Subsection: Deceptive Payment Practices 9
Project Team: Jessica Pryce, Ph.D., MSW, Principal BushraInvestigatorRashid, MSW Keishann Corley, MPA
ficw.fsu.edu
Background 2
Focus Groups 3
Data Collection Data Analysis
Individual Interviews ......................................................................................................4
FLORIDA INSTITUTE FOR CHILD WELFARE 1 RESEARCH REPORT
Author: Lisa Magruder, Ph.D., MSW, Co-Investigator
...................................................................................................................... 3
MARCH 17, 2022
Initial Training 4
Child Welfare Workers’ Experiences of Screening for Human Trafficking Victimization: Final Report
Table of Contents
Continuing Training 4
Building Rapport with Youth 6
Focus Groups 8
Subsection: Forced Labor 10 Subsection: Unsafe Online Activity 10 Subsection: Forced Tattooing/Branding 11
Tool Improvement 8
Evaluation completed by the Florida Institute for Child Welfare
Introduction 2 Evaluation Team 2
Sampling 3 Data Collection 4 Data Analysis 4
Sampling 3
Findings 4
.........................................................3
...........................................................
Section D | Living Conditions 9
The Screening Process 4
Prior Human Trafficking Screening Tool Research
Current Study 3
Pre-Commencement 5 Conducting the Screening 5
Needed Supports 8
Experiences and Perceptions of Screener Training 4
Section C | Youth Personal Background 9
Florida Institute for Child Welfare College of Social Work Florida State University 2139 Maryland Circle Suite Tallahassee,1100 Florida 32303
Determining the Likelihood of Trafficking 7 Screeners’ Suggestions for Change 7
Section F | Leaving or Running Away from Home 11
.................................................................................................................... 3
Section E | Work Information 9
Communication of Findings 6
Individual Interviews 3
Methodology 3
Human Trafficking in Florida 2
To better meet the needs of these vulnerable youth, the Florida Legislature enacted the Safe Harbor Act of 2012,10 which encourages Departmental circuits to better address the needs
Section G | Sexual Exploitation/Coercion/Control 12 Section H | Parent/Guardian Information 13 Section I | Post-Screening Assessment 13 Discussion 13 Summary of Findings 13 Limitations 14 Recommendations 15 Recommendation 1 15 Recommendation 2 15 Recommendation 3 15 Recommendation 4 ............................................................................................................................................................................ 15 Recommendation 5 ............................................................................................................................................................................ 16 Recommendation 6 ............................................................................................................................................................................ 16 Appendix A: Interview Schedule for Human Trafficking Screening Tool (HTST) Screeners ................................................................. 17 Interviewer Script 17 Interview Guide 17 References 18
EVALUATION TEAM
Considered a form of modern-day slavery,1 federal and Florida law defines human trafficking as “the transporting, soliciting, recruiting, harboring, providing, or obtaining of another person for transport; for the purposes of forced labor, domestic servitude or sexual exploitation using force, fraud and/or coercion” 2 While there is no official prevalence estimate of human trafficking victims in the United States, Polaris, a leading organization in anti-trafficking work, suggests the number is in the hundreds of thousands.3 The 2020 National Human Trafficking Hotline (NHTH) data shows 10,583 cases,4 though scholars have noted this is an underreported crime,5 so this is likely an underestimation. Notably, Florida had the third highest number of cases reported to the NHTH, with 738 cases.4,6
Bushra Rashid, MSW, served as a research assistant on the study. Ms. Rashid’s primary responsibility was interview data collection.
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HUMAN TRAFFICKING IN FLORIDA
Introduction
The Institute began collaborating with the Department of Children and Families (DCF) to validate the Human Trafficking Screening Tool (HTST, Tool) in 2017. In 2019, Institute researchers conducted psychometric testing with the HTST using a non-random sample of 248 completed assessments from disparate areas of Florida. Ultimately, the Tool was unable to be validated due to lack of reliability. The Institute suggested that with additional screener training, subsequent data collection, and new analyses, validation is possible. This present phase of this collaboration includes qualitative interview and focus group data to explore screeners’ interpretation and implementation of the Tool in an effort to inform recommendations for DCF.
Lisa Magruder, Ph.D., MSW, Co-Investigator, is the Program Director of Research at the Florida Institute for Child Welfare. Dr. Magruder’s role on this study included project conceptualization, grant writing, securing IRB approval, data collection and analysis, and report writing.
Keishann Corley, MPA, served as a research assistant on the study. Ms. Corley’s primary responsibilities were transcript editing and initial data analysis.
Background
According to DCF,7 the Florida Abuse Hotline received 2,289 reports of human trafficking allegations involving 1,750 children in SFY 2020-2021. DCF tracks two types of youth human trafficking cases:7 the commercial sexual exploitation of a child (CSEC)— which accounted for 92.97 percent of reported cases—and labor. Consistent with the research,8 males represent a minority of youth trafficking reports in Florida at 17.37 percent.7 The most recent data indicate that, of the 2,289 reported cases, approximately one-quarter were deemed verified as trafficking.7 A recent literature review documented the significant consequences of youth trafficking, which include significant adverse physical and mental health impacts (e.g., injuries from violence, sexually transmitted infections, major depression, suicidality).9
Jessica Pryce, Ph.D., MSW, Principal Investigator, is the Director of the Florida Institute for Child Welfare. Dr. Pryce’s role on this study included project conceptualization, grant writing, securing IRB approval, and project oversight.
This present study is a qualitative exploration of how screeners are implementing the Tool, specifically noting gaps in knowledge that may be able to be addressed in training. The study’s individual interviews focused on the lived professional experiences of designated HT screeners using an exploratory, phenomenological approach,15 while focus groups implemented cognitive interviewing to allow small groups of designated screeners to provide feedback on the HTST itself.
Despite the lack of reliability, there is promising evidence that the Tool could be validated in the future following improved training with screeners on how to understand and implement the HTST.
Data Analysis
The author analyzed interview data using NVivo software and by applying thematic analysis.16,17,18 Broadly, thematic analysis follows six overarching steps: 1) data familiarization, 2) initial coding, 3) theme searching, 4) theme reviewing, 5) theme defining, and 6) reporting of findings.16 The author reviewed approximately 25 percent of the transcripts and created a codebook consisting of nine substantive patterns which are primarily informed by the items in the interview guide (e.g., path to screener role, training descriptions, screening process). Some broader patterns included sub-codes; for example, the pattern “process” included several subcodes, such as location, speed, collaborators, and communication of findings. The codebook was then applied to all interviews. Using patterns in the data, the project PI arranged themes that were largely guided by the major sections of the semi-structured interview guide.
At the agreed upon interview time, a trained interviewer called the participant, reminded them that the conversation would be audiorecorded, and offered an opportunity for the participant to ask any questions. Using a semi-structured interview guide (see Appendix A), the interviewer asked participants about their experiences as a screener. Interviews lasted between 25 and 50 minutes, with an average of 36 minutes. Participants received a $25 Amazon.com gift card incentive within one week of completing their interview. All interviews were professionally transcribed then edited by a research assistant for clarity and confidentiality.
To establish a sampling frame, the DCF provided a list of designated screeners by region, with the exception being for the Northeast and Northwest regions; that list was combined. A total of 440 names and emails were provided. Using a tentative sample size of 30, the research team attempted to recruit a proportionate random sample by region, though pivoted to a convenience sampling technique when response rates were low. Excluding several duplicates, the research team invited 436 screeners to participate. Ultimately 31 individuals completed the online consent process, 29 were eligible to participate, and 26 completed an interview. All procedures, including amendments, were approved by the Florida State University Institutional Review Board.
Methodology
Building on this work, Institute researchers performed psychometric testing on the HTST using de-identified data provided by DCF.14 Initial findings suggested that when two items are removed (i.e., evidence of forced tattooing/branding, evidence of forced labor), the HTST measures two factors: environmental risks (e.g., running away, deceptive payment practices) and sexual exploitation (e.g., unsafe online activity, receiving compensation for sexual activity). In addition, a latent class analysis found three distinct classes of risk: 1) low risk, 2) runaway and environmental risk, and 3) sexual exploitation risk. That these classes of youth closely mirror the two-factor structure lends additional evidence of promise of the Tool’s utility in identifying youth human trafficking victims. Despite this, the reliability of the HTST is low, meaning there is a lack of consistency among individual indicator items; each item may be capturing something unique about youth involved in human trafficking. Anecdotally, researchers noted during data entry many inconsistencies in the ways in which screeners input data, which could be due to individual screeners’ misperceptions of items or problems with the Tool itself. Given that, as a rule, instruments cannot be valid if they lack reliability, the HTST in its current form and typical use is not valid.
INDIVIDUAL INTERVIEWS
Sampling
Using the same list of designated screeners provided by DCF, the researchers emailed all screeners (n = 430, excluding six bounced emails) inviting them to participate in a focus group within their region. Ultimately, 37 individuals completed the online consent process, 29 were eligible to participate, and 28 selected at least one potential focus group time slot. To ensure representation from across the State, the researchers attempted to conduct one focus
Data Collection
In 2016, the Office of Program Policy Analysis and Government Accountability (OPPAGA) expressed concern that the HTST was not being used as intended and recommended DCF gather systematic feedback from its screeners regarding implementation, as well as conduct psychometric testing (i.e., validation) of the instrument as data and resources became available.12 Validation, if possible, had previously been recommended in the 2014 expansion of the Safe Harbor Act.11 As a first step in this process, Institute researchers developed and disseminated an online survey in December 2017 to Florida’s CPIs and dependency case managers to assess frontline child welfare workers’ experiences with human trafficking cases.13 Those who self-identified as specialized screeners were asked additional questions regarding their perceptions of and experiences implementing the HTST. Results indicated that approximately half of workers had worked a case involving suspected or verified human trafficking, the majority of which involve CSEC, as opposed to forced labor or both forced labor and sexual exploitation on a single case. Among screeners, most reported feeling moderately self-efficacious in conducting the HTST. Despite a frequent lack of cooperation from youth, two-thirds of screeners reported being able to complete the HTST in a single visit with the youth. While over 80 percent of screeners find the HTST to be at least somewhat useful, participants reported several common concerns, including: 1) the Tool is too long, 2) the indicators are too broad, and 3) a scoring guide is needed.
PRIOR HUMAN TRAFFICKING SCREENING TOOL RESEARCH
CURRENT STUDY
of sexually exploited youth, including expansion efforts for shortterm safe housing availability and use. The Act was expanded on in 201411 to include the provision that DCF and the Department of Juvenile Justice (DJJ) develop a set of instruments to better identify, assess the needs of, and place CSEC victims. To meet this provision, DCF developed and piloted the HTST in 2015 before statewide implementation in January 2016. CPIs receive an eighthour training course on human trafficking and the Tool, after which they are considered “designated specialized screeners.” Each quarter, these screeners complete an additional hour of human trafficking-related training.
Sampling
FOCUS GROUPS
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Data Analysis
A total of 26 screeners completed an interview, including 15 CPIs, 8 senior CPIs, and three in other roles. Participants work in disparate regions of Florida including Central (n = 15), Southeast (n = 4), Suncoast (n = 4), and Northeast (n = 3). There were no participants from the Southern or Northwest regions. Additional demographics were not collected as part of the study.
