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Lin SC, Chang KSG, Marjavi A, Chon KY, Dichter ME, DuBois Palardy J. Intimate Partner Violence and Human Trafficking Screening and Services in Primary Care Across Underserved Communities in the United States-Initial Examination of Trends, 2020-2021. Public Health Rep 2024:333549241239886. [PMID: 38562004 DOI: 10.1177/00333549241239886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVES The Health Resources and Services Administration (HRSA) began collecting data on intimate partner violence (IPV) and human trafficking (HT) in the 2020 Uniform Data System (UDS). We examined patients affected by IPV and HT served by HRSA-funded health centers in medically underserved US communities during the COVID-19 pandemic. METHODS We established a baseline and measured trends in patient care by analyzing data from the 2020 (N = 28 590 897) and 2021 (N = 30 193 278) UDS. We conducted longitudinal ordinal logistic regression analyses to assess the association of care trends and organization-level and patient characteristics using proportional odds ratios (PORs) and 95% CIs. RESULTS The number of clinical visits for patients affected by IPV and HT decreased by 29.4% and 88.3%, respectively, from 2020 to 2021. Health centers serving a higher (vs lower) percentage of pediatric patients were more likely to continuously serve patients affected by IPV (POR = 2.58; 95% CI, 1.01-6.61) and HT (POR = 6.14; 95% CI, 2.06-18.29). Health centers serving (vs not serving) patients affected by IPV were associated with a higher percentage of patients who had limited English proficiency (POR = 1.77; 95% CI, 1.02-3.05) and Medicaid beneficiaries (POR = 2.88; 95% CI, 1.48-5.62), whereas health centers serving (vs not serving) patients affected by HT were associated with a higher percentage of female patients of reproductive age (POR = 15.89; 95% CI, 1.61-157.38) and urban settings (POR = 1.74; 95% CI, 1.26-2.37). CONCLUSIONS The number of clinical visits for patients affected by IPV and HT during the COVID-19 pandemic declined. Delayed care will pose challenges for future health care needs of these populations.
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Affiliation(s)
- Sue C Lin
- Bureau of Primary Health Care Office of Quality Improvement, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USA
| | | | - Anna Marjavi
- Futures Without Violence, San Francisco, CA, USA
| | - Katherine Y Chon
- Office of Trafficking in Persons, Administration for Children and Families, US Department of Health and Human Services, Washington, DC, USA
| | - Melissa E Dichter
- Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
- Temple University School of Social Work, Philadelphia, PA, USA
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Bounds DT, Rodrigues SM, Balsam D, Lennan N, Rodriguez KR, Milburn NG. Creating Space for Adolescents and Families With Lived Experience of Homelessness to Build Familial Empathy, Communication, and Emotional Regulation: A Qualitative Study of Facilitators of Implementation. J Psychosoc Nurs Ment Health Serv 2024; 62:27-35. [PMID: 37379121 DOI: 10.3928/02793695-20230622-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Youth experiencing homelessness are vulnerable to commercial sexual exploitation (CSE). Structural racism disproportionately entraps marginalized youth into CSE while simultaneously obscuring their identification as victims. Adaptation and tailoring of effective interventions to mitigate associated sequelae and inequities is warranted. Support To Reunite, Involve, and Value Each Other (STRIVE) is a strengths-based dyadic intervention with demonstrated efficacy in reducing delinquency, substance use, and high-risk sexual behaviors among marginalized adolescents experiencing homelessness. The adapted STRIVE+ was piloted to explore potential for reducing youth risk factors for CSE. The current article reports findings from interviews exploring participants' experiences with STRIVE+. Youth and caregivers reported increased empathy, communication, and emotional regulation post-STRIVE+ and found relevance and meaning through participating in the adapted intervention. Feasibility of recruitment, engagement, and retention of minoritized adolescents and their caregivers were also demonstrated. Findings warrant larger scale implementation trials of STRIVE+ among minoritized youth at highest risk for CSE. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 27-35.].
