USPSTF: Evidence lacking for interventions to prevent child maltreatment

The current evidence is insufficient for assessing the balance of benefits and harms of interventions in primary care for preventing child maltreatment. These findings form the basis of a final recommendation statement published in the Journal of the American Medical Association.

Meera Viswanathan, Ph.D., from the RTI-International-University of North Carolina at Chapel Hill Evidence-based Practice Center, and colleagues reviewed the evidence on primary care-feasible or referable interventions to prevent child maltreatment in a review including 25 trials with 14,355 participants.

The researchers found that evidence from 11 studies with 5,311 participants indicated there were no differences in the likelihood of reports to Child Protective Services within one year of intervention completion; five studies with 3,336 participants found no differences in removal of the child from the home within one to three years of follow-up.

No benefits were seen for emergency department visits in the short term (under two years) and hospitalizations. For all other outcomes, the evidence was inconclusive. Neither of the two trials reporting harms indicated statistically significant differences.

Based on these findings, the USPSTF concludes that in children and adolescents younger than 18 years without signs or symptoms of known exposure to maltreatment, the current evidence is inadequate for determining the balance of benefits and harms of primary care interventions to prevent child maltreatment (I statement).

"There is still not enough evidence on what can be done in primary care to prevent maltreatment before it occurs," USPSTF member James Stevermer, M.D., said in a statement. "The task force continues to call for more research in this area urgently."

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