Continuing Training
Although the researchers intended to hold in-person focus groups in each region, COVID-19 safety measures dictated a pivot to online data collection using Zoom. The researchers conducted all focus groups, beginning each group by answering any participant questions about the study or their participation. The researchers then implemented cognitive interviewing, a qualitative technique that can provide in-depth information on if and how instruments provide the desired information.19 The technique asks a small group of individuals to provide information about survey items, as opposed to answering the items, to provide insight into the performance of those items.19 Going through the HTST, the researchers used a combination of think aloud and verbal probing.19 That is, participants shared their thoughts on the HTST items, but the researcher also ask targeted questions based on the language of the Tool (e.g., “What does an ‘unsafe living environment’ mean to you?”). Focus groups lasted between 60 and 122 minutes, with an average of 98 minutes. The researchers did not provide incentives for participation as focus groups were scheduled during participants’ typical work hours. All interviews were professionally transcribed then edited by a research assistant for clarity and confidentiality.
While participants generally agreed the initial training was beneficial, there was less consensus regarding how prepared they felt to administer the tool post-training (e.g., “Oh, yeah, absolutely”; “Absolutely not”). For those who felt unprepared, challenges centered around real-world application of the tool. A participant (#85335) explained:
Participants shared that, following their initial training, they complete quarterly trainings to keep up their designated screener certification. Often screeners attended webinars or viewed approved online videos to meet their continuing education requirement. These trainings covered a multitude of topics such as gender-specific survivor needs, working with particular sub-populations of survivors (e.g., homeless youth, refugees, children with autism), trafficking and technology, and interviewing techniques. Despite this variety, several participants expressed a need for more offerings: “See, that’s the part that’s getting frustrating, honestly, because I was supposed to do one last month, and it’s literally picking out a video online that I might have already watched” (#50589). Several individuals expressed a desire for more in-person offerings, though acknowledged COVID-19 as a current barrier to this. Topically, participants suggested more content, such as interviewing skills and youth engagement strategies, lived experiences of professionals and youth, and connection to services.
Researchers applied a similar analytic technique as described for the individual interviews. Following the focus groups, the author read through all transcripts and created a codebook consisting of thirteen substantive patterns based on the purpose of the focus groups and content that emerged within the data (e.g., screener techniques, current item problems, suggested item revisions). Some broader patterns included sub-codes; for example, the pattern “suggested item revisions” included several subcodes, including “revise item,” “remove item,” “add new item,” and “other.” The codebook was then applied to all focus groups and matrices were used to cross-tabulate patterns by Tool section. Given the small sample size, thematic saturation was not achieved. However, emerging patterns within the data were organized by Tool section.
Data Collection
The Screening Process
The majority of screeners explicitly spoke about the initial day-long training to become a certified human trafficking screener. Many shared that the training included content on the signs of trafficking as well as the tool itself, including how it is intended to be administered, rapport-building techniques for use with youth, and understanding non-verbal communication. A participant (#39722) explained:
Findings
Participants reported variation in the way their area handles the screening process. Most individuals shared that trafficking investigations are handled by a particular unit (either traffickingspecific or otherwise encompasses all trafficking investigations) or that they work in a typical unit wherein all or some of the investigators are certified.
I don’t think it’s – it gave me the information I needed to use the tool, to screen the individuals but I don’t think it prepares you for the real situation of sitting in front of somebody who has possibly been human trafficked and the resistance that you get to the questions being answered. As far using the tool I think they did a good job. But I do think it could have been more in detail.
So, the first training is eight hours. That was done in person. They go over – I mean, it’s a lot. They go over indicators of human trafficking and different scenarios of human trafficking, what human trafficking looks like. They go over victim testimony from victims of human trafficking. And then, how to administer the tool, how to make it a conversational piece rather than just like a questionnaire to the youth. How to pick up on maybe nonverbal indicators, or how to gather more information from your more – youth that don’t want to answer questions, but how you could pick up from something else in the conversation that would raise a concern.
group in each of the six DCF regions. Ultimately, five focus groups were scheduled, though some screeners were ultimately unable to participate, leaving a sample of 10 participants across five regions. All procedures, including amendments, were approved by the Florida State University Institutional Review Board.
Though some screeners did not desire any changes to the initial training, other suggested various ideas (e.g., shorten training, offer trainings more frequently or sooner after onboarding). The most common desired change was for more time, depth of information, and hands-on opportunities to practice using the Tool.
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Experiences and Perceptions of Screener Training
Regarding their path to becoming a screener, approximately onethird of participants noted that the training was required for either their role (e.g., as a senior CPI) or their unit (e.g., human traffickingspecific). Others reported they elected to become certified or were selected to be certified by their supervisor. Participants estimated having been screeners for an average of three years (Range: six months to 11 years). For those who shared an estimate of the number of screenings they conducted (n = 23), they reported having screened between two and 125 youths. Based on their time as a screener, they screen approximately ten youths per year, though several supervisors noted that they oversee more.
INDIVIDUAL INTERVIEWS
Initial Training
Screeners were asked to define “at risk” as it relates to youth not yet verified as victims of trafficking and many cited specific indicators of the HTST, most frequently identifying a history of running away. Other indicators frequently mentioned included inappropriate sexual behaviors, having material items they cannot afford (e.g., cell phones), signs of grooming (e.g., hair done, nails done), suspicious tattoos, age-inappropriate friends or partners, and inappropriate website or social media engagement. Several screeners cited contextual factors or circumstantial factors of the youth’s life that could place them at risk for trafficking (e.g., lack of education, lack of family structure/support, mental health or substance use issues). Fewer screeners noted demographics or history of child welfare involvement as specific risk factors for trafficking.
Several screeners noted that conducting screenings away from the youth’s family can help them feel more comfortable, whether that is at school (e.g., “I felt like the one at school was, honestly, probably the best one, because they weren’t at home near their family or whatever”) or in the home (e.g., “…it’s away from the parents… the kitchen…a living room…[if] they have [an] outdoor patio or basketball court. They may feel more comfortable talking there”). While many screeners shared that law enforcement presence during screening is required—or at least considered best practice—given the potential that a crime has been committed, screeners explain officers’ presence to the youth during the conversation. Although no other individuals were identified as being routinely present for screenings, it is common for screeners to rely on collateral contacts, including caregivers, to round out their investigations. A participant (#49550) explained:
we’ll be called out on and it will be what we call an unknown case where we have nothing, we have no demographics. We’re lucky if we have a first name. Sometimes we only have an address of where we’re going to. So, it can vary depending on the source of the information, of how much we typically get. And the hotline doesn’t always do the extensive searches that we do. If we get an investigation, we can pull the address from the intake…So, we can take the address and get a general [idea] of who might live in
Very few screeners said they used the HTST in a checklist fashion. One participant (#85335) explained “the paper” to the youth at the outset of the screening:
Nearly every screener described using a conversational style when conducting a screening. Given the volume of data needed to complete the Tool, some screeners noted that they like to have the Tool nearby as a support or a “reference” (e.g., “Just using it as an aide. If there is something I realize that’s missing, I can flip through it and see something and then ask questions about it”). Other screeners shared strategies for making sure they get and record the information they need, such as using a “cheat sheet,” taking handwritten notes with youths’ permission, or typing out notes in their phone or tablet. A screener (#57478) explained:
Someinformation.cases
Sometimes we have a lot of information; sometimes we have very limited information. A lot of it depends on what we get, what we call pre-commencement activities. So, precommencement, we’re gonna be looking at criminal history, CCIS history, priors with the department, and if we’ve got a lot of priors with the department, those will give us a lot of information about what this kid has been through, trauma. We also talk to the reporter. That’s one of our requirements, and sometimes the reporter has a lot of information regarding the youth before we go out there. If you’re dealing with somebody that has known the youth for a long time, or, in some cases, like I was saying before, when we had the one case with somebody that I, honestly, at this point, still don’t know how they came to throw all this stuff together, we don’t have any
WhenPre-Commencementgoingintoanscreening, participants shared that the amount and type of information they have about a youth can vary. Many shared that they have access to demographic information and any prior history with DCF or DJJ. Several shared that would have already spoken to the reporter (e.g., “…The reporter is very important”). The amount of information can also vary depending on how the report comes to their caseload. For example, if a youth was in a JAC, DJJ will have already completed a Tool. If there are concerns on an existing case, the screener has information from previous interactions between the youth and the child welfare worker. There are also times where screeners have very minimal information (e.g., “…If they have no history with the department, then all I have is the intake that comes in”). A participant (#50589) explained this variation:
Though not all screeners spoke to the required speed of an investigation, those who did highlighted the “time-sensitive” nature of these cases. Some cases were described as “immediate,” where the screener needs to make contact within two to four hours of the report. Others were described as slightly less time-sensitive (i.e., 24 to 72 hours). In terms of location, many screeners stressed the importance of making the youth feel comfortable. The most common screening locations shared were the youth’s home, the youth’s school, or JACs; however, other locations were noted as being places the youth felt comfortable (e.g., restaurant, park) or were based on circumstances (e.g., at the hospital if the youth needed medical attention).
But they don’t always come in labeled as human trafficking. Oftentimes they do but they don’t always. So it’s just important, I think, to know what to look out for and just the questions to ask when you’re taking to a child or a youth to see if that is something that could be present or needs to be screened for.
Cases in which an HTST is warranted often come in coded as specifically having trafficking concerns, though not always. For youth in Juvenile Assessment Centers (JACs), DJJ will complete a Tool with them (e.g., “…But if you get the information from DJJ, then you try to reconcile that information and see if you can confirm it…”). Many participants shared that indicators could appear in new or ongoing maltreatment cases, making it important to be able to spot what numerous screeners called “red flags” at any point in time on a case. A participant explains:
FLORIDA INSTITUTE FOR CHILD WELFARE 5
the household, and then we can turn around and do a vital statistic check, and see what children these people that live in the household might have. And then try to get a good idea, before we go out there, and we also take law enforcement, so they can do a premise check and see if any law enforcement officers have been out there, and if there’s been any concerns at the residence. But, as for the youth themselves, we don’t always have the demographic information to be able to look up and see if they’ve had involvement with any of our agencies.
It’s usually in a laptop. They usually think that I’m working while I’m talking with them, when I’m like, oh, you know, I still have to work while – because usually by the time that we’re screening them, if I don’t have to go out with the PI – if I go out with the PI, they pretty much know that that’s what we’re screening for, but if it’s for some of the girls that we’ve picked up at the police station, they just think I’m working.
Conducting the Screening
“Hey listen –” get to know them and then like, “I have some questions to ask you. We’re going to go over this thing. I have this paper.” I don’t tell them it’s like a screening tool, I just tell them like, “Hey, I have this paper with some questions. I’m going to ask you some questions. It’s most important to just be honest; nothing you tell me is going to get you in trouble. Just be honest. Because the most important thing –” and then we’ll just go through and ask the questions.
1.
