Addressing Patients' Sex Trafficking Risk in a High-Risk Healthcare Setting: Findings from a Collective Case Study in the Midwest
Lara Gerassi, PhD, LCSW, MSW & Anna Pederson, MS | September 23 | 3:30-4:00 PM
Topic: Research, Healthcare | Knowledge Level: Intermediate
The Institute of Medicine and the Center for Disease Control recommend that healthcare providers have knowledge of sex trafficking (ST) indicators and conduct screenings to identify people at risk. However, barriers for healthcare staff who conduct such ST screenings remain largely understudied. The research question that guided this study was, “What are the perceived barriers to ST identification among staff in a high-risk healthcare setting?” This collective case study occurred across 5 sites of a large, high-risk health care organization in a Midwestern state. Researchers conducted 23 in-depth, semi-structured interviews with medical assistants and clinicians (e.g. nurse practitioners). Organizational materials (e.g. ST training modules, screening/risk assessment protocols) were collected. Two research team members conducted independent deductive and inductive coding. Although staff routinely screened by asking “Have you ever traded sex for money or drugs?”, they tended not to introduce the question in ways that were conducive to facilitating disclosures, and/or provided minimal follow-up. Occasionally, staff provided strong examples of follow-up assessment practices that they found helpful in soliciting more information (e.g. assessed patient risk by asking where/how sex exchanges happened). However, participants primarily described avoiding further discussions of ST because they 1) aimed to be non-judgmental and sex positive, 2) viewed following up as someone else’s job, and/or 3) lacked confidence discuss it themselves. There may be some missed opportunities to assess patients for ST risk and use harm reduction strategies or safety plan to address patients’ needs. Implications for healthcare trainings and future research will be discussed.
Presentation Objectives:
· Provide an overview of a collective case study in a high-risk healthcare setting, including information on perceptions of indicators and healthcare staff's challenges to follow-up
· Discuss recommendations to normalize sex trading questions/disclosure and provide harm reduction strategies for use in healthcare settings