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Limbaugh L, Gordon MR, Nguyen PT, Porter M, Coverdale J. Methods Used to Control the Reproductive Choices of Women Who Are Sex Trafficked: Considerations for Health Care Providers. J Psychiatr Pract 2023; 29:439-446. [PMID: 37948169 DOI: 10.1097/pra.0000000000000741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Reproductive control or reproductive coercion has negative health consequences but has not been systematically studied within the context of sex trafficking. Our goal is to identify the range of methods used by sex traffickers and buyers to control the reproductive choices of trafficked women and to provide specific examples of these methods. We searched PubMed, Embase, and PsycInfo using the terms "reproductive control" or "reproductive coercion" and "human trafficking" or "sex trafficking," including papers that contained original, specific examples of reproductive control occurring within the context of sex trafficking. These reports were described and categorized into established domains of reproductive control. Eight articles were located that met our inclusion criteria, of which 6 described outcomes of birth control sabotage, 2 described pressuring into pregnancy, 5 described controlling the outcome of a pregnancy, and 2 described forced birth control or sterilization. Our findings have implications for how to take sexual histories and for identifying and assisting trafficked persons.
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Lathan EC, Haynes T, Langhinrichsen-Rohling R, Sonu SC, Powers A. Primary Care Providers' Knowledge, Perceptions, and Practice of Trauma-Informed Care in a Public Health Care Setting. FAMILY & COMMUNITY HEALTH 2023; 46:209-219. [PMID: 37703510 DOI: 10.1097/fch.0000000000000376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Despite serving patients with especially high rates of trauma exposure and related sequelae, many primary care providers do not receive specialized training in the provision of trauma-informed care (TIC). This study sought to document primary care providers' baseline rates of TIC training and their knowledge, perceptions, and practice of TIC at a large, urban public hospital in the Southeastern United States. Participants (n = 67; 68.7% women; 44.8% white; Mage = 36.7 years, standard deviation [SD]age = 9.8 years) completed an online self-report survey on their TIC training status, trauma-related knowledge, perceptions, and practices, as well as burnout and secondary traumatic stress. Less than half of participants (43.3%) endorsed TIC training exposure. Participants generally had adequate levels of trauma-related knowledge (76.5% of items correct) and favorable perceptions of TIC (endorsed 89.7% of TIC-supportive statements). Most participants (86.6%) endorsed recently using trauma-informed practices, but only 47.8% reported routinely screening for trauma-related disorders. Participants who reported receiving prior TIC training scored better on knowledge items and endorsed recently using more trauma-informed practices than those who did not have training exposure. TIC training status' associations with current screening practices and perceptions of TIC were trending toward significance. TIC training status was not related to burnout, and trained participants reported greater secondary traumatic stress than those without training exposure. Results point to system-wide TIC training as a well-received, translational strategy that can enhance the trauma-informed nature of primary care provision.
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Affiliation(s)
- Emma C Lathan
- Departments of Psychiatry and Behavioral Sciences (Drs Lathan, Haynes, and Powers and Mr Langhinrichsen-Rohling), General Medicine and Geriatrics (Drs Haynes and Sonu) and General Pediatrics and Adolescent Medicine (Dr Sonu), School of Medicine, Emory University, Atlanta, Georgia
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Koegler E, Wood CA, Johnson SD, Bahlinger L. Service providers' perspectives on substance use and treatment needs among human trafficking survivors. J Subst Abuse Treat 2022; 143:108897. [PMID: 36215910 DOI: 10.1016/j.jsat.2022.108897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/05/2022] [Accepted: 09/29/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Understanding substance use and treatment needs for survivors of human trafficking remains an underdeveloped area in the field of substance use treatment. This study assessed the nature of substance use among survivors of all types of human trafficking and identified treatment barriers and needs, as reported by human trafficking service providers in one Midwest major metropolitan area. METHODS Participants were purposively selected from agencies that served foreign-born and domestic-born survivors of human trafficking. The study interviewed fifteen key informants across 13 agencies directly serving survivors of trafficking. RESULTS Providers highlighted frequent use of alcohol and marijuana, as well as polysubstance use. They noted survivors' significant use of opioids, associated concerns regarding fentanyl-related deaths, and increased frequency of stimulant use. Barriers for addressing substance use problems with survivors included low self-perceptions of need, lack of available residential or inpatient treatment options, and prioritizing basic needs such as housing over substance use treatment. CONCLUSIONS Results underscore how broader trends in substance use and overdose in a region can mirror substance use patterns and treatment needs of human trafficking survivors. Further, a need exists for broader substance use screening and low-barrier referral services to address emergent needs of survivors of trafficking.
