
• Due to time restrictions, we have not included books and reports in our synthesis
• Some longer studies could not be included due to time restrictions.
Synthesis – Mapping the evidence
Publication Date
6
5
4
3
2
1
0
pre 1979
1980-1989
1990-1999
2000-2009
2010+
Synthesis – Mapping the evidence
Country of focus
5
4
3
2
1
0
UK
USA
Canada
Global
Thailand
rim
En
vi
C
m
en
ta
l
n
tic
tio
pe
u
lis
a
ro
n
in
a
er
a
tio
n
rs
io
n
is
a
iv
e
ga
l
Th
Le
D
Synthesis – Mapping the evidence
Intervention Type
6
5
4
3
2
1
0
Synthesis – Mapping the evidence
Study Context
6
5
4
3
2
1
0
Policing and CJ
Social Care
Education
Legal
What does ‘good’ or ‘robust’ evidence look like?
Statements about
‘what works’
Systematic Reviews
(Based on level 3-5 studies)
5
Statements about
‘what’s promising’
Statements about
possible impact
Randomised controlled trials
4
Before/after measures
Multiple site comparisons
3
Before/after measures
Two site comparisons
2
Before/after measures
No comparison site
1
One-off measure
No comparison site
Study designs
increasingly rule
out potential
alternative
causes
Study designs
cannot rule
out potential
alternative
causes
Synthesis – Quality of evidence
Number of studies
6
5
4
3
2
1
0
Non-impact
studies
Level 1
Level 2
Level 3
Level 4
Level 5
Qualitative
Synthesis
What Works
There is no clear evidence to show ‘what works’ in responding to
prostitution
What’s Promising
There is promising evidence from one study conducted in Thailand that
criminalisation of the users and controllers of prostitution, together
with the provision of education and training for arrested prostitutes,
did have an impact on arrest rates but this varied regionally and was
not statistically significant. This was not accompanied by any change in
police tactics.
Evidence, from one UK study, suggests a short-term impact on
displacement of street prostitution away from residential areas with
the introduction of a road management schemes; the longer term
impact of this intervention was not known.
Synthesis
What’s Unknown
There is some evidence to suggest that:
• criminal justice diversion programmes (4) targeted at ‘Johns’ will result
in changed attitudes towards prostitution but there are mixed results,
using recidivism rates, that this attitude change translates into
behavioural change.
•Youth (13 – 19 yrs) involvement in ‘street schools’ (1) has a positive
impact on self esteem, school sentiment and reduced involvement in
child prostitution activities, as well as reducing depression in this group.
• Legalisation of prostitution (1) increases the demand for human
trafficking
• Criminalisation of prostitution in Canada (1) did not impact on rates of
prostitution but did facilitate prosecution; this was not applied equally.
• Therapeutic intervention programme (well being) aimed at
prostitutes in prison and community resulted in positive impact; long
term impact not known.
What Doesn’t Work
There was no evidence available.
What’s Harmful
There was no evidence available.
Key messages
What interventions have been shown to be effective in
responding to prostitution?
• Most studies were published in the last 10-15 years and were
undertaken in North America with only one UK study
• The overall quality of evidence is low
• The main focus of impact intervention studies has been on diversion
(5) and criminalisation (3).
• The two most robust research studies (Level 4) related to
criminalisation of users and controllers of prostitutes, together with
an education and training programme for prostitutes (Thailand) and
the impact of a road traffic management scheme on displacement of
street prostitutes (UK study).
• There are a number of policing operations that target prostitution, as
well as multi agency initiatives for which funding is sought; it was
surprising that the number of impact studies was so low.
Opportunities exist for more testing of such interventions.
Key messages
What interventions have been shown to be effective in
responding to prostitution?
Issues to consider:
• More research is needed both overall and in relation to adapting to
technological development (e.g. you could focus on the role of the
internet in facilitating prostitution and inhibiting the law enforcement
response).
• Lack of research evidence on how to manage and reduce demand
• Need to map out exactly what is going on with prostitution across the
UK to get a better idea of the issues involved so as to inform design
of more targeted interventions
• What is the outcome measure for an ‘effective’ response to
prostitution? Who is the intervention best aimed at – the client, the
prostitute, the community?
• Conducting research in this area with ‘sensitive’ populations will
always be challenging. Who conducts the research may have an
impact on the accuracy/value of the research outcomes (research
ethics); different agencies have different objectives (e.g. sex worker
well being Vs law enforcement) which impacts on what they are
looking for from research. Opportunities exist for collaborative, multi
agency research.