Tablet-Based Sex Trafficking Screening Works for Minors in the ED
(Reuters Health) – Using an electronic tablet to deliver a six-item screening tool to minors in a pediatric emergency department is effective in identifying sex trafficking, a new study suggests.
Researchers tested this confidential screening approach on 212 youth ages 12 to 17 years who presented alone at a large urban pediatric emergency department with chief complaints that indicated a high risk for sex trafficking, such as psychiatric or genitourinary problems, sexual assault or abuse, or law enforcement concerns about trafficking.
A total of 26 youth (12.3%) were victims of sex trafficking. The screening tool correctly identified 22 (84.6%) of them with a positive screen for sex trafficking, while four of these patients screened negative but were subsequently identified by a clinical social worker as a victim of sex trafficking.
“This confidential screening tool is a most critical first step to identifying minors who are victims of sex trafficking,” said Linda Roney, an associate professor at the Egan School of Nursing and Health Studies at Fairfield University in Connecticut.
“Raising awareness of those at risk and may present for care in an ED is vital as most victims have at least one healthcare encounter while they are being trafficked,” Roney, who wasn’t involved in the study, said by email.
Overall, 99 patients (46.7%) had accurate negative screening results, while 87 patients (41.0%) had false positive results.
The four patients with false negative screening results presented with conditions that were independent risk factors for sex trafficking and would typically involve an evaluation by a clinical social worker, the study authors note in Pediatrics.
One of these four patients, for example, answered in the negative to all screening questions despite having a presentation for sexual assault, abuse and violence. This patient had run away from home and was brought to the ED from a juvenile assessment center.
Another one of the four was also a runaway, and this patient was part of an open investigation into trafficking. One of the remaining patients with a false negative screening presented for known or suspected sex trafficking, while the other remaining patient reported drug or alcohol use and had sex with an unknown male partner.
One limitation of the study is that it was administered in a community with a large Spanish-speaking population but included just four patients who were Spanish speakers, leaving a potential for cultural or language barriers to influence the results. The study team also may not have received data on all patients ultimately determined to be victims of sex trafficking due to the lengthy nature of investigations of this crime, they note.
The authors were not available to comment by press time.
Even so, the study results suggest that it is feasible to administer confidential screenings for sex trafficking to help identify youth at risk, said Dr. Elizabeth Barnert, an assistant professor of pediatrics at the University of California Los Angeles who wasn’t involved in the study.
“Implementation of screening tools for sex trafficking among children and adolescents should become standard of practice for child health professionals,” Dr. Barnert said by email. “High yield settings likely include the emergency room, sexual and reproductive health clinics, psychiatry clinics, and clinics serving systems-involved youth such as youth in the juvenile justice and child welfare settings.”
SOURCE: https://bit.ly/3dmM6p7 Pediatrics, online February 16, 2021.
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