Evaluation of a Tool to Identify Child Sex Trafficking Victims in Multiple Healthcare Settings

Greenbaum, V. Jordan; Livings, Michelle S.; Lai, Betty S.; Edinburgh, Laurel; Baikie, Peggy; Grant, Sophia R.; Kondis, Jamie S.; Petska, Hillary W.; Bowman, Mary Jo; Legano, Lori A.; Kas-Osoka, Oriaku; Self‐Brown, Shannon

doi:10.1016/j.jadohealth.2018.06.032

Cited by 50 publications

(47 citation statements)

References 17 publications

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“…The finding of clustering of sexual risk-taking behaviours, violence exposure and outcomes such as rates of STIs and unintended pregnancy is in agreement with the results of both national and international studies [2][3][4]32], some of which have proposed that extended screening be performed by sexual health services [2,4,27]. To our knowledge, the clinical screening endeavours described in the scientific literature only focus on specific forms of ill health, which limits possible comparisons: child sex trafficking [9], violence victimisation [47,51], chlamydia [52] and alcohol use [53]. The questions and procedures in the mentioned studies are, however, similar to those of the present study, further supporting the feasibility of this approach to better identify youth with sexual health needs, when they come into contact with health care professionals.…”

Section: Similarities and Differences In Relation To Other Studiessupporting

confidence: 85%

“…Since no item was found on unintended pregnancy regardless of gender, item 12 was constructed for this instrument. Four items concern experiences of transactional sex and sexual violence [4,9,[32][33][34][35]. To initiate a discussion on sexually coercive behaviour, item 16 was formulated for this instrument [34].…”

Section: Sexit Itemsmentioning

confidence: 99%

“…Experience of sexual violence is associated with unintended pregnancy and STIs through unprotected sex, and a greater likelihood of engaging in transactional sex [4][5][6][7][8]. Engaging in transactional sex is associated with a history of abuse, substance misuse, previous STIs, multiple partners, state care and running away from home [9]. Previous STIs, unintended pregnancy and experience of sexual violence also increase the likelihood of repeated ill health [7,10,11].…”

Section: Introductionmentioning

confidence: 99%

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Identifying young people exposed to or at risk of sexual ill health: pilot implementation of an evidence-informed toolkit (SEXIT) at Swedish youth clinics

Hammarström

Nilsén

Lindroth

et al. 2019

The European Journal of Contraception & Reproductive Health

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Objectives: We aimed to develop and pilot-implement an evidence-informed toolkit (SEXual health Identification Tool; SEXIT) for identifying young people exposed to or at risk of sexual ill health, at Swedish youth clinics, and to investigate SEXIT's potential to identify young people in need of special care and monitoring. Methods: The SEXIT toolkit was developed, validated and pilot-implemented at three Swedish youth clinics. Pre-implementation staff readiness was assessed and youth clinic visitors' responses to SEXIT were analysed. Results: All staff perceived a need for screening for sexual risk-taking and exposure. The response rate from 268 youth clinic visitors (aged 15-24 years) was 86%. Half of the visitors had one or no variable associated with sexual ill health, a third had two or three, and 15% reported between four and seven variables. The most common variables were alcohol use, three or more sexual partners in the past year and previous chlamydia. Visitors rated SEXIT as important and not uncomfortable or difficult to answer. Conclusions: The SEXIT toolkit was found to be feasible and highly acceptable in a clinical setting. The use of SEXIT may facilitate important questions on sexual risk-taking and sexual ill health to be raised with youth clinic visitors.

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Section: Similarities and Differences In Relation To Other Studiessupporting

confidence: 85%

Section: Sexit Itemsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Identifying young people exposed to or at risk of sexual ill health: pilot implementation of an evidence-informed toolkit (SEXIT) at Swedish youth clinics

Hammarström

Nilsén

Lindroth

et al. 2019

The European Journal of Contraception & Reproductive Health

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“…1). From this set of results, 93 full-text articles were reviewed for inclusion, of which 19 new articles (representing 18 studies) were included [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. In addition, the 13 studies evaluated in the Bailhache et al review [43][44][45][46][47][48][49][50][51][52][53][54][55] were included in this review update, for a total of 32 articles (31 studies).…”

Section: Resultsmentioning

confidence: 99%

“…A few studies also used the index test as part of the reference standard, which can lead to serious incorporation bias. For example, Greenbaum et al [37] noted that the 6-item child sex trafficking screening questions were "embedded within the 17-item questionnaire," which was used by the reference standard (health care providers) to determine if child sex trafficking potentially occurred.…”

Section: Risk Of Bias and Grade Assessment Of Included Studiesmentioning

confidence: 99%

Identifying children exposed to maltreatment: a systematic review update

et al. 2020

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Background: Child maltreatment affects a significant number of children globally. Strategies have been developed to identify children suspected of having been exposed to maltreatment with the aim of reducing further maltreatment and impairment. This systematic review evaluates the accuracy of strategies for identifying children exposed to maltreatment. Methods: We conducted a systematic search of seven databases: Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Cochrane Libraries, Sociological Abstracts and the Education Resources Information Center. We included studies published from 1961 to July 2, 2019 estimating the accuracy of instruments for identifying potential maltreatment of children, including neglect, physical abuse, emotional abuse, and sexual abuse. We extracted data about accuracy and narratively synthesised the evidence. For five studies-where the population and setting matched known prevalence estimates in an emergency department setting-we calculated false positives and negatives. We assessed risk of bias using QUADAS-2. Results: We included 32 articles (representing 31 studies) that evaluated various identification strategies, including three screening tools (SPUTOVAMO checklist, Escape instrument, and a 6-item screening questionnaire for child sex trafficking). No studies evaluated the effects of identification strategies on important outcomes for children. All studies were rated as having serious risk of bias (often because of verification bias). The findings suggest that use of the SPUTOVAMO and Escape screening tools at the population level (per 100,000) would result in hundreds of children being missed and thousands of children being over identified. Conclusions: There is low to very low certainty evidence that the use of screening tools may result in high numbers of children being falsely suspected or missed. These harms may outweigh the potential benefits of using such tools in practice (PROSPERO 2016:CRD42016039659).

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