Screeners very similarly described how they communicate their findings after completing the HTST. In general, if the Tool determination is “unsure,” “likely is,” or “definitely is,” the screener first notifies their supervisor and then a multi-disciplinary staffing or team meeting is called. While specific stakeholders appear to vary by community or agency, screeners most frequently said these staffings include the child protection team, law enforcement (local or federal), a human trafficking specialist or liaison, and other child welfare providers (e.g., case management, guardians ad litem, children’s legal services). These staffings assist the collective providers in deciding how to move forward. A participant (#97878) explained:
Give youth a reason to like you
FLORIDA INSTITUTE FOR CHILD WELFARE 6
weeks. So, all human trafficking cases will have to present the case and report the status of the case. So, at that point, we already engage the child with services…On the second staffing, maybe the child has been able to open. So, things can change. Maybe at the beginning was like, “No. This is not happening.” But then the child start talking.
We talk about the case and we decide how we will now move the case forward and if the findings, so far, are going to be, at that point, what do you see it like verified, no-indicator, or not substantiated…The staffing help us to gather any missing part, because we’re humans. So, then we can miss something. So, that why the staff meeting is so important because there is, at the staff meeting, your supervisor, but there’s a bunch of other people but they have more insights. Then this staff meeting is not only one. [They’re] like every three or four
Show youth you care I get it. I would – if the roles were reversed, I would be awful, you know? And that I think helps too because I can say to them, you know, I get it. I know you don’t like it. If I were you, I wouldn’t like it either and I tell them but here’s why I’m doing it. Want to know why we’re doing this? I don’t know about anybody in your life. I really don’t. All I can tell you is that if I sit here and I’m talking to you, I truly care about you and what happens to you and I want to make sure that you’re safe, not because it’s my job because it is my job to make sure you’re safe but not because it’s my job. It’s because I’m a human being and that’s my obligation to make sure you’re safe so that’s why I’m asking you these questions so I’m sorry. I’ll apologize but I still got to do it. Let’s get through it. We’ll get through it together and I’ll try to go as quick as I can but it’s really important that I get details. So if you’re willing to do that and work with me, we can bang this out and sometimes they’re cool with that. Sometimes they tell me where to go. - #37093
Be aware of who is in the room
Technique Example Quote
Just talking to them. I mean, I tell them – because especially your more verified ones, they’re worried of – about, you know, “Is something going to happen if I talk? Am I in trouble?” And some of them get intimidated with law enforcement there, so it’s just the reassurance that, “Look, you can tell me and you’re not going to be in trouble.” And reassuring that, “You know, my job and the officer’s job is to keep you safe and make sure that nothing happens to you.” So, just reassuring them. - #39722
Communication of Findings
Table Rapport-building Techniques
Building Rapport with Youth
Screeners shared that they experience several major challenges when conducting a screening with youth, including youth who do not want to or otherwise refuse to answer, lack of youth honesty, and youths’ fear of getting in trouble. Few participants shared that
Consider the demographics of the screener
A lot of times just sitting down and – like you would with anybody that you just met, and talking to them about their life. So, you know, who do you live with, how long – if they’re already at the facility, sometimes because we have a human trafficking facility, how long have you been here, you know? So, what’s it like here? What do you like to do? Getting to know them as a person, not somebody that needs to be interviewed. And building rapport that way. You never wanna go into an interview and just start blasting questions at them…If you can get yourself humanized in their eyes, it goes a long way, not where you’re an investigator, and you show up with a DCF shirt on. - #50589
Then also male/female. I have some kids that – I mean they have a whole history of trauma. They have – we know where the behaviors are coming from. So, I’m not going to send my six-three guy out there that’s just really intimidating. I’m going to send somebody else. So, I’m going to try the team that will go out there. I’m going to try to find somebody who they’re probably going to be able to relate with a little bit more, which I mean sometimes you don’t know what you’re walking into. So, there’s nothing you can do about that. But when you can plan around it, it makes a huge difference as far as what your disclosure is going to even look like. - #11965
Some children, depending on their circumstances – I can tell you if I’m doing an interview at the juvenile detention center or the JAC you generally get a lot of cooperation because they don’t know what’s going on a lot of times, and all of a sudden they’re locked up. And so, you tend to get a lot more information. But a lot of times, when you do things at home, especially when Mom and Dad are there, you need to get them in a place where they feel a little more comfortable or Mom and Dad’s not listening, and you can sit there and talk to them and find out what’s happening, if something’s happening in the home. And so, I would say for a lot of times it depends on the circumstances of where you do the interview. - #33757
Participants did not consistently describe a “typical” interaction or relationship with youth being screened. Some shared sentiments such as, “Most kids are mad, angry, and closed off…,” while others shared feelings that, “Usually it’s pleasant…,” or that “it does vary.” Several noted that “it’s going to be the angry teenager who’s engaging in risky behaviors…” These youth tend not to be forthcoming with information, as one screener (#92397) explained: And if they are being trafficked, whether it’s they’re trafficking themselves and it’s voluntary or they have a pimp or whatever the situation is, they’re not forthcoming with information. It’s hard to get that stuff out of them. And to me, I think it’s for the same reason an adult that’s soliciting sex or work or something would do. It’s their business and they don’t give a –they don’t want to tell you. It’s hard to get that information out of a child.
Be honest with youth I always tell them that I don’t sugar coat anything, and I’m straightforward, and I’ll always be honest with them. - #44612
Do not be punitive
You talk to the parents, if they’re available. You talk to other people who are familiar with the child – whether it be the school counselor, their probation – some of these kids have DJJ history so, you know, talk to their probation officers or other family members who are close to the situation just to kind of see what’s going on here.
Screeners’ Suggestions for Change
To help combat some of these challenges, in addition to the general strategy of keeping the screening conversational, participants shared several techniques that they use to help build rapport with youth (see Table 1). Most often, screeners shared that try to give the youth a reason to like them or otherwise connect with them, including bringing laughter or self-depreciation into the conversation. Engaging youth in this way (e.g., asking about their life, their hobbies) can help establish a relationship with the youth so the screener is not just viewed as a DCF worker. Screeners spoke to being honest with the youth and showing that they care about them. They also noted the importance of maintaining an awareness of who else is in the room and how that can affect if and how youth respond to the screening. For example, the location of an interview can influence what a youth is willing to share. A participant (#11965) shared:
Determining the Likelihood of Trafficking
Outside of these few cases, screeners pointed to several indicators they feel are particularly useful, with the most frequently cited being tattoos. Screeners find tattoos to be useful for several reasons, such as identifying other adults in the child’s life besides a parent (e.g., “somebody had to sign for them to be able to get that tattoo”) or “certain symbols” being specifically tied to trafficking. One screener (#57478) noted that even the quality of a tattoo can be useful in identifying red flags:
Given that law enforcement is generally present during screenings, many screeners explain the reason for an officer’s presence as a safety measure for all parties. A participant (#50051) shared: I said I do try to explain law enforcement to any kid that I interview, whether it’s human trafficking or not. Law enforcement makes a lot of kids very jumpy, so I try to tell them, “They’re for my protection, your protection. They’re just here to make sure that you’re okay.” I try to make it not scary because, like I said, kids get scared of cops, especially ones like that because they feel like they’re going to get in trouble, because if they have drugs on them, or something like that. They feel like that gets them into trouble.
Another frequently noted useful indicator is a youth’s history of running away. Screeners shared that contextual information around runaway incidents (e.g., where they ran to, where they were found, how the youth reported supporting themselves while on the run) can illuminate risk factors related to trafficking. There was less consensus around other useful indicators. Table 2 includes example quotes for indicators deemed particularly useful by at least four screeners. Notably, there is overlap between some indicators, further illuminating the importance of how context can raise red flags for screeners
non-cooperation was due to the youth “lik[ing] the life.” Screeners reported that youth have not given them feedback on the Tool itself, but sometimes expressed frustration with the process (e.g., multiple screenings, “a lot of these questions are repetitive”).
So, if there’s issues at home and you’ve got mom in the kitchen and the kid’s like – let’s say you’re in the living room and the kid knows that mom’s right there around the corner, the kid’s not going to tell you anything. They’re not going to tell you how they’re leaving or when they’re leaving, because they don’t want mom to be like, “Uh-huh. Okay, well, this is what I’m going to do to prevent that from happening again.”
Screeners also noted the importance of body language, both their own as well as that of the youth. In terms of their own body language, some viewed this as a way to convey the tone of the conversation (e.g., “I try and be as least threatening as possible. I try and open up [m]y body language a lot…I try to get down to their level”). Being aware of the youths’ body language can be helpful to a screener in guiding the conversation. A screener (#83411) shared their experience in asking a youth about a visible tattoo: And she kind of, like, put her head down, and I was like, I was like, so, I was like, is that your way of telling me that you don’t wanna talk about the tattoo? And she was like yeah. And I was like, okay. And I mean, I can’t – I can’t force you to, you know? And I was like, you know, is it – and so we – I tried to, like, talk around it. And I was like, all right. I was like, did you want to get the tattoo, and she was like, oh yeah, like I did. And I was like, okay, you know? And so, come to find out, like, she was embarrassed by the tattoo, it was a – you know, stuff like that.
When deciding the likelihood of trafficking, most screeners spoke of how they completed the Tool based on their interactions with the youth and any collateral contacts. A participant (#25142) explained: It has to be a combination of everything like the information that you’re getting from the child, the information that you’re
Screeners shared their perspectives regarding possible improvements to the Tool itself as well as supports they need from the DCF to better carry out their role as screeners.
It’s difficult to prove who’s doing it to her, but most of the times, you can tell when it’s happening and when it’s not. Because there’s no reason why a 15-year-old is doing drugs all the time and has no money, but yet she’s getting drugs everywhere or don’t have any money whatsoever, but yet a brand-new cell phone and all these other items and a runaway tendency. So, you have to look for behavior patterns. You have to be able to tell how past behavior is indicative of the actual maltreatment.
Like some tattoos you can see right off the bat if it was a street tattoo, if it was a in-shop tattoo. And I can honestly like say, like, I’m like, who did this?...I’m like, whose kitchen did you get this out of? And I’ll tell the girls straight up. I’m like, which garage did you get this?
When specifically asked how much the Tool dictates their final determination, most screeners shared that they use the Tool in conjunction with other information gathered. These individuals described the Tool as “a guideline,” “a piece of the puzzle,” and a facilitative tool for gathering and documenting evidence of trafficking. For example, one screener shared: “I think it helps organize the information, but I think the contents you find out, along with teaming with others, helps get to that answer.” Fewer individuals shared that it maximally (e.g., “a ton,” “very important”) or minimally informed their decision (e.g., “not a ton,” “five to ten percent”).
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When asked which indicators on the Tool are or are not useful to their investigation, very few screeners cited items that were not helpful. Indicators considered to be less useful seemed to be so due to ambiguity. For example, one screener shared that school issues (i.e., poor grades) could be attributed to a number of factors outside of trafficking. Another shared that a history of sexual abuse could be so far removed from the time of the trafficking investigation, that it does not seem relevant. Finally, a screener noted that tattoos can be “kind of iffy,” as they had noticed an increase in the number of teenagers with tattoos generally.
getting from whoever made the report, and the information that you’re getting from the family. Sometimes it’s difficult just because the child is not being truthful, but if that investigator or myself, if I really pay attention to the things outside of what the child is saying and being able to put the two and two together, it’s not as hard as it looks.
