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Cover of Behavioral Interventions and Counseling to Prevent Child Abuse and Neglect

Behavioral Interventions and Counseling to Prevent Child Abuse and Neglect

Systematic Review to Update the U.S. Preventive Services Task Force Recommendation

Evidence Syntheses, No. 98

Investigators: , MD, MPH, , MD, , MPH, and , MPH.

Oregon Evidence-based Practice Center
Rockville (MD): Agency for Healthcare Research and Quality (US); .
Report No.: 13-05176-EF-1

Structured Abstract

Purpose:

To review new evidence on the benefits and harms of behavioral interventions and counseling in health care settings to reduce child abuse and neglect and related health outcomes for the U.S. Preventive Services Task Force.

Data Sources:

MEDLINE and PsycINFO (January 2002 to June 2012), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (second quarter 2012), Scopus, and reference lists were searched for English-language trials of the effectiveness of behavioral interventions and counseling and studies of any design about adverse effects.

Data Synthesis:

Eleven fair-quality randomized trials of interventions and no studies of adverse effects met inclusion criteria. A trial of risk assessment and interventions for abuse and neglect in pediatric clinics for families with children age 5 years and younger indicated reduced physical assault, Child Protective Services reports, medical care nonadherence, and immunization delay among screened children. Ten trials of early childhood home visitation reported reduced Child Protective Services reports, emergency department visits, hospitalizations, and self-reports of abuse and neglect or improved adherence to immunizations and well-child care, although results were inconsistent.

Limitations:

Trials were limited by heterogeneity, low adherence, high loss to followup, and lack of standardized measures.

Conclusions:

Risk assessment and behavioral interventions in pediatric clinics reduced abuse and neglect outcomes for young children. Early childhood home visitation also reduced abuse and neglect, but results were inconsistent. Additional research on interventions to prevent child abuse and neglect is needed.

Contents

Acknowledgements: The authors acknowledge Peggy Nygren, MA, for her contributions to this report, and Tracy Dana, MLS, Oregon Health & Science University, for conducting literature searches. We thank AHRQ Medical Officer Charlotte Mullican, BSW, MPH, and U.S. Preventive Services Task Force leads David Grossman, MD, MPH, Bernadette Melnyk, PhD, RN, Adelita Gonzales Cantu, PhD, RN, and Virginia Moyer, MD, MPH.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services1, Contract No. HHSA-290-2007-10057-I-EPC3, Task Order No. 3, Prepared by: Oregon Evidence-based Practice Center2

Suggested citation:

Nelson HD, Selph S, Bougatsos C, Blazina I. Behavioral Interventions and Counseling to Prevent Child Abuse and Neglect: Systematic Review to Update the U.S. Preventive Services Task Force Recommendation. Evidence Synthesis No. 98. AHRQ Publication No. 13-05176-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; January 2013.

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0024). The investigators involved have declared no conflicts of interest with objectively conducting this research. The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.

This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

1

540 Gaither Road, Rockville, MD 20850; www​.ahrq.gov

2

Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239; www​.ohsu.edu/epc

Bookshelf ID: NBK117232PMID: 23390658

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