Child sex trafficking identification and response in Ontario pediatric emergency departments

Rebecca Balasa is a clinician-researcher with a PhD in Social and Behavioural Health Sciences from the Dalla Lana School of Public Health at the University of Toronto. Her doctoral research, funded by the Edwin S.H. Leong Centre for Healthy Children, focused on identifying and addressing child sex trafficking in pediatric emergency departments across Ontario.

Findings from my recent publication in Child Abuse & Neglect underscore the complexity of child sex trafficking identification by providers in Ontario pediatric emergency departments. Providers perceived greater child sex trafficking vulnerability among children with multiple marginalized identities, yet primarily identified cases among white, feminine presenting youth who reside in Ontario. Recognizing the disparate and cumulative power dynamics within patient-provider relationships, identification practices necessitate a trauma- and violence-informed approach and joint consideration of the child’s sociodemographic and clinical profile. In my upcoming publications, I will discuss child-centered approaches to trauma- and violence-informed care, and present findings from a modified Delphi method on children’s temporal needs during and beyond their emergency department presentation.

My postdoctoral work will continue to advance provider knowledge and health systems in the field of human trafficking. Building on my work with providers, my future research will be co-developed with survivors to centre their lived expertise and priorities for advancing health and social services. Continuing the work from my doctoral dissertation, I will convene key informants, including survivors, to develop clinical practice guidelines for identifying and responding to child sex trafficking in Ontario’s pediatric emergency departments.

This is a critical time to advance research on provider-directed interventions among children exposed to sex trafficking as the Ontario government is revising their 2020-2025 Anti Human Trafficking Strategy. Aligned with the government’s focus to equip frontline providers to identify and intervene in cases of human trafficking, my research calls attention to health and social service providers’ informational and material resource needs. Relatedly, my research highlights the need for a multi-actor approach across sectors to effectively support children exposed to sex trafficking and advocates for policy that addresses geographic and built-environment barriers, such as funding and training austerity measures.

The Edwin S.H. Leong Centre for Healthy Children Studentship Award was invaluable to my doctoral research. It enabled me to network with leaders in child health equity, receive mentorship from clinician-scientists with nursing backgrounds, and compensate participants for their time and knowledge. This funding also allowed me to hire a Research Assistant, enhancing my skills in mentorship and leadership. I deeply appreciate the Centre’s contributions to my work and look forward to continued collaboration.