Jan 5, 2024

Evidence-informed guidelines for enhancing child sex trafficking identification and response in Ontario pediatric emergency departments

Rebecca Balasa is a doctoral candidate with the Dalla Lana School of Public Health, University of Toronto, and a Leong Centre Studentship Recipient. Informed by her ongoing work as a Registered Nurse and Sexual Assault Nurse Examiner, Rebecca provides an update on her research examining child sex trafficking identification and response in Ontario pediatric Emergency Departments. She highlights her province-wide, modified Delphi method study and the conceptualization of evidence-informed clinical practice guidelines.

I have a dual role as a clinician-researcher which has provided me with a comprehensive understanding of the physical, psychosocial, forensic, and protection needs of child sex trafficking victims/survivors. This is crucial, as more than 80% of victims/survivors of child sex trafficking will access an Emergency Department while they are being trafficked. Yet, providers working in this healthcare context consistently report little to no training in identifying presentations of trafficking and a lack of institutional support for effectively responding to this population’s health and psychosocial needs. Despite the increasingly high prevalence of human trafficking in Canada, with most cases being reported in Ontario, there is no published research that has investigated child sex trafficking identification and response practices in Ontario pediatric Emergency Departments.

My doctoral research proposes the use of evidence-informed guidelines for enhancing child sex trafficking identification and response in Ontario pediatric Emergency Departments. I have used an intersectional modified Delphi method to achieve expert consensus across identification, intervention, and response strategies. The Delphi method is an iterative, consensus-based research technique that is valuable for decision-making, priority setting, and policy development in healthcare. Combining intersectionality theory with a modified Delphi method demonstrated a crucial need to examine non-mono-categorical variables for identifying child sex trafficking; a universal need to centre pediatric patients’ safety using a trauma and violence-informed approach for assessment and intervention practices; and recommendations for integrated health and social services across hospital and community institutions. The next steps are to disseminate my research into practical recommendations for implementation in clinical settings and policy. In addition to publishing the findings of my research, I am currently developing clinical practice guidelines to share with healthcare providers working in pediatric Emergency Departments across Ontario. The evidence-informed guidelines are set to support providers’ clinical decision-making and inform wider institutional protocols for care.

The Leong Centre Studentship has provided me with exceptional networking opportunities among scientists and scholars seeking to address child health inequities in various fields. These connections and my fellowship training have supported my research advancements as well as my post-doctoral career endeavours as a clinician-scientist.