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Child Abuse Negl. 2017 Mar;65:48-57. doi: 10.1016/j.chiabu.2017.01.004. Epub 2017 Jan 19.

A systematic review of randomized controlled trials of interventions designed to decrease child abuse in high-risk families.

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The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, 5 Longfellow Pl., Suite 215, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Institute for Juvenile Research, University of Illinois College of Medicine, 1747 W Roosevelt Rd., Chicago, IL 60608, USA. Electronic address:
Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA 02115, USA.
Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.
Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Urb Ingeniería, San Martin de Porras, Lima, Peru.
Boston Medical Center, Department of Psychiatry, 840 Harrison Ave., Boston, MA 02118, USA; Boston University School of Medicine, 72 East Concord St., Boston, MA 02118, USA.


Child abuse is a global problem, and parents with histories of childhood abuse are at increased risk of abusing their offspring. The objective of this systematic review is to provide a clear overview of the existing literature of randomized controlled trials evaluating the effectiveness of interventions to prevent child abuse. PubMed, PsychINFO, Web of Science, Sociological Abstracts, and CINAHL were systematically searched and expanded by hand search. This review includes all randomized controlled trials (RCTs) of interventions designed to prevent abuse among mothers identified as high-risk. Of the eight studies identified, only three found statistically significant reductions in abuse by any measure, and only two found reductions in incidents reported to child protective services. While much has been written about child abuse in high-risk families, few RCTs have been performed. Only home visitation has a significant evidence base for reducing child abuse, and the findings vary considerably. Also, data from low- and middle-income countries are limited.


Abuse; Child maltreatment; Intergenerational transmission; Neglect; Randomized controlled trial; Systematic review

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