Abstract
BACKGROUND: Female entertainment workers (FEWs) in Cambodia experience high levels of stress due to economic hardship, exposure to violence, and harassment by law enforcement due to their employment. This study aims to gather qualitative data on stressors, coping strategies, and preferences for chatline functions to inform the development of a WhatsApp hotline (chatline) for FEWs in Cambodia. METHODS: This qualitative study includes data from 5 focus groups and 10 in-depth interviews (IDIs), at which point data collectors felt we approached saturation. Participants were asked to respond to open-ended questions, a comic strip showing how the hotline might work and an audio recording of a hypothetical hotline conversation. Primary structural coding was used to identify the preferred functions and type of support participants want to receive from hotline staff. As more secondary themes arose during codebook development, an inductive thematic analytical approach was selected to categorize these data. RESULTS: Participants identified several stressors associated with female entertainment work, including concerns about physical and mental health, fear related to experiences with the police or threat of arrest, and exposure to violence. Passive/avoidance and active coping strategies were also identified. Participants preferred a 24 h chatline that provides emotional support from a kind and comforting female staff person. The types of support participants were looking for were advice about personal problems, encouragement to achieve their goals and address depression, and immediate help for violence. Most participants felt that the hotline could bring them a sense of relief and safety and improve their mood. Some stated that the hotline alone would not alleviate the stressors they were exposed to, particularly related to violence and called for more transformational change. CONCLUSIONS: This study offers textured evidence to inform the WhatsApp hotline development and staff training tailored to meet the needs of this specific population. Linking this hotline with crisis response, legal support, and longer-term in-depth counseling and using information gathered from this project to inform more extensive structural and policy-level changes should also be part a foundational part of this project.