Pediatric Emergency Care
Volume 30, Issue 12, 2014, Pages 856-861

Educating health care professionals on human trafficking (Article)

Grace A.M.* , Lippert S. , Collins K. , Pineda N. , Tolani A. , Walker R. , Jeong M. , Trounce M.B. , Graham-Lamberts C. , Bersamin M. , Martinez D.J. , Dotzler D.J. , Vanek L.J. , Storfer-Isser A. , Chamberlain L.J. , Horwitz S.M.
  • a Department of General and Community Pediatrics, Children's National Health System, 111 Michigan Ave NW, 432 10th St NE, Washington, DC 20002, United States
  • b Department of Emergency Medicine, Stanford University, School of Medicine, Stanford, United States
  • c Department of Pediatrics, Northern Inyo Hospital, Bishop, United States
  • d Stanford University, School of Medicine, Stanford, CA, United States
  • e Stanford University, School of Medicine, Stanford, CA, United States
  • f Department of Emergency Medicine, Stanford University, School of Medicine, Stanford, United States
  • g Weill Cornell Medical College, New York, NY, United States
  • h Department of Emergency Medicine, Stanford University, School of Medicine, Stanford, United States
  • i Department of Pediatrics, Stanford University, School of Medicine, Stanford, United States
  • j Department of Child Development, California State University, Sacramento, United States
  • k San Jose Police Department, San Jose, CA, United States
  • l San Jose Police Department, San Jose, CA, United States
  • m San Jose Police Department, San Jose, CA, United States
  • n Statistical Research Consultants, LLC, Schaumburg, IL, United States
  • o Department of Pediatrics, Stanford University, School of Medicine, Stanford, United States
  • p Department of Child and Adolescent Psychiatry, New York University, Langone Medical Center, New York, NY, United States

Abstract

Background: The US Department of State estimates that there are between 4 and 27 million individuals worldwide in some form of modern slavery. Recent studies have demonstrated that 28% to 50% of trafficking victims in the United States encountered health care professionals while in captivity, but were not identified and recognized. This study aimed to determine whether an educational presentation increased emergency department (ED) providers' recognition of human trafficking (HT) victims and knowledge of resources to manage cases of HT.Methods: The 20 largest San Francisco Bay Area EDs were randomized into intervention (10 EDs) or delayed intervention comparison groups (10 EDs) to receive a standardized educational presentation containing the following: background about HT, relevance of HT to health care, clinical signs in potential victims, and referral options for potential victims. Participants in the delayed intervention group completed a pretest in the period the immediate intervention group received the educational presentation, and all participants were assessed immediately before (pretest) and after (posttest) the intervention. The intervention effect was tested by comparing the pre-post change in the intervention group to the change in 2 pretests in the delayed intervention group adjusted for the effect of clustering within EDs. The 4 primary outcomes were importance of knowledge of HT to the participant's profession (5-point Likert scale), self-rated knowledge of HT (5-point Likert scale), knowledge of who to call for potential HT victims (yes/no), and suspecting that a patient was a victim of HT (yes/no).Findings: There were 258 study participants from 14 EDs; 141 from 8 EDs in the intervention group and 117 from 7 EDs in the delayed intervention comparison group, of which 20 served as the delayed intervention comparison group. Participants in the intervention group reported greater increases in their level of knowledge about HT versus those in the delayed intervention comparison group (1.42 vs -0.15; adjusted difference = 1.57 [95% confidence interval, 1.02-2.12]; P < 0.001). Pretest ratings of the importance of knowledge about HT to the participant's profession were high in both groups and there was no intervention effect (0.31 vs 0.55; -0.24 [-0.90-0.42], P = 0.49). Knowing who to call for potential HT victims increased from 7.2% to 59% in the intervention group and was unchanged (15%) in the delayed intervention comparison group (61.4% [28.5%-94.4%]; P < 0.01). The proportion of participants who suspected their patient was a victim of HT increased from 17% to 38% in the intervention group and remained unchanged (10%) in the delayed intervention comparison group (20.9 [8.6%- 33.1%]; P < 0.01). Copyright © 2014 by Lippincott Williams & Wilkins.

Author Keywords

Women's health Slavery Social justice Public health Human trafficking

Index Keywords

Health Personnel education patient care Likert scale pretest posttest design Education, Medical, Continuing multicenter study clinical trial health care personnel human Self Report middle aged controlled study randomized controlled trial Aged sensitivity analysis emergency ward knowledge Emergency Responders Humans male female Aged, 80 and over patient referral very elderly medical education prevention and control human trafficking Article health care major clinical study adult emergency health service Emergency Service, Hospital emergency physician rescue personnel recognition
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84917672349&doi=10.1097%2fPEC.0000000000000287&partnerID=40&md5=3312b424e6a7ff7ee578e4b3a7292f7c
DOI: 10.1097/PEC.0000000000000287
ISSN: 07495161
Cited by: 39
Original Language: English