A few individuals shared that they might change the way certain questions are worded (e.g., to avoid repetition). Though, given the conversational nature of the Tool, this did not appear to rise to the level of a necessary change. For example, one participant (#57478) shared how this challenge could be resolved with additional guidance or training:
Tattoos I mean, the number one hugely the one that – giant red flag that sticks out, I mean, that’s gonna be your tattoos, your scars, your brandings. - #83411
With them talking to people who aren't their right – aren't age-appropriate for their friends and stuff like that, meeting people on social media and then going to meet up with them in person. I think those ones are big, too. - #24093
Relationships(Age-Inappropriate)
Focus group participants represented five regions: Central (n = 3), Northeast (n = 3), Southeast (n = 2), Southern (n = 1), and Suncoast (n = 1). The Northwest region was not represented. Importantly, while these are referred to as “focus groups” in this report to capture their original structure and purpose, all groups had small sample sizes and two are considered individual interviews.
Although they reported being generally satisfied with both their initial and continued training on human trafficking, approximately half of screeners provided training-related suggestions for further screener support. Some suggested process-oriented changes (e.g., expand the number of offerings, more in-person trainings, more time to participate). Others offered more content-related suggestions for training (e.g., incorporating more lived experience from survivors, engagement and rapport techniques, more trainers with screening experience, additional content on how to administer the Tool). While several screeners noted other types of supports needed (e.g., additional community resources for survivors, retention of good screeners), these tended to be singular suggestions.
Notably, approximately one-quarter of participants shared that they
A lot of times it has to do with running away and it has a lot to do with hanging out with adult males known to the trafficking – that have been known to traffic young girls... - #44612
2) Providing more response options or space for screeners to capture contextual details:
Not a box. But like a – an area where you could free – you could be able to write freely, like tie something freely explaining why you’re answering no or why you’re answering yes. - #38554
did not need any additional supports from the DCF, noting that they already do “pretty well” in supporting screeners. One participant (#33757) shared:
Tool Improvement
1) Separating the sex and labor trafficking items into separate Tools:
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Table 2. Useful Indicators
Needed Supports
To shorten a lot of it so that you – I guess, from the get-go, when you’re gathering all the initial information, then understanding which sections are going to be relevant. I mean, I get that there needs to be some kind of consistency and this is the information that needs to be gathered, but I think a lot of it really goes back to the quality of your investigators. - #11965
Grooming And to know that the children can be groomed. Although, you know, the hair is nice – a lot of young ladies do have their hair done, nails done, boys always looking fly. You want to make sure that their caregiver in the home, you know, the one that is taking care of them, is the one that is providing these – the money for them to be groomed and not someone else. So those indicators are very helpful to me. - #46971
Social Media/Internet
Participants in several focus groups indicated the Tool, although long, provides them with the information they need, if not to make a definitive determination of trafficking, to at least to guide the next step in calling a multidisciplinary staffing. They reiterated the importance of using the HTST as a conversational guide and many offered specific examples of what this looks like in practice. In terms of broad changes, several participants expressed a desire for separate labor and sex trafficking tools, though this was not a
…So, they’re both in the tool. It almost would be better sometimes if there was two tools, if there was a labor tool separately from a sex tool. But I know initially when the tool was put together they tried to cover all the bases. - #33757
Debt Bondage I would say the debt bondage traits…Traits in terms of how children are acquiring different things that they have. Some things will be gifted. But, if there are things beyond getting good grades, children get rewarded and stuff like that, they may receive different things for good grades or whatever their behavior management system is in their home, but there is a line where what is it that they're having to do to receive whatever these things are, or pay off debt to the things that are occurring? - #31215
FOCUS GROUPS
Oh, DCF. We get fabulous support from our human trafficking coordinator here locally and our regional person. They keep us up to date with what’s going on. They’re very, very good in assisting us when we need assistance, no matter what the case is. They work as an intermediary between us and law enforcement and other agencies. So, they make doing our job a lot easier.
Indicator Example Quote
I think – because a lot of the questions I have to do, I have to kind of come up and get those conversational questions that I can – like I can change that question into a conversation. I feel like it would be a lot easier if that was kind of given to us, like giving us examples of how to convert that, if that makes any sense
Screeners offered little suggestion for change regarding the Tool itself. The top three suggestions, each offered by few participants, included:
Runaway History The runaway ones can be really helpful, especially about "Do you go out of town?" How they're supporting themselves when they're gone. Anything uncomfortable that they've had to do while they've been away to support themselves. - #39722
3) Shortening the Tool:
Suggestions for change centered around rewording items to make them more conversational and easier for youth to understand. Several screeners focused on items 20 and 20a, which assess who pays for where the youth live (e.g., “…I just asked them do you pay rent or who helps you…,” “Who pays the rent? Who’s the landlord,” “Who pays the bills where you live?”). A couple of screeners also suggested revising language around prior DCF history (e.g., “Has anybody like me come and talked to you before?”).
Section E | Work Information
Section C | Youth Personal Background
Section D | Living Conditions
Region Example Quote
Suncoast I take "evidence of unsafe living environment" as a home that has environmental hazards or exposed wires or feces on the ground or that kind of thing. That's what I would say would be – I wouldn't base it on any of the questions. But again, the hard thing is that we're not doing – we're not always doing these tools at their home. We've never been to their home…
Northeast I would say this is one I’ve got tripped up on because like they were saying the situation. A lot of the kids that we have are kids that are in placement or in shelter or things of that nature but they’re running off. So necessarily their placement of where they actually live or we place them with someone it’s not a danger or safety issue or a concern.
Table 3. Ambiguous Interpretations of Unsafe Living Environment
Central I wouldn’t necessarily agree that living in a motel is necessarily unsafe or living with a romantic partner is necessarily unsafe because it could be a really nice hotel or it could be a really crappy hotel but you have a place to live. You have food to eat. You have, you know, you could still be in a safe living environment. So this question to me is just way too vague. It needs more, a lot more…Define in terms of this tool what is unsafe, what “unsafe” looks like. Don’t leave it up to the screener or … no, not even or – and a place to write why the screener feels like it’s unsafe.
Southern Yes, like their first job, their first, you know, anything when it comes to any kind of work or anything like that, it may be harder to comprehend, especially when talking about minimum wage and how much you make. I just think that could be a little bit challenging.
Suncoast The only thing with 24, "How much do you make an hour?" some of these kids don't make per hour. So, even if there was a spot that said instead of "per hour," "How much money do you make in a day?" and then you can do "Is it per hour; is it flat rate for the day?”…A lot of these teens…it's not a kind of per-hour thing. So, I think that is a very vague question.
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Screeners similarly had few concerns with the items included in Section D. When discussing the evidence of unsafe living environment indicator, one group discussed the vagueness of the information gathered in supporting their decision. In response to a Central screener sharing that living in a motel is a “red flag” for them, their colleague shared that more contextual information is needed. This screener went on to say that, although there are clearcut examples (e.g., exchanging sex for housing), this is not always the case. Responses generally indicate that it is not necessarily the type of housing that raises concerns, but the total circumstances of their living situation. See Table 3 for relevant quotes.
Table 4. Perceptions of Item 24 (Wages)
uniform request. For example, one participant suggested adding in a couple items that could help the screener determine which type of trafficking was of concern for the youth. Other participants noted a need for space to include contextual explanation for their findings. Currently, screeners use several strategies to document this context, such as writing notes in the margins of the Tool or appending additional documentation or case notes to the Tool. When reviewing the Tool by section, there were many items for which screeners had no feedback. When items were considered problematic, it was primarily attributed to their vagueness or youth transparency with certain items or sections. A few screeners suggested shifting items to other sections, though these suggestions were not consistently shared. The following findings report patterns in screener responses by section. Importantly, sections A and B were not routinely discussed, as these were considered background information sections.
Screeners had few concerns with the items included in section C. As one Central screener shared, “For me, generally those questions get answered way before I even make it to the tool, so I don’t even need to ask them those questions.” Several participants shared COVID-specific concerns regarding Section C. For example, during the time of data collection many students had recently been or were still being homeschooled due to COVID-19. This made assessing for school attendance less informative as a potential trafficking red flag. Another screener mentioned homeschooled students had increased access to technology, which can place them at greater risk for online trafficking activities.
The longest section of the HTST, Section E, elicited the most feedback from screeners. Items in this section were again described as vague. In addition, screeners expressed concerns that youth do not understand some of the Section E items and that this section is one in which youth tend not to be transparent, which hinders Tool completion. For example, a Southern screener said, “Especially when you go into money, ‘How do you get your money?’…I’ve have struggled getting answers for that question.” While screeners made specific suggestions for item revisions, more often they shared how they themselves reword questions in the moment to build rapport with youth and make the conversation more comfortable.
Subsection: Deceptive Payment Practices
Central With our sales crew, they get paid on the amount of sales they make so there really is no hourly rate. Then, of course, stuff is deducted for use of cell phones, for McDonalds, for whatever so the pay rate is not really what’s right there.
Region Example Quote
Among the items that were described as potentially confusing for youth were those included in the deceptive payment practices subsection. Screeners shared that some of the items on the HTST could be hard to assess given the nuances of a youth’s particular situation (e.g., if a youth works in a family restaurant). The Central region screeners discussed needing to distinguish between human trafficking and smuggling, particularly when working with the migrant community, though acknowledged both can exist simultaneously. A consistent point of feedback was that, even if youths knew the meaning of “minimum wage,” many youths do not work in situations with structured pay scales (see Table 4). Screeners shared several ways in which they determine if there is evidence of deceptive pay practices (see Table 5), including item-specific red flags as well as paying attention to youth’s demeanor in how they respond.
Region Example Quote
Subsection: Forced Labor
Southeast They might give you hints that they've been trafficked. And like, "Yeah, he owes me money," and da-da-da. Depending on how streetwise the youth is that you're working with, they might give you hints of something like that going on because it triggers them. So they're angry that they haven't been paid, or the person isn't taking very good care of them, so to speak, in their mind. So if I start seeing those types of responses, then I would probably check yes that there's evidence of deceptive pay practices.
There was more consistency in screeners’ perceptions of technology use, as they have little doubt youth are accessing the Internet and mobile applications (“apps”). For example, a Northeast screener said, “…These kids have access or will find access to something.
As previously noted, although screeners shared suggestions for item revisions or additions, they often shared specific examples of how they reword items in the moment to get the information they need. For example, within the forced labor subsection, a Southeast screener shared how they elicit information about a youth’s relationship with their boss:
So I don’t even ask. To me, no is not an option…” A Central screener corroborated this: “I don’t give them the opportunity to lie to me and say no. I just ask straight up what are your apps?”
Southern For one, the kind of job that they're doing, and the amount that they're getting paid for it. I think if I'm able to engage the child, and they're able to tell me that they have no idea what they do make but can tell me what exactly kind of job that they do, I think that would be of some concern. I'm not saying they know the exact price point, but if they have no idea of what they're making but they're able to say, "Yes, I'm able to tell you what kind of work I do." Also, that ties in with 27, of them doing anything and not getting payment for it.
Suncoast If they had answered “yes” for 25…Twenty-five through 27…That would be more or less if they’re owed money from somebody and are not getting it. To me, that would be a separate thing [from the type of work or amount they are getting paid].
