Frontline Medical Professionals' Ability to Recognize and Respond to Suspected Youth Sex Trafficking

Abstract

Objectives: Many youth sex trafficking victims visit health care facilities while being trafficked. Little is known regarding whether frontline medical professionals recognize risk factors or are aware of effective interviewing approaches to identify and intervene for youth victims. The aim of the present study was to assess frontline medical professionals' knowledge of youth sex trafficking, adolescent development, and forensically informed interviewing to provide guidance for professional training. Methods: Two hundred seventy-seven frontline medical professionals [first responders and emergency department (ED)/clinical professionals] in Southern California completed an online survey about their background, training, perceptions of likely youth sex trafficking scenarios, knowledge of adolescent development, sex trafficking, and forensically informed interviewing.Results: Nearly all professionals recognized risk and the need to collect additional information, yet few (1% first responders and 12% ED) recognized that risk as sex trafficking. Forty-six percent of first responders also indicated that responding to nonmedical needs was outside of their job responsibilities. A mixed model analysis of covariance revealed significant interactions of gender by domain (P = 0.01) and domain by training (P = 0.045). Women evidenced better knowledge (78% accuracy) about sex trafficking and interviewing (73%) than adolescent development (64%), whereas men were more accurate with sex trafficking (64%) than adolescent development (61%) and interviewing (62%). For domain by training, tests of within subjects' contrasts showed a quadratic relation ( P = 0.02) was the best fit model, where training was most strongly associated with accuracy in sex trafficking knowledge. Conclusions:Frontline medical professionals are lacking in their knowledge of youth sex trafficking, interviewing, and especially adolescent development. An area in which interventions can be targeted is with training (because it emerged in a significant interaction). Training could combat unrepresentative depictions of victims, improve understanding of common victim characteristics, and highlight how forensically informed interviewing can improve medical professionals' ability to gather crucial history about victims' experiences and needs.

Improving the value of school professionals as partners in efforts to enhance recognition of and responses to youth sex trafficking

“…Common stereotypes about victims, as well, may run counter to actual victims' presentations, reducing professionals' knowledge of trafficking but also their knowledge of which adolescents might be presenting with cues. Surveys of other professionals have also highlighted tendencies toward endorsing stereotypes about trafficking and difficulties identifying actual characteristics (Winks et al, 2023), a pattern we also observed here.…”

“…Each vignette contained six cues to trafficking. Cues were based on details in prior trafficking or pandering criminal cases involving youth victims prosecuted in California (Quas et al, 2022), and the vignettes are highly similar to those used in prior studies of healthcare professionals' ability to recognize trafficking of minors (Winks et al, 2023), but were adapted for school settings. The cues in the first vignette were more ambiguous than the cues in the second, so the order was standardized.…”

“…Most studies concerning knowledge of trafficking have assessed how much other professionals (e.g., healthcare workers, social workers) and laypersons know about trafficking, at times assessing accuracy relative to false stereotypes often promulgated in popular media about victims (Rodríguez‐López, 2018). Results consistently reveal that, although professionals and laypersons possess basic knowledge of human trafficking (e.g., it is a problem), they lack knowledge of nuanced details needed for actual identification (e.g., that kidnaping of middle‐class youth is rare; Beck et al, 2015; Havig & Mahapatra, 2021; Jacobson et al, 2023; McAmis et al, 2022; Winks et al, 2023). For example, many social workers lack a clear understanding of victims' displays and needs, resulting in victim identification being missed and victims then receiving inadequate care (Jacobson et al, 2023).…”

“…For example, many social workers lack a clear understanding of victims' displays and needs, resulting in victim identification being missed and victims then receiving inadequate care (Jacobson et al, 2023). Likewise, healthcare professionals often lack education about how to recognize risks that present in medical settings (Beck et al, 2015; Havig & Mahapatra, 2021; Winks et al, 2023), labeling victims of trafficking as either victims of child abuse or as being engaged in prostitution (Beck et al, 2015; Winks et al, 2023). Finally, law enforcement tend to endorse inaccurate perceptions; they often see minor victims as prostitutes when they are evasive and hostile (Farrell et al, 2010, 2015), potentially a result of a lack of training or knowledge (Mapp et al, 2016).…”

Successful Criminal Prosecutions of Sex Trafficking and Sexual Abuse of Minors: A Comparative Analysis

“…This hostility may reduce the officers’ provision of support during an interview and increase their use of interrogative practices to obtain information (Dianiska et al, 2023), both of which are associated with decreases in disclosure completeness in victims and suspects (Meissner et al, 2012; Saywitz et al, 2019). In addition, law enforcement and other professionals may not believe claims made by youth who appear complicit with the sexual activities, who behave in a hostile manner, or who have a history of delinquency (Luna et al, 2023; Winks et al, 2023). Finally, introducing details in court about victims’ delinquency could increase perceptions that they are responsible for their experiences, just as perceptions of adolescent victims’ responsibility for sexual assault increase when they are described as having engaged in age-inappropriate behavior (e.g., having been in a bar) (Rogers et al, 2016).…”