Preventing adult sexual and labour exploitation in the UK:Findings from a participatory evidence synthesis of what does or could work

Preventing trafficking and exploitation is an elusive global goal. We completed a participatory evidence synthesis to explore what does or could work in preventing labor and sexual exploitation among UK adults. Electronic database (ASSIA, IBSS, Scopus, MEDLINE) and gray literature searches were completed. We also conducted six consultation panels to build in lived and learned experience of exploitation. Searches identified 36 evaluative papers. Insights from these were synthesized with those of consultation panels using a realist-informed analytical approach. We developed a novel “BETR prevention framework” (Before-Early-Treat-Retrafficking) which includes: 1) a health promotion-informed definition of prevention as “thriving;” 2) typology of 25 interventions; and, 3) five prevention mechanisms of change (access to basic essentials of life, critical literacy, power and control, deterrence, and disruption and partnership). We found that community-based and survivor-led initiatives offer promise for prevention. This should be set within a “whole systems” response that includes preventative law and national policies.