236 - Pediatricians' Understanding of Youth Labor and Sex Trafficking: A Need for Training

Poster Number: 236
Publication Number: 236.402

Kanani E. Titchen, University of California, San Diego School of Medicine, San Diego, CA, United States; Cynthia Kuelbs, Rady Children's Hospital San Diego, San Diego, CA, United States; Hyeri You, UC San DIego Altman Clinical and Translational Research Institute, San Diego, CA, United States; Kay Rhee, University of California, San Diego School of Medicine, San Diego, CA, United States

Background: A public health issue, human trafficking (HT) for labor and sex compromises the health of youth, particularly marginalized and minority youth. Although 68% of HT survivors report accessing healthcare while being exploited, most U.S. healthcare professionals report a lack of training in HT and an inability to respond effectively.

Objective: To quantify pediatricians’: (1) knowledge of HT, (2) ability to recognize different types of HT, and (3) confidence in connecting victims of HT with resources.

Design/Methods: We surveyed pediatricians at a free-standing academic children’s hospital. The 20-question online tool used vignette-based, Likert scale, true/false, and multiple-choice questions about HT. Means and frequencies were used for descriptive analysis. Fisher’s exact tests were used to examine differences in skills/behaviors based on previous training.

Results: Of 914 pediatricians surveyed, 206 responded (22.5%): 71.4% female; 33.5% general pediatricians, 66.5% subspecialists; 37.6% non-White; 61.6% in practice more than 10 years. Most respondents had not received training about HT (62.8%). Only 26.2% of respondents correctly identified labor trafficking in the vignettes, whereas 76.2% correctly identified sex trafficking. Previous HT training was not associated with a greater likelihood of recognizing sex (p=0.52) or labor (p=0.88) trafficking in these vignettes. Most pediatricians (80.6%) reported never identifying a victim of HT in their practice. However, respondents with past HT training (n=77) were more likely than those without training (n=129) to report identifying victims of HT in their practice (42.9% vs 6.2%; p < 0.001). Few reported confidence in their ability to identify a victim of labor (5.8%) or sex (14.1%) trafficking, and 73.3% lacked confidence in their ability to connect a victim with needed resources. Of 204 respondents, 99% attributed victimhood to youth who were sex trafficked, while 86.6% ascribed victimhood to labor trafficked youth (p < 0.001).Conclusion(s): Although pediatricians are in a unique position to help youth victims of HT, most lacked training in HT, were unable to recognize labor trafficking in case-based scenarios, and lacked confidence in connecting patients to resources. Biases may also exist around youth labor trafficking which make it more difficult to recognize. Training is needed to build pediatricians' skills and confidence to recognize all categories of trafficked youth and link them to services.