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Ann Intern Med. 2018 May 1;168(9):658-663. doi: 10.7326/M17-2605. Epub 2018 Mar 13.
Human trafficking, also known as modern-day slavery, is an egregious human rights violation associated with wide-ranging medical and mental health consequences. Because of the extensive health problems related to trafficking, health care providers play a critical role in identifying survivors and engaging them in ongoing care. Although guidelines for recognizing affected patients and a framework for developing response protocols in health care settings have been described, survivors' ongoing engagement in health care services is very challenging. High rates of disengagement, lost contact, premature termination, and attrition are common outcomes. For interventions to be effective in this marginalized population, challenges in engaging survivors in long-term therapeutic primary and mental health care must be better understood and overcome. This article uses the socioecological model of public health to identify barriers to engagement; offers evidence- and practice-based recommendations for overcoming these barriers; and proposes an interdisciplinary call to action for developing more flexible, adaptable models of care.
人口贩运，又称现代奴役，是一种严重侵犯人权的行为，涉及广泛的医疗和心理健康后果。由于与人口贩运相关的健康问题广泛，医疗保健提供者在识别幸存者并使他们参与持续护理方面发挥着关键作用。尽管已经描述了识别受影响患者的指南和制定卫生保健环境中应对协议的框架，但幸存者持续参与医疗保健服务非常具有挑战性。高比例的脱离、失去联系、过早终止和淘汰是常见的结果。为了使干预措施在这个边缘化群体中有效，必须更好地理解和克服使幸存者参与长期治疗性初级和精神保健的挑战。本文使用公共卫生的社会生态学模型来确定参与的障碍；提供了克服这些障碍的基于证据和实践的建议；并提出了一项跨学科行动呼吁，以制定更灵活、适应性更强的护理模式。