Related, screeners also noted a lack of clarity around the forced labor subsection, with several suggestions for additional items. Again, concerns specific to the migrant community arose, with screeners in two groups suggesting an item be added regarding living with coworkers to supplement the item asking if youth live and work in the same place. In both instances, screeners noted that sometimes trafficked individuals live together and are brought to the same worksite (e.g., “But they were being trafficked; it’s just they were all living together and being taken to where they work”). Another screener suggested an item be added to assess whether or not the youth’s boss is withholding documents: “That’s a key, because they threaten them. They say like, ‘If you don’t do this,’ or ‘You don’t work if you don’t.’ Allow people to torture them. ‘You will not be back to your country.’”
Screeners from several regions agreed that when determining evidence of unsafe online activity, how the youth respond to item 32 (“Have you ever agreed to meet someone you met online or through the Internet or through a phone app”), and any follow-up probing, is important. A Suncoast screener pointed out that even if a youth did not actually meet up with someone they met online, even the youth being asked to meet in person can be concerning in and of itself. Finally, the websites youths use can also be telling, especially if they are not age appropriate (e.g., “…Tinder, depending on their
Screeners reported different conversational techniques to elicit information about potential unsafe online activity. Given that popular apps are constantly changing, the Central region screeners noted it would be helpful to continuously update the list on the Tool and to provide a space for the screener to include information about the youth’s usernames, passwords, etc.; however, not all screeners expressed a desire for this (e.g., “usually I don’t ask [for usernames]”). While the idea of keeping abreast of current relevant website and apps seems prudent, a Southern screener stressed that knowing how youth engage with websites and apps is most telling regarding potential safety risks:
Screeners shared inconsistent strategies and conversation outcomes when assessing for youth relationships. For example, Northeast screeners generally agreed items around current boyfriends or girlfriends, including their ages and how they met, are “pretty straightforward” and often asked in the course of a typical investigation, regardless of trafficking concerns. A Suncoast screener reported challenges with youth transparency related to these items (e.g., “most [youth] are not forthcoming with information”). Meanwhile, screeners in the Central region noted that asking youth about “boyfriends” or “girlfriends” relies on outdated terminology:
[I’m] gonna ask, if I have a case like this, so like, “How is your relationship with your boss? Is he good?” And then they start telling me things. I can ask like, “You have time for lunch?” If
they say like, “No, I have like 20 minutes, 10 minutes,” so I say like they think like he’s fair? And then I gonna start going to the payment, the money thing.
When determining evidence of forced labor, Southeast screeners agreed that “any sort of coercion” to continue their job is concerning and would result in marking “yes” for this indicator.
The youth, because they probably don’t know what you say punishment, but it may not be punishment to them. What’s the result if they were to quit, because it may not be the punishment as far as what they’ve been used to growing up as far as punishment from a parent or being disciplined. I think it could indicate some concern, as well, if they’re unsure what the results would be if they were to leave or quit as opposed to just a yes, no, or they just didn’t want to answer.
Subsection: Unsafe Online Activity
Screener 2: So the next thing they say, “No, I’m pansexual. I’m this.” There’s so many different terminologies now too… The terminology that they’re using now, it’s so different. Sometimes I have to kind of like Google while I’m there just to figure out what they’re saying, to understand it more. So when you say, “Do you have a girlfriend or boyfriend?” it’s kind of like so old school.
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More generally, some screeners shared that they are unsure if youth have clarity around item 29—quitting without penalty. For example, a Southern screener noted that youth may equate the term “punishment” with parental forms of discipline and suggest an open-ended item might be more informative:
Screener 1: “That question doesn’t fit in the modern time. Who are you talking to? More colloquial because boyfriend, girlfriend? There are way too many options beyond just boyfriend and girlfriend at this point.
…If there is a way to ask, or it would be probably just [be] relative to who is conducting the tool, like what do they do on these particular sites. They could be on Instagram, and those could be just as bad as the sites that have the automatic red flag, such as Backpage. I would want to know, not what’s your purpose, but are you on the site to make friends, to talk to your friends, to meet other people, like see if there’s a way to capture that.
I would say like, “Tell me something that would you like to do when you can make your own decisions.” They can tell me anything, and then if they said a tattoo, it’s gonna be easy for me. But then, I let them talk, and then I add, “Have you ever think about a tattoo?”
And also asking how the tattoo was paid for. Because it might not necessarily be that they were taken to some sort of professional place. That’s kind of like a general, “How’d you pay for the tattoo?” “I don’t know, this person did it on me,” that kinda gives a little bit more information.
Section F | Leaving or Running Away from Home
While scarring and branding was less frequently discussed than tattoos, some screeners did express challenges with completing the Tool for youth who engage in self-injury (e.g., cutting). The Central participants noted that they “have a lot of self-injurious kids. So it doesn’t really translate for the sake of the Tool.” Still, a Southern screener noted that following up on self-injurious behavior could be telling:
Example Quote
And this question with running away points – at least to me it suggests that we’re talking a more old school traditional type of CSEC trafficking where they’re scooped up and they’re working the streets more in terms of that. I don’t see a great deal of that kind of CSEC here. I see a lot of different more “I’m going to meet up with you, hookup for a few hours and I’m going to go home,” so it doesn’t really address that.
Concerns about youth transparency regarding tattoos arose in nearly every focus group (see Table 6), particularly lack of transparency around gang-related tattoos: “They’re going to say it’s a family thing or ‘I liked it.’ They’re not – I don’t know anybody who’s ever come out…and said, ‘Oh, yeah, gang-related. Check it out.’” Some screeners reported relying on visual evidence of tattoos to complete this section of the Tool (e.g., “I have never asked if they have any tattoos. If I see it…then yes. If I – and I’ve never seen it”). Others noted that if they do not see a tattoo, they probe further using techniques previously described in other sections (e.g., building rapport, rewording items). For example, a Suncoast screener said, “If I don’t see any, then I ask them. Or if I do see some then I’ll say, ‘Do you have any more?’ And I’ll try to say ‘Well, here’s my tattoo’ or try to get them to open up.” A Southeastern screener similarly explores:
In general, youth tend to be guarded around questions related to support they received while away from home. For example, a Southeast screener shared that youth will say, “Oh, I was with friends,” but not give specific details, like names. This was, however, not the case for all screeners. In the Northeast region, screeners experience extremes: “But this, these questions right here you either have the kid absolutely shuts down and tells you no about everything or the kid who is doing something that’s kind of braggy about it and wants to tell you everything…”
Southern [On possible tattoo meaning options] Yeah, I do like the personal meaning, so they could explain what it means to them. Some of these other options would probably be, what's the word I'm looking for? Not too much, but when you say gang-related, the chances of them being forthcoming with that are slim to none.
Most screeners shared that determining excessive running away is dependent on context related to how frequently the youth run and for how long they are gone when they do. While some of this contextual information is captured in the Tool, a Central screener noted that item 35b only assesses duration for the last run; they prefer to establish a “pattern of behavior” regarding duration of time away from home. Importantly, while screeners typically shared that their determination of running away includes consideration of duration, a Central screener noted that this may not always capture the types of trafficking they encounter in their region:
When specific suggestions were given for revising this section, screeners mentioned needing more contextual items to help them determine if a tattoo is concerning or not (e.g., who took them to get the tattoo, location of tattoo). A Southeast screener explains how this type of information is helpful:
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Because in my mind, my investigative mind, it would just be if you’re self-harming, find out the reasoning behind that. It could be because you’re in a situation that you don’t want to be in, or it’s like you’re getting anxiety from being in a certain situation. It would be more so me wanting to know more about why you self-harm, and that’s just from my experience outside of this tool of knowing why children self-harm. If you’re doing it for attention-seeking purposes, what attention is that you’re trying to get? Do you feel like you’re not being heard, or you don’t have a voice or an outlet? That would be what I would want to know, so if there is kind of like a fill-in-the-blank or something that you could be more specific with what you observe as far as it relates to that.
Central Just from knowing what they mean mostly and, hopefully, getting them to be forthcoming, a lot of times not.
Table 6. Youth Lack of Transparency Regarding Tattoos
I try to kind of come from a safety standpoint. I just want to make sure you’re safe and around safe people in a safe environment, no one is taking advantage of you where you are. And a lot of times they just tell me, “Oh I’m fine. I don’t want to get anybody in trouble,” that type of thing.
Subsection: Forced Tattooing/Branding
Suncoast It's not my favorite question but – because it's one of those that's really hard to determine…I think that it's one of those things that they're not going to be forthcoming with information, so it's up to me to decide whether it is or isn't.
Region
age, that would be a red flag if they’re substantially younger and on Tinder…”).
Southeast Usually when people have a tattoo, they chose. "Oh, I have this. I choose this for a good reason." So if this child is willing, open to talk, I would get the tool. Then I would see like maybe evidence. But if they refuse, they don't want to talk, they shut down…like, “Why?”
Similar to other sections, screeners reported relying on a combination of objective information (e.g., type of tattoo/meaning) and interpretation of youth responses (e.g., “…[if] they don’t want to explain or can’t explain, then that would be a red flag for me”) in determining whether there is evidenced of forced tattooing or branding.
For another Central screener, consistent lack of parental permission can offer insight into runaway behaviors: “…Because if they’re constantly running away whether it’s a day or two but they’re leaving the house as a minor without the permission of their parents. I think I look at it straightforward like that…” A Suncoast screener similarly noted that excessive running away is characterized by a “chronic runner” without parental permission. This means it may be necessary to obtain corroborating information from parents or law enforcement since youth are rarely transparent about runaway behaviors to avoid getting someone in trouble, losing their “safe place,” or tipping off investigators as to their location the next time they run. A Northeast screener shares their strategy for promoting transparency:
Yeah, like try a workaround, like, “You have an ID from school? Do you have any other ID?” If this person likes to, I don’t know, take the drugs, alcohol, I maybe gonna ask, “Have you ever go to a bar?”…Oh, yes, I enjoy it.” And then I gonna said like, “Okay, so, how you get the ID?”
When assessing for forced identity deception, screeners expressed a need for gathering and documenting more contextual information (e.g., type of document, who helped them get the document). For example, a Central screener noted that falsified documents can be an indicator of either CSEC or labor trafficking and that knowing the type of document (e.g., green card, driver’s license) could provide additional information for their case. A Southeast screener noted that this part of the Tool is reliant on disclosure (i.e., “a statement from the child or their parents”), so they explain their “workaround” to directly asking the item as written:
When assessing for sexual activities for money, support, or gifts, screeners might ask generally if anything made the youth uncomfortable while they were way and then follow up for detail. Participants shared that money and material items are a typical red flag (e.g., “Money, the money trail is really pretty obvious in a lot of these cases…”). Sometimes this is readily apparent with just the youth (e.g., “…Whether it were stolen or not, it was a gift from somebody…”), while other times screeners have to rely on collateral contacts for their perspective. For example, a Southeast screener shared:
When determining evidence of questionable support while away, screeners commonly noted that if a youth cannot or will not identify how they supported themselves, they would mark “yes” for that indicator. As a Southeast screener said, “…That’s circumstantial evidence that somebody was giving him or giving her questionable support.”
Screeners from multiple regions perceived that item 37, assessing inability to leave, is similar, if not repetitive, to items in section F assessing coercion to stay on the run. In terms of distinguishing between the two sections, a Southeast screener explains their approach to this item:
Again, when I ask them like, “Tell me what happened,” they go, “Oh, you know, the police took me, and I was like two blocks away from my house.” But I know they were around. And they say like, “Oh, yeah, I took transportation, train,” I know they were out of the city. And then on the 35I, so like, “Were you scared at any time?” If they say yes, so I said, “Were you thinking to go back home? Why you didn’t come back? You maybe wanted to come back but somebody or a situation didn’t allow you to go back to home?” Something like that.
