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

Journal of the American College of Emergency Physicians Open

Emily F. Rothman¹  George T. Loo²  Cindy Clesca²  Elizabeth Singer²  Makini Chisolm‐Straker³  Lynne D. Richardson⁴  Naomi Alanis⁵  James d'Etienne⁵  David Strong⁶ 

[1] Community Health Sciences School of Public Health Boston University Boston Massachusetts USA;Department of Emergency Medicine Icahn School of Medicine at Mount Sinai New York New York USA;Department of Emergency Medicine Institute for Health Equity Research Icahn School of Medicine at Mount Sinai Mount Sinai Queens New York New York USA;Department of Emergency Medicine Institute for Health Equity Research, Population Health Science & Policy, Icahn School of Medicine at Mount Sinai New York New York USA;Department of Emergency Medicine, Integrative Emergency Services John Peter Smith Hospital Fort Worth Texas USA;Herbert Wertheim School of Public Health University of California San Diego San Diego California USA;

关键词: commercialized violence;    human trafficking;    identification;    labor trafficking;    screening;    sex trafficking;   

DOI  :  10.1002/emp2.12558

来源: DOAJ

【 摘 要 】

Abstract Objective Patients 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. Methods Patients 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. Results Overall, 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%). Conclusions The 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.

【 授权许可】

Unknown