Preventing Child Abuse Through a Brief Parenting Intervention: 2.5-Year Outcomes From the Safer Kids Randomized
Livia van Leuven1, Pia Enebrink1, Maria Lalouni2
1Karolinska Institutet, Stockholm, Sweden.
Objective:
Child abuse is associated with lifetime risks for psychiatric disorders. This study evaluated 30-month effects of Safer Kids, a parenting program designed for rapid implementation after suspected child abuse.
Method:
In an open-label, randomized controlled trial, families reported for child abuse to 26 Swedish child welfare agencies were randomized to Safer Kids or intervention as usual. Primary outcomes were official child abuse reports (time to first new report and total number of reports) and caregiver abuse risk (the Brief Child Abuse Potential Inventory). The secondary outcome was child mental health (the Strengths and Difficulties Questionnaire). The trial was preregistered at clinicaltrials.gov (NCT04163367).
Results:
The trial included 112 families (194 parents). The cumulative number of new child abuse reports was lower for Safer Kids compared with intervention as usual (incidence rate ratio 1.79; 95% CI 1.06-3.02; p = .028), although there was no difference in time to first new report (hazard ratio 0.74; 95% CI 0.31-1.76; p = .50). At 30 months, the Strengths and Difficulties Questionnaire showed a consistent effect favoring Safer Kids across analytical approaches (nonimputed data: d = 0.60; 95% CI 0.11-1.09; p = .001). For the Brief Child Abuse Potential Inventory, an effect was observed in nonimputed analyses (d = 0.41; 95% CI -0.08-0.89; p = .044) but was not supported in sensitivity analyses.
Conclusion:
Safer Kids did not reduce the time to the first new abuse report but was associated with somewhat fewer total reports and better child mental health at 30 months, suggesting preventive effects in families with suspected abuse.
Clinical Trial Registration Information:
A Randomized Controlled Study of Safer Kids: A Manualized Intervention to Prevent Child Abuse; https://clinicaltrials.gov; NCT04163367.
Diversity And Inclusion Statement:
We worked to ensure sex and gender balance as well as ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way.
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