Background: Female child welfare-involved youths who are removed from the home are at risk of commercial sexual exploitation of children (CSEC). The aim of this study was to develop a prediction model to identify those at greatest risk of trafficking. Methods: Data were from the Florida Department of Children and Families' Florida Safe Families Network Database. A Cox proportional hazard regression of 60 cases and 3857 controls generated the proposed risk model. Results: Factors found to be associated with a higher risk of trafficking were quantified into point scores, generating the Welfare-Involved Female Sexual Exploitation Risk Assessment (WISER) tool with a cutoff of 20 points: first out-of-home placement at ≥15 years of age (11 points); run away from home in past year and age <15 years (40 points) or ≥15 years (16 points); English spoken as other language (14 points); on a psychotropic drug (17 points); congregate first placement (14 points); runaway/abducted status first "placement" (16 points); psychiatric facility experience (9 points); residential facility experience (7 points); and no time in temporary shelter (9 points). Of those who experienced CSEC, 92% had a WISER score above 20. Discussion: The WISER tool achieved good discrimination and calibration ability with a receiver operating characteristic for the validation data set of 0.923. The WISER tool can (1) inform risk assessment for CSEC among child welfare-involved females and (2) identify youths at greatest risk before they are harmed by trafficking.
Keywords: child welfare; commercial sexual exploitation; foster care; human trafficking; out-of-home care; sex trafficking.