Journal of Adolescent Health
Volume 63, Issue 6, 2018, Pages 745-752

Evaluation of a Tool to Identify Child Sex Trafficking Victims in Multiple Healthcare Settings (Article)

Greenbaum V.J.* , Livings M.S. , Lai B.S. , Edinburgh L. , Baikie P. , Grant S.R. , Kondis J. , Petska H.W. , Bowman M.J. , Legano L. , Kas-Osoka O. , Self-Brown S.
  • a Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, Georgia, Georgia
  • b School of Public Health, Georgia State University, Atlanta, Georgia, United States
  • c School of Public Health, Georgia State University, Atlanta, Georgia, United States
  • d Midwest Children's Resource Center, Children's Hospital and Clinics of Minnesota, St. Paul, MN, United States
  • e Denver Health, Now at Colorado Department of Human Services, Denver, CO, United States
  • f Cook Children's Hospital, Fort-Worth, TX, United States
  • g Washington University School of Medicine, St. Louis, MS, United States
  • h Medical College of Wisconsin, Milwaukee, WI, United States, Children's Hospital of Wisconsin, Milwaukee, WI, United States
  • i Nationwide Children's Hospital, Columbus, OH, United States
  • j Bellevue Hospital, New York City, NY, United States
  • k Las Vegas School of Medicine, University of Nevada, Las Vegas, NV, United States
  • l School of Public Health, Georgia State University, Atlanta, Georgia, United States

Abstract

Purpose: Estimate the prevalence of child sex trafficking (CST) among patients seeking care in multiple healthcare settings; evaluate a short screening tool to identify victims in a healthcare setting. Methods: This cross-sectional observational study involved patients from 16 sites throughout the U.S.: five pediatric emergency departments, six child advocacy centers, and five teen clinics. Participants included English-speaking youth ages 11–17 years. For emergency department sites, inclusion criteria included a chief complaint of sexual violence. Data on several domains were gathered through self-report questionnaires and examiner interview. Main outcomes included prevalence of CST among eligible youth; sensitivity, specificity, positive/negative predictive values, and positive/negative likelihood ratios for a CST screening tool. Results: Eight hundred and ten participants included 91 (11.52%) youth from emergency departments, 395 (48.8%) from child advocacy centers, and 324 (40.0%) from teen clinics. Overall prevalence of CST was 11.1%: 13.2% among emergency department patients, 6.3% among child advocacy center patients, and 16.4% among teen clinic patients, respectively. The screen had a sensitivity, specificity, and positive likelihood ratio of 84.44% (75.28, 91.23), 57.50% (53.80, 61.11), and 1.99% (1.76, 2.25), respectively. Conclusions: This study demonstrates a significant rate of CST among patients presenting to emergency departments (for sexual violence complaints), child advocacy centers, and teen clinics. A six-item screen showed relatively good sensitivity and moderate specificity. Negative predictive value was high. Intervention for a “positive” screen may identify victims and help prevent high-risk youth from becoming victimized. This is one of the first CST screening tools specifically developed and evaluated in the healthcare setting. © 2018 Society for Adolescent Health and Medicine

Author Keywords

identification Adolescent Commercial sexual exploitation healthcare Child sex trafficking Human trafficking

Index Keywords

Child Abuse, Sexual multicenter study mass screening predictive value human Self Report emergency ward speech sex trafficking Cross-Sectional Studies interview Surveys and Questionnaires United States school child cross-sectional study Humans Adolescent male female juvenile evaluation study observational study questionnaire sexual exploitation diagnostic test accuracy study victim prevalence child sexual abuse Article sensitivity and specificity human trafficking major clinical study child advocacy hospital emergency service Emergency Service, Hospital crime victim Crime Victims Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85055886609&doi=10.1016%2fj.jadohealth.2018.06.032&partnerID=40&md5=015fceba4dc71effd92ab55a2f160ee4
DOI: 10.1016/j.jadohealth.2018.06.032
ISSN: 1054139X
Cited by: 3
Original Language: English