If we have the mother, the parent…telling me, “Oh, she has been in grooming. Somebody has been grooming her –” If she’s telling me, ‘cause I have experienced this, “Oh, yeah. I have friends that like to buy me things,” and she or he doesn’t explain, then like what is the logic? That’s a kind of evidence for me.
Participants had minimal feedback on the overarching indicator of compensation for sexual activity, with a Suncoast screener saying, “…I would judge that – the evidence of compensation for sexual activity based on a lot of other questions that they answer from the other sections.” As in other sections, screeners shared ways they are able to elicit Tool answers for section F through conversation. A Southeast screener explained how they make connections between a youth’s narrative and the items on the Tool:
Central Those three questions after at the end “when you didn’t want to.” I don’t think that needs to go. It gives very clear indication that maybe they wanted it. That victimizes – it revictimizes the youth so those three definitely need to change…We don’t need to know if they wanted it or not.
Screeners agreed that coercion to stay on the run generally equated to not being allowed to leave, though several screeners across regions specifically shared that they reframe the question around being allowed to go home at any time. As a Central screener stated, “Yeah, there’s a big difference between coercion and outright kidnapping.” A Southern screener shared similar sentiments about why they reword this item:
Table 7. Rephrasing of Evidence of Sexual Exploitation Items
“Wouldn’t allow,” they may not take it as they weren’t allowed to go back home, per se, because the person didn’t probably say, “You’re not allowed to go back home.” But, did they feel like they could leave at any time to go back home?
In addition, some screeners felt item 37 is vague, leaving room to misinterpret parental discipline (i.e., grounding) as inability to leave. A Northeast screener shared:
Region Example Quote
Or again because they’re running away all the time the parents are locking. So even though they might tell me yes. My mom used to lock my windows at night all the time ‘cause she don’t want me sneaking out. I don’t – I’ll put that they said yeah but document why that truly was a nose as it pertains to this tool.
Section G | Sexual Exploitation/Coercion/Control
But using something broader first, and then asking something more specific like this afterwards…
Again, I don’t think that I would be that specific initially. Because, again, this is a direct one. So I think I would ask an open question first, and – “Has anybody ever prevented you from leaving or impeded your ability to walk away?” ‘Cause you might have more of a coercive situation, not necessarily they physically restrain them, but did something else. I think this one is just a little bit too specific, about locking doors, windows. Granted, some questions might trigger a memory.
Southeast 'Cause it almost feels like, when you read it, like you're interrogating them. And that's the only thing that I personally don't like. I don't wanna put a child that's been victimized on the defense. And when you're asking such direct questions, it'll make them uncomfortable.
Central …In youth-speak what does it mean to be asked to do something that you don’t want to do? You know what I'm saying? I’m not really sure how to word the question so that they understand that – because there are kids that are sexually exploited and they have enjoyed it. It’s a particularly shaming moment for them. Some don’t want to reshame or continue with that shame. But we also need to find out “What does it mean to you? What does ‘coercion’ mean to you? What does ‘forced to do something’ mean to you?” They may not understand what “force” is in terms of being sexually exploited, especially because if it’s happening in the home, it could be so normalized that it’s not forced and it’s not coercion. Somewhere in there we need to understand what they think those words mean.
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Suncoast But I don't ever use – I don't say "pressured." I say, "Have you ever touched someone physically or sexually when you didn't want to." I leave out all those other words…Because most people don't – most kids aren't going to say – "Has anyone ever pressured you?" – they don't want to get somebody else in trouble. So, it's "Have you ever touched someone when you didn't want to?" … I try to leave it as vague as possible, at least to get some of the information, and then follow up with – because it's not my job to determine who is forcing them to do these things. They're not going to – most of them are not going to – that's law enforcement's job. So, I just try to get the answers to at least get law enforcement on the right track.
SUMMARY OF FINDINGS
Region Example Quote
Section I | Post-Screening Assessment
Responses to how they determine the likelihood of trafficking varied, and speak to possible subjectivity among screeners. As a Suncoast screener explained, the determination “is 1000 percent our own impression of them depending on who you get.” Other screeners’ comments reflected these individual nuances. For example, in the Northeast, screeners talked about several specific signs they consider (i.e., youth’s age, age-inappropriate relationships, runaway episodes, circumstantial vulnerability). A Central region screener shared that it can be difficult to distinguish between “unsure” and “likely”: “…I mean it is or it isn’t I always think, you know, and then if you’re not sure, is it likely? The ‘likely’ and the ‘not sure’, they sort of to me almost seem the same sometimes.” That cases are not always clear cut was similarly noted by a Northeast screener who suggested that there be a way to capture risk for future trafficking too:
Table 8. Desire for More Information from Parents, Guardians, and Professionals
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Overall, screeners are pleased with the training they receive for the screener role. Although initial training was considered beneficial, some screeners still felt unprepared to actually complete the Tool. Notably, some screeners shared that they do not regularly conduct screenings. Given the time in between screenings, it is possible that this presents challenges to their self-efficacy in administering the Tool given the heavy emphasis on making the screening conversational while still completing a very comprehensive assessment. Focus group participants corroborated this, noting that both newer screeners and those who infrequently use the HTST might not implement it as intended, particularly if they must rely heavily on the physical Tool to conduct the screening. Providing continued opportunities for training on not only trafficking-related topics, but refreshers on how to best administer the Tool may be beneficial. In addition, it could be beneficial to explore the possibility of screener-friendly data collection methods (e.g., “cheat sheets,” electronic data collection) that would not harm the rapport process with the youth. Screeners are interested in receiving other types of training that highlight the realities of screening. In addition to skillbuilding (e.g., engagement and rapport), they expressed interest in hearing from individuals with lived experience—both survivors of human trafficking and professionals (e.g., seasoned screeners, law enforcement who know current trends in trafficking).
Central It’s helpful speaking with the parent. It’s helpful to speak with the parents or the guardians first before I screen the youth unless the parents are the traffickers, of course, but I think they're – I think it’s helpful. I think we can probably pull a whole lot more information, get a whole lot more information from them than we actually do.
Much discussion regarding the post-screening assessment focused on non-verbal indicators of past victimization: “shutting down,” crying or being visibly upset, “losing eye contact easily,” fidgeting, and defensiveness (e.g., “not aggressive, but quick to have an attitude…over some of the questions”). A Central screener suggested that this item is vague in that it is unclear if “past victimization” refers to past sexual abuse or the primary reason for the present screening; however, they added, “I think both are very important in terms of current trafficking and future trafficking.” Relevant, they suggest that an assessment of non-verbal cues could be added to each major section of the Tool for specificity. This suggestion may be well received by others. For example, Northeast screeners noted that item 47 serves as a catch all for their analyses (e.g., “This is where I would write everything. Could be one, two, three, see attached form. Everything would go in there of why the answer would be yes”).
Discussion
Screeners offered little feedback on Section H, though when they did it centered around wanting more comprehensive information from parents and caregivers (see Table 8). Screeners noted that parents can offer insights that help them determine if a youth may not have been truthful. Most screeners indicated they are able to get in touch with parents or guardians, though a Northeast region screener noted when a child is on “runaway status” it is challenging to have a useful conversation with their caregiver: “…So they’re happy that they’re found. They want to get the child help or tell us to keep them, put them in foster care or something. They’re sick of it, fed up.” Screeners in various regions shared that in instances where a youth is “in the system,” they rely on proxies (e.g., case managers, group home coordinators, therapists, law enforcement) to help complete section H.
The vast majority of screeners reported using the Tool as a guide. They are not using it as a checklist, but rather a repository for information collected from various sources (e.g., precommencement, the youth, collateral contacts). As far as items’ clarity and the quality of information they elicit, screeners were generally satisfied. In fact, there was only a single mention across all focus groups regarding removing an item entirely (i.e., item 50, providing three reasons to support likelihood of trafficking determination). Numerous suggestions were made for item revisions or additions, though none consistently enough to warrant a strong recommendation for change to the Tool at this time. Suggestions for consideration are offered in the recommendations section below.
Southeast And I think it's kind of downplayed, because I believe the caregivers, especially if the case is human trafficking with multiple priors, they have information. And they are the adults….They are in a caregiver role which – I believe we have to take more information from them. And I think we should ask more question over here. Like if you are telling me like what kind of question, I have to think about it, but I think this section has to be better.
Suncoast Some of them aren't very helpful so it's kind of like a waste….They don't care. They care – but then other times we have really solid parents who want – they want their kids home. They want help for their kids.
Section H | Parent/Guardian Information
I also think that the tool should, even when it asks about the likelihood that they’re trafficked, I wish there was a way we could discuss the likelihood that they’re more susceptible to future trafficking…Because I believe that – I know for me I get a lot of repeat kiddos that every time they run away and they go to DJJ we do a new trafficking tool on them. And the reality is that the more that occurs, the more they’re out on the streets, the more that things are happening and then they’re more vulnerable to that… So I may have a likely no. But that doesn’t mean that they’re not at risk and we shouldn’t have concerns and be vigilant on this child and provide them therapy.
Finally, when assessing for sexual exploitation, screeners reported rewording items, often to avoid revictimization (see Table 7). When determining if there is support to mark “yes” for evidence of sexual exploitation, screeners include the “totality” of information, citing use of information from this section, as well as others (e.g., “Usually children have things that the parent didn’t buy or the caregiver didn’t buy…”).
LIMITATIONS
The present study is not without limitations. Namely, given the methodology, these results cannot be generalized to all screeners in Florida. Although self-selection bias is a concern, the sample size for the interviews is adequate for phenomenological research1 and saturation was achieved except where noted. The focus group sample size, overall and within groups, were smaller than ideal. However, general findings were able to be triangulated with current interview data as well as data from previous phases of HTST validation work to support conclusions and recommendations. Finally, given that data was collected in 2020, it is possible that there have been updates to the HTST and relevant processes, including training, that are not captured here.
This suggests that additional training might be helpful to build screeners’ abilities to assess for red flags that are either not as visible or more ambiguous. Focus group participants shared feedback that items in several sections or subsections were ambiguous or vague, including living conditions (section D), deceptive pay practices (section E), and inability to leave (section G).
Though screeners acknowledged that their interactions with youth vary depending on the circumstances, they are able to utilize multiple rapport-building techniques to engage with the youth; however, they noted that these are not guaranteed to be successful (e.g., “…sometimes they’re cool with that. Sometimes they tell me where to go”). Focus group participants articulated that they regularly reword Tool items, or the flow of items, to not only make the screening more conversational, but to make the youth feel more comfortable (e.g., starting with broad questions before narrowing to specific concerns). This was particularly notable in Section G (Sexual Exploitation/Coercion/Control), as several screeners shared that the Tool language, if used verbatim, could be revictimizing for youth. Many screeners reported they often need more contextual information to inform their decisions, so they ask follow-up questions. Notably, screeners find it problematic that there is nowhere to add the contextual details they gather within the relevant sections
Determining the likelihood of trafficking is based on the totality of the information gathered, with screeners demonstrating critical thinking and consideration of circumstantial evidence. Screeners find several indicators to be particularly helpful in their investigation (i.e., tattoos, runaway behavior, debt bondage, grooming, age-inappropriate relationships, social media activity). Interestingly, many of these items could be considered more visible indicators; that is, some of these indicators might be known to the screener without the explicit cooperation of the youth. One screener (#94202) noted this:
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labor indicator did not fit within the two-factor model presented in the previous phase of work.
