Critical Time Intervention to Facilitate Exiting Sex Work: Lessons Learned From a Fidelity Assessment
Bibliographic record
Abstract
Abstract IntroductionIndividuals who engage with sex work face barriers to maintaining overall health and well-being such as criminalization, stigmatization, and violence. An emerging approach to facilitating exiting sex work for individuals is through programs applying the Critical Time Intervention (CTI) model. CTI represents a time-limited practice that supports vulnerable individuals during periods of transition. The objectives of this study were to apply an existing CTI fidelity assessment to the sex work exiting program Exit Doors Here (EDH) to (1) report on the program’s fidelity and (2) discuss the effectiveness of CTI for supporting these groups. MethodsTo determine the applicability to the EDH of an existing fidelity assessment tool, we consulted with program staff through in person meetings. Staff highlighted areas for adaptation. We adapted the tool based on this feedback and used it to assess program fidelity by analyzing data from 8 participants’ CTI notes. Fidelity ratings were computed and interpreted according to established guidelines. ResultsConsultations with program staff resulted in adaptations to seven items out of the 12 comprising the fidelity assessment tool. The majority of adaptations surrounded the time-limited nature of CTI and unique needs of the program participants. In regards to the fidelity assessment using the adapted tool, half of the items were ideally implemented, one was well implemented, one was fairly implemented and two were respectively found to be poorly implemented and not implemented at all. Conclusions Difficulties in implementing selected program components with high fidelity can be attributed to specificities of the target population and to contextual factors, which are hard to control from a staff and program standpoint. This assessment reiterates the importance of considering such factors when developing and implementing programs aimed at improving the health and well-being of marginalized women such as those who engage in sex work.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.068 | 0.127 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".