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Affiliation(s)
- Erica Koegler
- University of Missouri-St. Louis, 1 University Blvd., St. Louis, MO 63121, United States of America.
| | - Claire A Wood
- Missouri Institute of Mental Health, 1 University Blvd., St. Louis, MO 63121, United States of America.
| | - Sharon D Johnson
- University of Missouri-St. Louis, 1 University Blvd., St. Louis, MO 63121, United States of America.
| | - Lilly Bahlinger
- University of Missouri-St. Louis, 1 University Blvd., St. Louis, MO 63121, United States of America.
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Greenbaum J, Sprang G, Recknor F, Harper NS, Titchen K. Labor trafficking of children and youth in the United States: A scoping review. CHILD ABUSE & NEGLECT 2022; 131:105694. [PMID: 35749904 DOI: 10.1016/j.chiabu.2022.105694] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Child labor trafficking is a largely unexplored and unpublished phenomenon in the United States. OBJECTIVE To 1) characterize the state of the science on child labor trafficking, and 2) identify empirical information regarding risk and protective factors, and physical/behavioral health needs of labor-trafficked children/adolescents. METHODS This scoping review involved an electronic review of five databases; the search was restricted to studies in English or Spanish and published between Jan 1, 2010-Oct 16, 2020. The search yielded 1190 articles; 48 studies qualified for full review and 8 met inclusion criteria (US-based study addressing risk factors/vulnerabilities for child labor trafficking; protective factors; health impact; or health/behavioral healthcare). RESULTS Only one study had sufficient sample size to compare sex to labor trafficking among minors; some did not separate data by age group or by type of trafficking. A few shared data from a common source; one was a single case review. Findings suggested that sex and labor trafficking may share common risk factors (e.g., prior child maltreatment and out-of-home placement) as well as within group differences (e.g., labor trafficked children had less prior child welfare involvement than those involved in sex trafficking and were more likely to be younger, male, Black or non-white, and Hispanic). Multiple physical/behavioral health symptoms were reported and may be useful items for a healthcare screen. CONCLUSIONS Child labor trafficking research in the U.S. is in its infancy, although the results of this review point to opportunities for screening and case conceptualization that may be useful to practitioners.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, 2318 Mill Road, Suite 1010, Alexandria, VA 22314, USA; Stephanie V. Blank Center for Safe and Healthy Children at Children's Healthcare of Atlanta, 975 Johnson Ferry Rd, NE, Atlanta, GA 93342, USA.
| | - Ginny Sprang
- University of Kentucky, College of Medicine/Department of Psychiatry, Center on Trauma and Children, 3470 Blazer Parkway Suite 100, Lexington, KY 40509, USA.
| | - Frances Recknor
- Baylor College of Medicine, Menninger Department of Psychiatry, Anti-Human Trafficking Program, One Baylor Plaza, MS 350, Houston, TX 77030, USA.
| | - Nancy S Harper
- Otto Bremer Trust Center for Safe and Healthy Children, University of Minnesota, Department of Pediatrics, USA; University of Minnesota Masonic Children's Hospital, 1st Floor Suite R107, 2512 S 7th Street, Minneapolis, MN 55454, USA.
| | - Kanani Titchen
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UC San Diego/Rady Children's Hospital, 3020 Children's Way MC 5165, San Diego, CA 92123, USA.
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Nguyen P, Coverdale J, Gordon M. Addressing the scourge of human trafficking: Developing services and advocacy. Bull Menninger Clin 2022; 86:1-7. [PMID: 35238610 DOI: 10.1521/bumc.2022.86.suppa.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Phuong Nguyen
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | | | - Mollie Gordon
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas
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