1 Polkinghorne (as cited in Creswell, 2007) suggests a sample size of 5 to 25 is typical in phenomenological research.
Regarding tattoos, not all screeners report asking youth about this. Some rely on visual cues and may not probe further, while others delve deep and use their own tattoos to elicit conversation. Again, there exists a discrepancy in process that could lead to inaccurate data captured on Tools, and which could have influenced statistical findings in the prior report. It could also suggest a training need regarding the significance of these items. In addition to youth transparency issues, some screeners pointed out that tattoos can be a vague sign of trafficking (e.g., “…Kids are just wild and crazy and they just go get tattoos because it’s so much more popular…”), so it takes skill on the part of the screener to decipher contextual clues. Focus group participants suggested adding items to the Tool for more contextual information (e.g., who took you, who paid). Related, some screeners noted that it is unclear how to respond to scarring items if the youth is known to engage in self-injurious behavior. One screener contradicted themselves within the course of the focus group, first saying they would indicate scarring for selfinjurious behavior, then saying they were not sure. More guidance from the Department is needed.
Really, the only indicators I would say that are useful in identifying victims is the physical indicators. So, again, that would be like the child having money, the child having their hair and nails done, the child having tattoos, those physical indicators that are right in your face. Those are the easiest indicators that are like “Okay, yeah, something is definitely going on with this kid.
Because it – I don’t think that it impacts anything. I mean, if you’re – if I’m the one [completing] the training and I’m the one responsible for doing the tool, I don’t think that I should have to answer three reasons why I chose the answer I did. I mean, ask me. Have a conversation.
Importantly, in phase two of the Institute’s HTST work, there were two items that did not align well with the factor structure of the scale: evidence of forced labor and evidence of forced tattooing/ branding. Present data helped to illuminate potential reasons for why these particular items might not have fit within the statistical model. Regarding forced labor, it was initially suggested that this item might have been statistically problematic due to small number of youths who screened positive for that indicator.14 This remains a reasonable suggestion, though the present focus group data illuminated challenges with the sub-items for that indicator which could also have impacted data quality. First, some screeners felt that asking “do you live and work in the same place” might not be reflective of labor trafficking victims’ living situations. Some suggested broadening this question to ask if youth live with any coworkers, given that sometimes multiple victims live together and are brought to a common work site. Second, screeners questioned if youth would be able to understand what is meant by “punishment” for the item: “Can you quit or could you have quit your job at any time without punishment from your boss or supervisor?” Again, they suggested a more open-ended item. Related, one screener noted that if a youth was “unsure” if they would be punished, this would be marked as “yes.” The potential need for new or reworded items, as well as insight into the nuance of particular screeners’ processes, highlights potential inconsistencies in how the Tool is completed. This could help explain why the evidence of forced
Nearly all interviewees shared that if their determination is “unsure,” “likely is,” or “definitely is,” they notify their supervisor, and a multi-disciplinary team meeting is called to determine next steps. Among focus group participants, evidence of screener subjectivity in how they make their determination arose; however, this could be interpreted as screeners being responsive to individual youth. There was also variation among focus group participants in how engaged they are with the post-screening assessment (Section I). This inconsistency was noted in the previous HTST validation report with respect to screeners providing three reasons for their determination.14 In the present study, some screeners shared they append multiple pages of notes, while another screener noted that they do not feel a need to answer item 50:
Finally, data were collected during the first year of the COVID-19 pandemic. Although very few screeners discussed the impacts of COVID-19 on the HTST process, the few who did noted general safety protocol changes (e.g., “… When we receive a call, we have to go through, we have to see if there’s any Covid concerns, any exposure concerns”) or challenges related to assessment (e.g., school attendance as a red flag is no longer relevant).
RECOMMENDATIONS
Recommendation 1: The Institute recommends the Department develop a robust training catalogue, to include additional content on how to administer the Tool.
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From a screener burden standpoint, an electronic Tool would allow the Department to set up skip patterns so that screeners are not completing sections irrelevant to their investigation. The previous HTST validation report noted that there were problems in the skip patterns of hard copy tools: “Specifically, some skip patterns instructed screeners to wrong questions, ultimately leading to missing data, which skews the results” (p. 20).14 Having an electronic Tool can ensure all screeners are working off the most accurate and up-to-date Tool, allowing the Department to correct errors as they are identified without having to recall hardcopy versions. It could also improve data quality as it would indicate an item was not completed due to a skip pattern (i.e., not applicable) versus it being true missing data. An electronic tool could also allow the Department to indicate mandatory fields that screeners may not skip over. This could be helpful for sections where discrepant screener perspectives and processes have been noted (e.g., Section I).
Finally, from a data standpoint, an electronic HTST would provide DCF more readily accessible data for specific youth (e.g., for repeat trafficking concerns), as well as for ongoing analysis needs, including but not limited to identifying current youth trafficking trends in Florida and continued Tool validation efforts.
The previous HTST validation report did not find age or race to be predictive of trafficking outcomes, though females, compared to males, had significantly greater total and sexual exploitation scale scores.14 Screeners in the current study acknowledge the importance of age as contextual information for their determination (e.g., “…if they’re substantially younger and on Tinder…”). Moreover, research on the association between race and trafficking is mixed.20 That females are at high risk of trafficking aligns with literature,21 though scholars have suggested that male and transgender victims are less visible.22 The Department should consider monitoring demographics to continuously assess trends in risk and tailor intervention efforts accordingly. Simultaneously, it is important to maintain an understanding that some social identities might indicate higher risk, but that any youth can experience trafficking.23
prefer to take notes during their interviews in some capacity. While some use handwritten notes, others are already capturing data electronically through their laptops or phones. Having an electronic copy of the Tool would not necessitate screeners complete it in the moment (i.e., they can complete it after the interview), though it offers the flexibility to do so. Importantly, training may be necessary on how to incorporate this strategy into the interview (e.g., to avoid reading a checklist, to maintain rapport). Related, the Department might consider creating a “cheat sheet” (hardcopy or electronic) for screeners to take into the field that would help them gather information needed to later complete an electronic Tool.
Recommendation 3: The Institute recommends the Department make the HTST an electronic tool.
Notably, several screeners mentioned that they perceive lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) youth to be at high risk for trafficking. For example, a Northeast screener shared that LGBTQ+ youth on the run are sometimes taken advantage of “because they found people that they felt were likeminded because they had no one that [previously] accepted them.” Studies of runaway and homeless youth and young adults have demonstrated increased risk of trafficking for sexual and gender minorities.24,25,26 Though the HTST does not provide specific response options for gender identity, Tools included in the previous validation study indicate binary responses (i.e., female and male). There is no item to indicate sexual orientation. Assessing for these demographics could be useful in the aforementioned monitoring of
Recommendation 4: The Institute recommends the Department determine how to best assess risk among particularly vulnerable populations.
Recommendation 2: The Institute recommends the Department include text boxes for each major section to document contextual information.
While maintaining a conversational approach, many screeners
The Institute makes the following recommendations for the Department’s consideration:
Across interviews and focus groups in this study, screeners indicated a need to capture the contextual data they gather to support their responses within the Tool and, ultimately, their determination of likelihood of trafficking. While Tool items could be revised (see below), providing open-response space in each section allows screeners the flexibility to be responsive to individual youth (i.e., tailoring follow-up questions). The previous HTST validation report recommended DCF trainers provide specific guidance on including contextual data on the HTST, such as what type of information to include and where it should be included.14 Having designated spaces for such information would address the latter, though training on specific content inclusion might still be needed.
Despite previous feedback from screeners,13 the current study’s findings suggest that the HTST should not be shortened. Screeners find items useful in guiding their determination of trafficking and do not recommend the removal of specific items. Notably, separating the HTST into sex and labor trafficking tools has been suggested in this and a previous phases of the Institute’s HTST work,13 including in the present data. The Department’s position on this matter is that the two forms of trafficking can co-occur, and it remains important to keep items together to comprehensively assess for both forms (K. Coonan, M. Anderson, S. Aboul-Hosn; personal communication; February 24, 2022). This position was supported by DJJ (K. Gomez, personal communication, February 24, 2022). Previous self-report data from screeners indicates that a small percentage of their cases do have elements of both CSEC and labor trafficking (5.6%).13 Some screeners recognize this link, even pointing to indicators that could be indicative of one or both forms of trafficking (e.g., forced identity deception). At this time, the Institute does not recommend separating the HTST into labor and sex trafficking tools, though additional training on the matter (e.g., why and how CSEC and labor trafficking are linked) may be prudent.
Though satisfied with initial training, screeners requested continued training on how to administer the HTST. They are particularly interested in hearing from trafficking survivors and improving their engagement and rapport-building techniques. They also expressed an interest in learning techniques from seasoned screeners. The Department could consider hosting content-approved, peer-led trainings to help foster skill development among screeners. The Department might offer HTST section-specific training sessions, focused on those noted within this report as particularly challenging (e.g., Section E). The Department could establish plans for quarterly sessions, sharing training dates in advance to provide workers the opportunity to save the date on their calendars. Based on screener feedback, the Department should consider in-person or hybrid options, with recording capability to share with those who cannot join live. Ideally beneficial for all screeners, including in keeping up their quarterly training requirement, these strategies might be particularly helpful for newer screeners or those who infrequently use the Tool.
• Item 31a: “What kind of sites or apps do you use?” Several screeners noted that the list of response options for potential website and app used needs to be updated to reflect current popular options. It is possible this section may need to be revised regularly over time. Similarly, some screeners felt that this item in particular needed space for additional context (e.g., usernames, what the youth uses the site for); however, this might be addressed through recommendation 2.
And I don’t believe that we ask anything pertaining to that. Sometimes it’s hard to get them to open up about their sexuality. But when you do have a kid that does that’s definitely something when I write like an analysis on it that I acknowledge in additional factors. So even though it’s not on there I know that on a couple of mine that’s played a role.
Recommendation 5: The Institute recommends the Department consider the addition of items to provide context to the evidence of forced tattooing/branding subsection.
In general, screeners already reword items to make interviews more conversational and help youth feel comfortable. The Department could consider adjusting the following items:
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may not feel genuine to gender and sexual minority youth. Use of more inclusive language could help screeners toward their goal of making youth comfortable throughout the screening. Screener feedback-based suggestions: “Are you dating,” or “Do you like somebody?”
Issues noted within recommendation 6 might be alleviated through implementation of recommendations 1 and 2. The Department should consider if recommendation 6 is also needed.
Issues noted within recommendation 5 might be alleviated through implementation of recommendations 1 and 2. The Department should consider if recommendation 5 is also needed.
• Item 28: “Do you live and work at the same place?” Some screeners felt this item did not account for circumstances in which a labor trafficking victim lives with others off-site and are taken to work together. Screener feedback-based suggestion: “Do you live with any of your co-workers?”
