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Abstract
Victims of domestic minor sex trafficking experience a myriad of health problems, giving healthcare providers an important opportunity to identify these children. Despite the significant role of physicians, midlevel providers, nurses, and social workers, little is known about factors influencing healthcare providers likelihood of identifying and reporting possible victims. The purpose of this study was to examine the individual (knowledge, perceived barriers, self-efficacy) and environmental (healthcare environment) factors impacting a healthcare providers intention to identify and report domestic minor sex trafficking victims within a clinical setting. This exploratory, mixed-methods study was divided into two phases. In both phases, participants were healthcare providers working in the United States. In Phase 1, participants (n=21) completed an in-depth interview exploring their views and experiences in relation to sex trafficking of American children. In Phase 2, participants (n=59) completed an electronic survey examining knowledge, perceived barriers, self-efficacy, views of the healthcare environment, and behavioral intention. Results from the analysis in Phase 1 informed the development of the survey in Phase 2. Interview respondents reported a lack of awareness and minimal education on sex trafficking as the primary factors impacting their perceived ability to assist victims. Environmental factors constraining their capacity to identify victims were time limitations, lack of multidisciplinary teams, and unclear policies to identify and report victims. Phase 1 participants described the need for more education among healthcare providers in order to increase victim identification. Results of the Phase 2 surveys supported the results from Phase 1. Participants in Phase 2 reported low self-efficacy in their ability to identify and assist victims of sex trafficking. Knowledge and views of the healthcare environment predicted participants intention to identify and report possible sex trafficking victims. Participants with higher knowledge of domestic minor sex trafficking and greater self-efficacy had the greatest intention to report possible victims. Based on these results, interventions targeting healthcare professionals should incorporate more education on trafficking victims and their clinical characteristics. As a part of these interventions, improving policies and organizational environment for healthcare providers are essential to increase identification and reporting.