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Meta-Analysis
. 2015 Oct 18:15:1068.
doi: 10.1186/s12889-015-2387-9.

A gloomy picture: a meta-analysis of randomized controlled trials reveals disappointing effectiveness of programs aiming at preventing child maltreatment

Saskia Euser  1 , Lenneke Ra Alink  2 , Marije Stoltenborgh  3 , Marian J Bakermans-Kranenburg  4 , Marinus H van IJzendoorn  5
Affiliations
Meta-Analysis

A gloomy picture: a meta-analysis of randomized controlled trials reveals disappointing effectiveness of programs aiming at preventing child maltreatment

Saskia Euser et al. BMC Public Health. .

Abstract

Background: Consistent findings about the effectiveness of parent programs to prevent or reduce child maltreatment are lacking.

Methods: In the present meta-analysis we synthesized findings from 27 independent samples from randomized controlled trials (RCTs) on the effectiveness of 20 different intervention programs aimed at (i) preventing the occurrence of child maltreatment in the general population or with at-risk but non-maltreating families, or (ii) reducing the incidence of child maltreatment in maltreating families.

Results: A significant combined effect on maltreatment (d = 0.13; N = 4883) disappeared after the trim-and-fill approach that takes into account publication bias against smaller studies without significant outcomes. However, moderator analyses showed that larger effect sizes were found for more recent studies, studies with smaller samples, programs that provide parent training instead of only support, programs that target maltreating instead of at-risk families, and programs with a moderate length (6-12 months) or a moderate number of sessions (16-30).

Conclusions: More RCTs are needed to further unravel which factors are associated with program effectiveness. Because currently existing programs appeared to only reduce and not prevent child maltreatment, efforts in the field of preventive intervention should also focus on the development and testing of preventive programs for families at risk for child maltreatment.

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Figures

Fig. 1
Fig. 1
Overview of articles included and excluded in the meta-analysis
Fig. 2
Fig. 2
Forest plot for interventions with effects on child maltreatment in the general population, at risk, and maltreating groups. *p < .05. Note. BCT = Behavioral Couples Therapy; BCT-PC = Parent Skills Behavioral Couples Therapy; CAMP = Colorado Adolescent Maternity Program; CPEP = Child Parent Enrichment Project; Healthy Start + = Enhanced Health Start Program; MST-CAN = Multisytemic Therapy for Child Abuse and Neglect; PCIT = Parent Child Interaction Therapy; EPCIT = Enhanced Parent Child Interaction Therapy
Fig. 3
Fig. 3
Funnel plot of intervention studies with effects on child maltreatment in the general population, at risk, and maltreating groups. Note. White circles indicate observed studies and black circles indicate imputed studies
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