In previous HTST validation work, the evidence of forced tattooing/ branding indicator did not fit the structure identified by the exploratory factor analysis. The current study illuminated several issues that could be contributing to inconsistent or inaccurate responses to related items, including not asking about tattoos or branding at all. In addition to reiterating to screeners the importance of assessing for these things, the Department could consider the addition of contextual items to assist in determining evidence of forced tattooing/branding (e.g., “Where did you get the tattoo,” Who paid for the tattoo”).
Recommendation 6: The Institute recommends the Department consider rewording certain items or response options.
• Item 24: “How much money do you make an hour?” Screeners consistently shared that many youth do not make an hourly wage or would otherwise not understand the concept of minimum wage. Screener feedback-based suggestion: “How much money do you make in a day?”
risk and align with the Children’s Bureau’s (2022) recent information memorandum regarding affirming and supportive care for LGBTQ+ youth.27 The same Northeast screener shared:
In addition, it may be prudent to include an item to identify self-harm injuries or scars. Self-harm is not standardly assessed in the HTST, as noted in the prior validation study.14 Data from the current study indicate screeners would appreciate a space to denote self-inflicted scars. Even if self-inflicted, this information could still be informative to screeners. For example, self-harm has been associated with trafficking among homeless youth.29 In Florida specifically, DJJinvolved youth who have experienced trafficking, compared to nontrafficked youth, are more likely to engage in internalizing health risk behaviors, such as self-harm.30
• Item 30: “So, do you currently have a boyfriend or a girlfriend?” Screeners noted that this terminology is outdated based on their interview experiences with youth. Youth may not use these particular labels for their relationships, or they
Still, to ensure maximum safety of youth, the Department should take a thoughtful approach in how they assess for these demographics, including who has access to the information and for what purposes.28 Partnering with a sexual orientation, gender identity, and gender expression (SOGIE) data expert is recommended.
• Items 39-41: Evidence of sexual exploitation. Several screeners indicated that they reword these items to avoid revictimization or shaming youth. Screener feedback-based suggestion: Removing “when/that you didn’t want to” from the end of each item and using follow-up questions to assess for context.
8) How much of a role, if any, does the HTST play in your final determination of the case outcome?
Good [MORNING/AFTERNOON]. My name is [INSERT INTERVIEWER NAME] and I work at the Florida Institute for Child Welfare. I am part of a research team that is helping the Florida Department of Children and Families to improve the human trafficking screening process. As part of that, we are interested in hearing about your experiences as a designated human trafficking screener. Our conversation should last about an hour. Remember, this is completely voluntary and you can stop participating at any time. Additionally, you can choose to skip any question, for any reason, which you are not required to share with me. After completing your interview, our research team will e-mail you a $25 Amazon gift card to show our appreciation for your time.
b. Under what conditions do you typically complete the HTST?
d. How and to whom are your findings communicated following the screening?
a. How did your training prepare you for screening?
a. Which indicators, if any, do you think are particularly useful in identifying human trafficking victims? Why?
b. Are there any techniques that you find particularly useful to promote youth honesty and openness during the screening?
Appendix A: Interview Schedule for Human Trafficking Screening Tool (HTST) Screeners
5) Once you’ve completed the screening, how do you determine the likelihood that a youth is a victim of human trafficking?
b. What, if anything, would you change about the training for designated screeners?
1) How did you come to be a designated screener?
INTERVIEWER SCRIPT
i. Note to interviewer: Assess for conversation vs. checklist style implementation.
b. Approximately how many youth have you screened for trafficking?
c. Describe any continuing education or follow-up training you’ve received regarding the human trafficking screening tool.
I know you have already read through the consent form, but before we begin, I wanted to make sure that you did not have any questions. What questions can I answer for you about this study? [Interviewer should answer all questions before proceeding].
3) How do you define “at risk” in regard to youth who are not yet verified, but are “at risk” for human trafficking?
i. Note to interviewer: If clarification is needed, ask, “Do you primarily complete the HTST based on indicators or a new maltreatment investigation,” “What indicators?”
4) Can you give me an overview of the screening process?
INTERVIEW GUIDE
a. What information do you have about the youth going into the screening?
2) Describe the training you received to become a designated screener.
9) If you could change anything about the tool, what would it be?
b. Which indicators, if any, do you think are not particularly useful in identifying human trafficking victims? Why?
7) What feedback, if any, have your received from youth regarding the human trafficking screening?
*Questions 1-10 are intended to be asked of all participants. Sub-questions are meant to guide interviewers if additional probes are needed.
6) When conducting a screening, what is your typical interaction with the youth like?
a. How long have you served as a screener?
a. How do you build rapport with youth?
c. What, if any, strategy do you implement when using the screening tool?
10) How can DCF best support you in your role as a designated screener?
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4 4 National Human Trafficking Hotline. (2020a). Hotline statistics. Retrieved February 22, 2022 from https://humantraffickinghotline.org/states
14 14 Woods, M., Magruder, L., & Killian, M. (2019). Human Trafficking Screening Tool validation. Internal report to the Florida Department of Children and Families: unpublished report.
10 10 Fla. Stat. § 409.1678 (2012)
22 22 Franchino-Olsen, H. (2021). Vulnerabilities relevant for commercial sexual exploitation of children/domestic minor sex trafficking: A systematic review of risk factors. Trauma, Violence, & Abuse, 22(1), 99-111. https://doi.org/10.1177/1524838018821956
19 19 Boeije, H., & Willis, G. (2013). The Cognitive Interviewing Reporting Framework (CIRF): Toward the harmonization of cognitive testing reports. Methodology, 9(3), 87-95. doi: 10.1027/1614-2241/a000075
5 5 Hopper, E. K. (2004). Underidentification of human trafficking victims in the United States. Journal of Social Work Research and Evaluation, 5(2), 125-136.
8 8 United Nations Office on Drugs and Crime. (2018). Global report on trafficking in persons 2018. Retrieved from https://www.unodc.org/documents/dataand-analysis/glotip/2018/GLOTiP_2018_BOOK_web_small.pdf
28 28 Michigan Department of Health and Human Services, Ruth Ellis Center, Children’s Bureau, QIC LGBTQ2S, & University of Maryland School of Social Work. (n.d.). Rollout of data collection on sexual orientation and gender identity. National SOGIE Center. Retrieved March 17, 2022, from https://www. sogiecenter.org/media/ssw/institute/sogie-center/Michigan-SOGIE-Data-Collection-Rollout-Graphic.pdf
17 17 Clarke, V., & Braun, V. (2013). Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning. The Psychologist, 26(2), 120-123.
26 26 Wright, E. R., LaBoy, A., Tsukerman, K., Forge, N. Ruel, E. … Darkwa, A. (2021). The prevalence and correlates of labor and sex trafficking in a community sample of youth experiencing homelessness in metro-Atlanta. Social Sciences, 10(32). https://doi.org/10/33.90/socsci10020032
23 23 Klein, L. B., Chesworth, B. R., Rizo, C. F., Franchino-Olsen, H., Croft, C., … & Martin, S. L. (2021). Commercial sexual exploitation of children: Indicators and recommended inquiries and responses for social workers. Social Work, 66(3), 265-268. https://doi.org/10.1093/sw/swab017 24 Hogan, K. A., & Roe-Sepowitz, D. (2020). LGBTQ+ homeless young adults and sex trafficking vulnerability. Journal of Human Trafficking https://doi.org/10. 1080/23322705.2020.1841985
25 25 Walls, E., & Bell, S. (2011). Correlates of engaging in survival sex among homeless youth and young adults. The Journal of Sex Research, 48(5), 423-436. https://doi.org/10.1080/0224499.2010.501916
7 7 Florida Department of Children and Families [DCF]. (2021). Human Trafficking of Children Annual Report. Retrieved February 22, 2022 from https://www. myflfamilies.com/service-programs/human-trafficking/publications.shtml
27 27 Children’s Bureau. (2022). Information memorandum (ACYF-CB-IM-22-01). U.S. Department of Health and Human Services: Administration on Children, Youth, and Families. https://www.acf.hhs.gov/sites/default/files/documents/cb/im2201_1.pdf
20 20 Choi, K. R. (2015). Risk factors for domestic minor sex trafficking in the United States: A literature review. Journal of Forensic Nursing, 11(2), 66-76. doi:10.1097/JFN.0000000000000072
15 15 Creswell, J.W. (2007). Qualitative inquiry & research design: Choosing among five approaches (2nd ed.). Thousand Oaks, CA: Sage Publications Inc.
16 16 Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. doi: 10.1191/1478088706qp063oa
12 12 Office of Program Policy Analysis and Government Accountability (2016). Placement challenges persist for child victims of commercial sexual exploitation; question regarding effective interventions and outcomes remain. Report No. 16-04. Tallahassee, Florida.
24
1 1 Florida Office of the Attorney General. (n.d.). What is human trafficking? Retrieved August 29, 2019 from http://myfloridalegal.com/pages.nsf/ Main/0108F1C73781B7F485257AC20074F49E
11 11 Fla. Stat. § 409.1754 (2014)
9 9 Barnert, E., Iqbal, Z., Bruce, J., Anoshiravani, A., Kolhatkar, G., & Greenbaum, J. (2017). Commercial sexual exploitation and sex trafficking of children and adolescents: A narrative review. Academy of Pediatrics, 17(8), 825-829. doi: 10.1016/j.acap.2017.07.009
13 13 Magruder, L., Woods, M., & Tutwiler, M. (2018). Human Trafficking Screening Tool survey data report summary. Retrieved from the Florida Institute for Child Welfare website: Survey%20Data%20Report%20Summary%20041118.pdfhttps://ficw.fsu.edu/sites/g/files/upcbnu1106/files/Final%20Reports/FR%20Human%20Trafficking%20Screening%20Tool%20
3 3 Polaris. (n.d.) The facts. Retrieved August 29, 2019 from https://polarisproject.org/human-trafficking/facts
FLORIDA INSTITUTE FOR CHILD WELFARE 18 References
18 18 Guest, G., MacQueen, K. M., & Namey, E. E. (2012). Applied thematic analysis. London: Sage
6 6 National Human Trafficking Hotline. (2020b). Florida. Retrieved February 22, 2022 from https://humantraffickinghotline.org/state/florida
2 2 Florida Department of Children and Families [DCF]. (2019). Human trafficking. Retrieved August 29, 2019 from https://www.myflfamilies.com/serviceprograms/human-trafficking/
21 21 Gibbs, D. A., Henninger, A. M., Tueller, S. J., & Kluckman, M. N. (2018). Human trafficking and the child welfare population in Florida. Children and Youth Services Review, 88, 1-10. https://doi.org/10.1016/j.childyouth.2018.02.045
FLORIDA INSTITUTE FOR CHILD WELFARE 19 29 29 Middleton, J., Gattis, M. N., Frey, L. M., & Roe-Sepowitz, D. (2018). Youth Experiences Survey (YES): Exploring the scope and complexity of sex trafficking in a sample of youth experiencing homelessness. Journal of Social Service Research, 44(2), 141-157. https://doi.org/10.1080/0148837 6.2018.1428924 30 30 Reid, J. A., Baglivio, M. T., Piquero, A. R., Greenwald, M. A., & Epps, N. (2019). No youth left behind to human trafficking: Exploring profiles of risk. American Journal of Orthopsychiatry, 89(6), 704-715. http://dx.doi.org/10.1037/ort0000362
