Date of Award

December 2019

Document Type


Degree Name

Doctor of Philosophy (PhD)


Institute on Family and Community Life

Committee Member

Mark Small

Committee Member

Bonnie Holaday

Committee Member

Natallia Sianko

Committee Member

Arelis Moore de Peralta

Committee Member

Amy Ramsay


The purpose of this qualitative case study was to assess the readiness of a Department of Emergency Medicine (ED) to respond to human trafficking (HT), using an adapted Transtheoretical Model’s Stage of Change Model as a guide. Content analysis allowed for an assessment of 13 system-wide policies and procedures and 25 hours of on-site observations of patient data collection processes and clinical practices during intake, triage, and the medical screening evaluation at three ED sites. Thematic analysis identified five readiness themes based on semi-structured interviews with 22 healthcare personnel from four ED sties. Results indicated that system-wide policies and procedures and patient data collection processes were at the precontemplative level of change across ED sites, meaning low levels of readiness to respond to HT. Clinical practice findings showed participants used their knowledge and expertise with other vulnerable patient populations to raise concerns about possible trafficked individuals seeking medical care, placing clinical practices at the contemplative level of change. Based on findings, recommendations to increase the ED’s readiness to respond to HT included: mandating HT training for all ED personnel to enhance awareness, incorporating HT into current policies and procedures for vulnerable patient populations as well as creating a HT protocol that addresses a procedural work flow, enhancing patient data collection to include HT warning signs, identifying a consistent area to record suspicions in patients’ medical records, and making community referral information readily available for staff. Future research with other EDs can apply the adapted TTM framework to determine the efficacy of this assessment model to assess HT readiness.



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