Healthcare and Human Trafficking



This is an ANONYMOUS survey.

The purpose of this survey is to learn about how doctors, nurses, and other healthcare providers assist
victims of human trafficking who come to a clinic or emergency room
as patients. If you don’t know an answer, that is ok. Thank you for your time.

Title: Missing Patients in the Emergency Department: Victims and Survivors of Human Trafficking, An Anonymous Survey
Name: Makini Chisolm-Straker
Physical Address: 3 East 101st St, 2nd Floor, New York, New York 10029
Mailing Address: 1 Gustave L. Place, Box 1149, New York, NY 10029
Phone: 347.560.9249
A research study is when scientists try to answer a question about something that we don’t know enough about. Participating may not help you or others.
People volunteer to be in a research study. The decision about whether or not to take part is totally up to you. You can also agree to take part now and later change your mind. Whatever you decide is okay. It will not affect your ability to get medical care at Mount Sinai.
This research study will be explained to you. Feel free to ask all the questions you want before you decide. Any new information that develops during this research study which might make you change your mind about participating will be given to you promptly.
The purpose of this study is to find out what the health needs of trafficked persons are. Currently doctors and nurses are not trained on how to treat people who are being exploited, as in human trafficking. This means that people who are being trafficked are not getting the best in medical care, like they deserve. This study will gather experiences, from people like you, in an effort to improve the education of doctors and nurses, so they can provide better care to people in similar situations to yours.
You may qualify to take part in this research study because you can read and write in your own language, you are older than 17 years old and you have been trafficked or “in the situation” before.
Funds for conducting this research are provided by the Department of Emergency Medicine at the Mount Sinai School of Medicine.
Your participation in this research study is expected to last 15 minutes.
The number of people expected to take part in this research study at this site is 20. The total number of people expected to take part in this research study is at least 100.
If you agree to participate in this research study, the following information describes what may be involved.
You will answer a brief written survey. You will not provide your name or birthday or national identification number.
If you decide to take part in this research study you will be responsible for the following things:
Please answer the questions to the best of your ability, knowledge and memory. If you do not know the answer, write “I don’t know.”
Participants will not be paid for their participation; participation in this study is free.
You are not expected to get any benefit from taking part in this research study. Others may not benefit either. However, possible benefits to others include improved medical care and a chance at freedom, if they see a doctor or nurse while they are in their situation.
Answering the questions on the survey may be uncomfortable or make some people sad or scared or angry.
You may decide not to take part in this research study without any penalty. The choice is totally up to you. There are no consequences for you if you decide not to participate.
If you believe that you have suffered an injury related to this research as a participant in this study, you should contact the Principal Investigator.

You may stop taking part in this research study at any time without any penalty. This will not affect your ability to receive medical care at Mount Sinai or to receive any benefits to which you are otherwise entitled.
If you decide to stop being in the research study, please contact the Principal Investigator or the research staff.
You may also withdraw your permission for the use and disclosure of any of your protected information for research, but you must do so in writing to the Principal Investigator at the address on the first page. Even if you withdraw your permission, the Principal Investigator for the research study may still use the information that was already collected if that information is necessary to complete the research study. Your health information may still be used or shared after you withdraw your authorization if you should have an adverse event (a bad effect) from participating in the research study.
Withdrawal without your consent: The study doctor, the sponsor or the institution may stop your involvement in this research study at any time without your consent. This may be because the research study is being stopped, the instructions of the study team have not been followed, the investigator believes it is in your best interest, or for any other reason. If specimens or data have been stored as part of the research study, they too can be destroyed without your consent
If you have any questions, concerns, or complaints at any time about this research, or you think the research has hurt you, please contact the office of the research team and/or the Principal Investigator at phone number 347.560.9249
This research has been reviewed and approved by an Institutional Review Board. You may reach a representative of the Program for Protection of Human Subjects at Mount Sinai School of Medicine at telephone number (212) 824-8200 during standard work hours for any of the following reasons:
• Your questions, concerns, or complaints are not being answered by the research team.
• You cannot reach the research team.
• You are not comfortable talking to the research team.
• You have questions about your rights as a research subject.
• You want to get information or provide input about this research.
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