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EMS professionals: critical partners in human trafficking response
  1. Alyssa F Harlow1,
  2. Emily F Rothman2,
  3. Sophia Dyer3,
  4. Hanni Stoklosa4
  1. 1 Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
  2. 2 Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
  3. 3 Department of Emergency Medicine, Boston University Medical Center, Boston, Massachusetts, USA
  4. 4 Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Alyssa F Harlow; afharlow{at}

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EMJ brought to the attention of emergency physicians the pressing public health issue of human trafficking in its podcast ‘Detecting human trafficking: a life-saving diagnosis in the emergency room’.1 A recent news article in Emergency Medical Service (EMS) World by Amato now highlights the role first responders have in breaking the cycle of human trafficking violence.2 EMS providers can leverage their access to vulnerable populations to identify and advocate for trafficking victims. But it is estimated that less than half of EMS providers have ever received training on how to identify trafficked persons, and how to intervene if they do recognise signs of trafficking.3

We recently conducted a pilot training programme developed by a group of experts in human trafficking and EMS. The one-session 90 min training aims to improve human trafficking-related awareness and self-efficacy among Boston-area EMS professionals by teaching participants definitions of trafficking, how to identify trafficked persons, and how to respond to potential cases of human trafficking. To evaluate the course, before and 3 months after the training, 38 participants (out of 57 attendees) completed a survey on encounters with trafficked persons in a professional capacity, responded to six true/false questions about human trafficking relevant to EMS personnel, and answered seven questions on attitudes/beliefs related to identifying and providing help to trafficked persons.

At baseline, 46% of participants had ever encountered a suspected trafficked person in a professional capacity. At follow-up, 26% of participants encountered at least one trafficked person in the 3 months since completing the training. Paramedics also improved in two attitude/belief scores: ‘I feel confident that I could identify a victim of human trafficking’ and ‘EMS workers should not probe further if they suspect a person has been trafficked.’ While the latter statement may seem counterintuitive, the primary goal on encountering a trafficked person is to transport them safely to the hospital, not to ask a suspected trafficked person intrusive questions. Although for several other knowledge and belief questions, we did not find significant improvement after the course, we are encouraged that the training appeared to increase awareness and confidence in managing potential victims of trafficking. (Full results of the survey and results available on request)

As described in the EMJ podcast, human trafficking is a form of modern slavery. While the development of trafficking training programmes for first responders is an integral step towards saving lives of victims, it is also necessary we ensure programming is effective through evaluation and process improvement.


We would like to thank the men and women of Boston EMS and MetroBoston Region 4 for their participation in this training programme.



  • Contributors All authors contributed to the original idea for the paper and the writing and revision of the manuscript. AFH performed the data analysis and wrote the original draft.

  • Funding Supported by the Lynne Stephens Award from Boston Medical Center and the Tynan Fellowship, Connors Center for Women’s Health, Brigham and Women’s Hospital.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Patient consent for publication Not required.