This dissertation was completed in partial fulfillment of the Doctor of Public Health program at East Tennessee State University. The dissertation follows the Manuscript Format which includes three manuscripts, these manuscripts regard familial sex trafficking and are as follows, a scoping review, an empirical study on regional familial sex trafficking, and a policy implications paper on criminal record relief for survivors of familial sex trafficking. The scoping review includes eight peer reviewed studies on familial sex trafficking and a summary of grey literature. Thematic analysis was used to map the existing literature onto the Three Ps of human trafficking: Prevention, Protection, Prosecution, and a 4th crosscutting element Partnership. The scoping review summarized these characteristics and found that familial sex trafficking remains widely understudied and needs better data, awareness, training, and collaborations. The empirical study interviewed 10 individuals who had expertise or lived experience working with perpetrators or victims/survivors of familial sex trafficking in East Tennessee. This study found that like previous literature, the social determinants of health influence this form of abuse. Further, it contextualized the experience of traffickers, their vulnerabilities, and how these vulnerabilities tempted them into familial sex trafficking to meet their basic needs. This study highlights gaps in awareness, training, and programming for prevention and survivor support. The final paper, the policy implication paper, leverages data collected from the empirical study to demonstrate the reality of forced criminality during familial sex trafficking victimization and how criminal records impact recovery. This paper further explores the implications for developing policy and promising practices to further inform policy development. In summary, these manuscripts were carried out in partial fulfillment of the Doctor of Public Health program at East Tennessee State University.