Barriers to the access and utilization of healthcare for trafficked youth: A systematic review

Garg, Anjali; Panda, Preeti; Neudecker, Mandy; Lee, Sara

doi:10.1016/j.chiabu.2019.104137

Cited by 19 publications

(14 citation statements)

References 12 publications

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“…Of the participants who completed the survey, 96.88% exhibited at least mild to moderate knowledge of HT and 47.51% did not feel confident in identifying TIPs (Sinha et al, 2019). Several similar studies supported the need for policies that require clinicians to receive additional training to be equipped with the skills to identify TIPs (Garg et al, 2020; Lumpkin & Taboada, 2017; Powell et al, 2017).…”

Section: Resultsmentioning

confidence: 96%

Primary Care Clinician’s Knowledge of Trafficking in Persons: A Systematic Review

Ram

Goldin

2022

J Transcult Nurs

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Introduction: Human trafficking is an enormous global threat. Primary care clinicians are part of a safety net of professionals who may be able to identify and assist trafficking in persons (TIPs). The purpose of this systematic review was to explore clinicians’ knowledge, attitudes, and behaviors in identifying and assisting TIPS in health care settings. Methodology: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. Searches were conducted using PubMed, Medline Plus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases that yielded 130 articles, of which 10 quantitative articles met eligibility criteria. Eligibility determination, data extraction, synthesis, and evaluation were independently conducted by the authors. Results: Findings revealed deficits in clinician’s knowledge, attitudes, and behaviors on identifying TIPs in clinical settings. In addition, cultural influences affect TIP’s decision-making. Discussion: To support the wide-ranging needs of TIPs, education programs that include clinician trainings on the skills required to identify and assist TIPs across cultures is warranted.

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Section: Resultsmentioning

confidence: 96%

Primary Care Clinician’s Knowledge of Trafficking in Persons: A Systematic Review

Ram

Goldin

2022

J Transcult Nurs

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“…These barriers indicate that a decrease in ICD-10 codes utilization could also be due to decreased presentation of trafficked children to healthcare systems. The provision of trauma informed, patient centered care could reduce many of these survivor barriers to seeking healthcare (24,26). Psychiatric illness was common in our cohort of children.…”

Section: Discussionmentioning

confidence: 97%

“…In a systematic review, three major sub-groups of themes were identified and noted to be significant barriers to healthcare utilization for trafficked children (24). Some of the barriers included trafficker control, physical confinement, lack of trust in healthcare providers, concerns about confidentiality, decreased knowledge of the healthcare system, and emotional reluctance (24). Cost and long appointment wait times were also cited (24).…”

Section: Discussionmentioning

confidence: 99%

“…Some of the barriers included trafficker control, physical confinement, lack of trust in healthcare providers, concerns about confidentiality, decreased knowledge of the healthcare system, and emotional reluctance (24). Cost and long appointment wait times were also cited (24). Another systematic review also reported legal repercussions, perception of biased care, trafficker control, or lack of interest in engagement with healthcare for various reasons facilitated as barriers to seeking healthcare (25).…”

Section: Discussionmentioning

confidence: 99%

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Human Trafficking ICD-10 Code Utilization in Pediatric Tertiary Care Centers Within the United States

et al. 2022

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BackgroundHuman trafficking is a global public health issue that affects pediatric patients widely. The International Labor Organization estimates children comprise approximately 25% of the identified trafficked persons globally, with domestic estimates including over 2000 children a year. Trafficked children experience a broad range of health consequences leading to interface with healthcare systems during their exploitation. In June 2018, International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) released diagnostic codes for human trafficking.ObjectiveTo use a large, multicenter database of US pediatric hospitalizations to describe the utilization of the ICD-10-CM codes related to child trafficking, as well as the demographic and clinical characteristics of these children.MethodsThis study was descriptive in nature. Encounters using data from the Pediatric Health Information System database (PHIS) with ICD-10-CM codes indicating trafficking from June 1, 2018 to March 1st, 2020 were included in the study cohort, with data collection continuing for 30 days after first hospital encounter, until March 31st, 2020. Patients 19 years old and younger were included. Condition-specific prevalence as well as demographic and clinical characteristics for patient encounters were analyzed. Study subjects were followed for 30 days after first hospital encounter to describe healthcare utilization patterns.ResultsDuring the study period, 0.005% (n = 293) of patient encounters in the PHIS database were identified as trafficked children. The children of our cohort were mostly female (90%), non-Hispanic Black (38%), and had public insurance (59%). Nearly two-thirds of patients (n = 190) had a documented mental health disorder at the initial encounter, with 32.1% classified as the principal diagnosis. Our cohort had a 30-day hospital inpatient, overnight observation, or emergency department readmission rate of 16% (n = 48).DiscussionOur study demonstrates a low utilization of human trafficking ICD-10-CM codes in academic children's health centers, with code usage predominantly assigned to Non-Hispanic Black teenage girls. As comparison, in 2019 the National Human Trafficking Hotline identified 2,582 trafficked US children in a single year. These results suggest widespread under-recognition of child trafficking in health care settings, including the intensive care unit, in addition to racial and socioeconomic disparities amongst trafficked children.

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“…Although there is a need to identify barriers that affect youth access to healthcare, there have been no cited review studies that broadly identify these factors within the last ten years. Previous reviews either target specific healthcare services, particular subpopulations and/or include studies outside of the U.S. [ 7 , 8 , 9 , 10 ]. Barriers described in these studies focus on mental health services, sexual and reproductive health services, or focus on trafficked youth.…”

Section: Introductionmentioning

confidence: 99%

Social-Ecological Barriers to Access to Healthcare for Adolescents: A Scoping Review

Garney

Wilson

Ajayi

et al. 2021

IJERPH

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Access to healthcare for adolescents is often overlooked in the United States due to federal and state-sponsored insurance programs such as Medicaid and the Children’s Health Insurance Program. While these types of programs provide some relief, the issue of healthcare access goes beyond insurance coverage and includes an array of ecological factors that hinder youths from receiving services. The purpose of this scoping review was to identify social-ecological barriers to adolescents’ healthcare access and utilization in the United States. We followed the PRISMA and scoping review methodological framework to conduct a comprehensive literature search in eight electronic databases for peer-reviewed articles published between 2010 and 2020. An inductive content analysis was performed to thematize the categories identified in the data extraction based on the Social-Ecological Model (SEM). Fifty studies were identified. Barriers across the five SEM levels emerged as primary themes within the literature, including intrapersonal-limited knowledge of and poor previous experiences with healthcare services, interpersonal-cultural and linguistic barriers, organizational-structural barriers in healthcare systems, community-social stigma, and policy-inadequate insurance coverage. Healthcare access for adolescents is a systems-level problem requiring a multifaceted approach that considers complex and adaptive behaviors.

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Barriers to the access and utilization of healthcare for trafficked youth: A systematic review

Cited by 19 publications

References 12 publications

Primary Care Clinician’s Knowledge of Trafficking in Persons: A Systematic Review

Primary Care Clinician’s Knowledge of Trafficking in Persons: A Systematic Review

Human Trafficking ICD-10 Code Utilization in Pediatric Tertiary Care Centers Within the United States

Social-Ecological Barriers to Access to Healthcare for Adolescents: A Scoping Review

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