Primary Care Interventions to Prevent Child Maltreatment: US Preventive Services Task Force Recommendation Statement

, Michael J Barry1, Wanda K Nicholson2

  • 1Harvard Medical School, Boston, Massachusetts.

JAMA
|March 19, 2024
PubMed

Insights

Evidence is insufficient to determine the benefits and harms of primary care interventions for preventing child maltreatment in children and adolescents. More research is needed to guide prevention strategies for child abuse and neglect.

Area of Science:

  • Public Health
  • Preventive Medicine
  • Pediatrics

Background:

  • Child maltreatment, encompassing abuse and neglect, has severe lifelong health and developmental consequences.
  • Prevalence in the US is uncertain, with 600,000 children identified by CPS in 2021 and 1,820 deaths attributed to maltreatment.
  • Primary care settings are crucial for identifying and intervening in cases of child maltreatment.

Purpose of the Study:

  • To evaluate the benefits and harms of behavioral counseling interventions for preventing child maltreatment.
  • Focus on interventions feasible or referable within primary care settings.
  • Target population: children and adolescents under 18 without current signs or symptoms of maltreatment.

Main Methods:

  • Systematic review commissioned by the US Preventive Services Task Force (USPSTF).
  • Evaluation of behavioral counseling interventions for primary prevention of child maltreatment.
  • Inclusion criteria: children and adolescents younger than 18 years without signs or symptoms of or known exposure to maltreatment.

Main Results:

  • The USPSTF found insufficient evidence to assess the balance of benefits and harms.
  • Current evidence does not support or refute the effectiveness of primary care interventions for preventing child maltreatment.
  • Further research is required to establish efficacy and safety.

Conclusions:

  • The USPSTF concludes that evidence is insufficient to make a recommendation (I statement).
  • There is a need for more high-quality research on primary care interventions for child maltreatment prevention.
  • The potential benefits and harms remain uncertain.
Abstract

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