Sex Trafficking Assessment Protocol for Medical Professionals in the Emergency Department

Abstract

Background: An estimated 17,500 to 20,000 victims are trafficked annually into the United States (U.S.) (Ernewein & Nieves, 2015). In a global study conducted by the United Nations, a majority of trafficked victims are women and girls, with 28% of them being children (Banks & Kyckelhahn, 2011). Recent studies have shown that in the U.S., approximately 28% to 50% of trafficked victims interacted with medical professionals during their captivity, but remained unidentified (Grace et al., 2014). The objective of this project was to determine whether an educational session and screening tool increased clinician knowledge, identification, and reporting of human sex trafficking (HST) victims in the emergency department (ED). Methods: A review of evidence-based literature indicated a lack of provider knowledge and skills in the identification of HST victims. Three educational sessions were provided to all ED personnel at Kapiʻolani Medical Center for Women and Children (KMCWC) from August to December 2017. The training focused on national and local statistics on the incidence of HST, HST risk factors, potential indicators, common assessment findings, approaching the victim, reporting procedures, and referral options. A screening tool consisting of six questions was provided during the session. Participants’ baseline knowledge was assessed prior to the educational training (pre-session). All ED professionals were sent a post-session survey via SurveyMonkey four months after the last educational session. Comparing the pre- and post-session results assessed the efficacy of the educational training and screening tool. Results: A total of 48 participants were surveyed for this project. Thirty-eight participants attended the educational sessions and completed the pre-session survey. Twenty post-session surveys were returned from those who did and did not attend the sessions. The initial analysis included those who attended the training sessions and showed an increase in the levels of HST knowledge (32.7%), suspicion of sexual exploitation (41.1%), and identification and reporting of trafficked victims (12.1%) by ED physicians and nurses. The final analysis included all responders to the survey sent to all ED staff and showed only 25% of clinicians reported childhood sex trafficking when encountering a patient they suspected. Conclusion: An educational session and screening tool has the potential to increase ED clinicians’ knowledge, identification, and reporting of sex trafficked youth.