Human Trafficking: It’s Not Just a Crime

Human trafficking, although commonly conceived of as a crime, is also a matter for the fields of health and public health. Trafficked individuals suffering physical, sexual, and/or psychological abuse can experience acute and chronic health sequelae, bringing them to the attention of health and/or mental health professionals. Communicable infections affect many trafficked individuals and can be transmitted to those not trafficked. The factors that contribute to people being trafficked, like poverty, educational disparities, and systematic oppression based upon identities, are multifaceted and interlinked with other trauma experiences. Incorporation of public health principles into anti-trafficking efforts facilitates a comprehensive and holistic prevention/intervention anti-trafficking strategy. This commentary illustrates how both the health care and public health sectors can contribute to improving the health and well-being of trafficked people, the general public, and to anti-trafficking efforts

A Theoryâ based Didactic Offering Physicians a Method for Learning and Teaching Others About Human Trafficking

Emergency clinicians are on the frontlines of identifying and caring for trafficked persons. However, most emergency providers have never received training on trafficking, and studies report a significant knowledge gap involving this important topic. Workshops often employ a â trainâ theâ trainerâ model to address cliniciansâ knowledge gaps involving various topics (including trafficking). By offering participants knowledge and skills needed to both understand relevant content and teach this content to future learners, this model aims at promoting widespread dissemination of essential information. However, current trainâ theâ trainer workshops typically involve full or multiday sessions and employ multimodal instructional techniques, making them time and resource intensive for both participants and facilitators.To address these challenges, we created a 50â minute trainâ theâ trainer workshop to teach emergency clinicians the knowledge and skills needed to recognize and care for trafficked patients while providing instructional techniques to teach learners this content in the clinical environment. Learning theory and principles informed the choice of instructional methods and were employed when designing the paperâ based learning guides that functioned as this intervention’s primary instructional resource. Guides contained detailed scripts used to perform roleâ playing exercises. These â scripted guidesâ were designed for participants to learn important content while simultaneously practicing techniques to teach this content to one another. They provided the scaffolding necessary to independently direct learning during the workshop (with minimal facilitator intervention), while also being carefully formatted and organized to create an accessible tool for future use during clinical teaching.The session was implemented at the 2018 Society for Academic Emergency Medicine Annual Meeting in Indianapolis, Indiana. Based on participantsâ selfâ assessment using a retrospective preâ post test, the workshop was successful in creating a trainâ theâ trainer model that is brief, requiring minimal facilitator resources and offers instruction on both content knowledge and instructional methods to disseminate this knowledge to future learners.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147170/1/aet210206_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147170/2/aet210206.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147170/3/aet210206-sup-0001-DataS1.pd

Public Health Research Priorities to Address US Human Trafficking

In this Perspective, HEAL Trafficking, the nation\u27s leading public health anti-trafficking organization maps out a national research agenda to tackle the problem of human trafficking. Given the paucity of research on trafficking, HEAL Trafficking engaged its membership in a consensus development process throughout 2016 to develop its national research agenda. HEAL Trafficking proposes five priorities that public health researchers should focus on in the decade ahead to make meaningful progress on preventing and responding to human trafficking in the Unites States

Human Trafficking Is a Public Health Issue: A Paradigm Expansion in the United States

This clear-sighted reference examines the public health dimensions of labor and sex trafficking in the United States, the scope of the crisis, and possibilities for solutions. Its ecological lifespan approach globally traces risk and protective factors associated with this exploitation, laying a roadmap towards its prevention. Diverse experts, including survivors, describe support and care interventions across domains and disciplines, from the law enforcement and judicial sectors to community health systems and NGOs, with a robust model for collaboration. By focusing on the humanity of trafficked persons, a public health paradigm broadens our understanding of and ability to address trafficking while adding critical direction and resources to the criminal justice and human rights structures currently in place. Among the topics covered: Children at Risk: Foster Care and Human Trafficking LGBTQ Youth and Vulnerability to Sex Trafficking Physical Health of Human Trafficking Survivors: Unmet Essentials Research Informing Advocacy: An Anti-Human Trafficking Tool Caring for Survivors Using a Trauma-Informed Care Framewor

Validation of a screening tool for labor and sex trafficking among emergency department patients

ObjectivePatients with labor and sex trafficking experiences seek healthcare while and after being trafficked. Their trafficking experiences are often unrecognized by clinicians who lack a validated tool to systematically screen for trafficking. We aimed to derive and validate a brief, comprehensive trafficking screening tool for use in healthcare settings.MethodsPatients were randomly selected to participate in this prospective study based on time of arrival. Data collectors administered 5 dichotomous index questions and a reference standard trafficking assessment tool that requires 30 to 60 minutes to administer. Data collection was from June 2016 to January 2021. Data from patients in 5 New York City (NYC) emergency departments (EDs) were used for tool psychometric derivation, and data from patients in a Fort Worth ED were used for external validation. Clinically stable ED adults (aged ≥18 years) were eligible to participate. Candidate questions were selected from the Trafficking Victim Identification Tool (TVIT). The study outcome measurement was a determination of a participant having a lifetime experience of labor and/or sex trafficking based on the interpretation of the reference standard interview, the TVIT.ResultsOverall, 4127 ED patients were enrolled. In the derivation group, the reference standard identified 36 (1.1%) as positive for a labor and/or sex trafficking experience. In the validation group, 12 (1.4%) were positive by the reference standard. Rapid Appraisal for Trafficking (RAFT) is a new 4-item trafficking screening tool: in the derivation group, RAFT was 89% sensitive (95% confidence interval [CI], 79%-99%) and 74% specific (95% CI, 73%-76%) and in the external validation group, RAFT was 100% sensitive (95% CI, 100%-100%) and 61% specific (95% CI, 56%-65%).ConclusionsThe rapid, 4-item RAFT screening tool demonstrated good sensitivity compared with the existing, resource-intensive reference standard tool. RAFT may enhance the detection of human trafficking in EDs. Additional multicenter studies and research on RAFT's implementation are needed

A Teach-the-Teacher Module for Human Trafficking Bedside Instruction

Introduction Human trafficking (HT) is a public health issue that adversely affects patients’ well-being. Despite the prevalence of trafficked persons in health care settings, a lack of educational modules exists for use in clinical contexts. We developed a 50-minute train-the-trainer module on HT. Methods After piloting the workshop for faculty, fellows, and residents (n = 19) at the Society for Academic Emergency Medicine (SAEM) national conference, we implemented it in medical students’ curricula during their emergency medicine clerkship at the University of Iowa (n = 162). We evaluated the worskhop by (a) a retrospective pre-post survey of self-reported ability to (1) define HT, (2) recognize high-risk signs, (3) manage situations with trafficked persons, and (4) teach others about HT, and (b) a 3-month follow-up survey to assess longitudinal behavior change. Results In both contexts, results demonstrated improvement across all learning outcomes (pre-post differences of 1.5, 1.3, 1.9, and 1.7 on a 4-point Likert-type scale for each learning objective above, respectively, at the SAEM conference and 1.2, 1.0, 1.3, and 1.3 at the University of Iowa; p < .001 for all). In the 3-month follow-up, we observed statistically significant changes in self-reported consideration of and teaching about HT during clinical encounters among learners who had previously never done either (p < .001 and p = .006, respectively). Discussion This train-the-trainer module is a brief and effective clinical tool for bedside teaching about HT, especially among people who have never previously considered HT in a clinical context