Primary Care Interventions to Prevent Child Maltreatment: An Evidence Review for the U.S. Preventive Services Task Force.
Evidence Synthesis No. 170 AHRQ Publication No. 18-05241-EF-1
RTI International. Research Triangle Institute-University of North Carolina Evidence-Based Practice Center. U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality.
vi, 332 p.
Published: November 2018
U.S. Preventive Services Task Force (USPSTF)
540 Gaither Road
Rockville, MD 20850
This federally funded report summarizes the evidence on the benefits and harms of interventions to prevent child maltreatment and identifies key gaps in the scientific literature. The investigators, U.S. Preventive Services Task Force (USPSTF) members, and Agency for Healthcare Research and Quality (AHRQ) Medical Officers developed the scope, key questions, and analytic framework that guided the literature search and review. The study investigated whether primary care feasible or referable interventions to prevent child maltreatment reduce exposure to abuse or neglect, improve behavioral, emotional, physical, or mental well- being, or reduce mortality among children and adolescents without obvious signs or symptoms of abuse or neglect; and what are the harms of primary care feasible or referable interventions to prevent child maltreatment. A total of 33 articles including 22 randomly controlled trials were included in the review. Findings indicate the evidence on the effect of interventions that are feasible in or referable from primary care settings on short-term outcomes for interventions to prevent child maltreatment, reports to Child Protective Services, emergency department visits, and hospitalizations suggests no benefit. Results from the Nurse Family Partnership generally demonstrate benefit and the other trials do not. Other systematic reviews also found inconsistent evidence of benefits for trials other than the Nurse Family Partnership. The report concludes that on the whole, the evidence base on interventions feasible in or referable from primary care settings to prevent child maltreatment does not consistently demonstrate benefit, and no information was available about possible harms of these interventions. The need for additional research is noted. 3 figures, 3 tables, and 186 references.
child abuse; child neglect; risk assessment; prevention; intervention; health personnel; hospital emergency services; hospitalized children; visiting nurses; evidence based practice