April 2019Vol. 20, No. 3Review of Primary Care Interventions to Prevent Child Maltreatment

Child maltreatment can have long-lasting, negative physical and mental health outcomes for children and youth. It can also contribute to worse outcomes well into adulthood, such as lower performance in school and increased chance of drug use and alcohol abuse. Many agencies and organizations across the country focus on prevention or interventions to stop child maltreatment. 

A recent review in the Journal of the American Medical Association aimed to evaluate the efficacy of interventions in preventing child maltreatment by assessing existing studies on the topic. The review assessed the following: (1) whether programs to prevent child maltreatment that could occur in a primary care setting or through a referral from a primary care clinician could reduce exposure to maltreatment, improve well-being, or reduce mortality and (2) what the harms of those interventions are. The evidence base spans over three decades, and almost all studies included had a home visiting component.

The review found there was no significant association between interventions and reports to child protective services within 1 year of completion. Neither were there any significant associations between interventions and outcomes for emergency room visits, school performance, child development, or mortality. There was insufficient evidence of any effect on other outcomes or on any potential harm interventions can cause.

"Primary Care Interventions to Prevent Child Maltreatment: Updated Evidence Report and Systematic Review for the U.S. Preventative Services Task Force," by Meera Viswanathan et al. (Journal of the American Medical Association, 320) is available at https://www.uspreventiveservicestaskforce.org/Home/GetFile/1/16923/child-maltreatment-evidence-summary/pdf (505 KB).