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Meta-Analysis
. 2022 Jul 5;7(7):CD011775.
doi: 10.1002/14651858.CD011775.pub2.

Child protection training for professionals to improve reporting of child abuse and neglect

Kerryann Walsh  1 , Elizabeth Eggins  2   3 , Lorelei Hine  2 , Ben Mathews  4 , Maureen C Kenny  5 , Sarah Howard  6 , Natasha Ayling  1 , Elizabeth Dallaston  4 , Elizabeth Pink  1 , Dimitrios Vagenas  7
Affiliations
Meta-Analysis

Child protection training for professionals to improve reporting of child abuse and neglect

Kerryann Walsh et al. Cochrane Database Syst Rev. .

Abstract

Background: Many nations require child-serving professionals to report known or suspected cases of significant child abuse and neglect to statutory child protection or safeguarding authorities. Considered globally, there are millions of professionals who fulfil these roles, and many more who will do so in future. Ensuring they are trained in reporting child abuse and neglect is a key priority for nations and organisations if efforts to address violence against children are to succeed.

Objectives: To assess the effectiveness of training aimed at improving reporting of child abuse and neglect by professionals and to investigate possible components of effective training interventions.

Search methods: We searched CENTRAL, MEDLINE, Embase, 18 other databases, and one trials register up to 4 June 2021. We also handsearched reference lists, selected journals, and websites, and circulated a request for studies to researchers via an email discussion list.

Selection criteria: All randomised controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies examining the effects of training interventions for qualified professionals (e.g. teachers, childcare professionals, doctors, nurses, and mental health professionals) to improve reporting of child abuse and neglect, compared with no training, waitlist control, or alternative training (not related to child abuse and neglect).

Data collection and analysis: We used methodological procedures described in the Cochrane Handbook for Systematic Reviews of Interventions. We synthesised training effects in meta-analysis where possible and summarised findings for primary outcomes (number of reported cases of child abuse and neglect, quality of reported cases, adverse events) and secondary outcomes (knowledge, skills, and attitudes towards the reporting duty). We used the GRADE approach to rate the certainty of the evidence.

Main results: We included 11 trials (1484 participants), using data from 9 of the 11 trials in quantitative synthesis. Trials took place in high-income countries, including the USA, Canada, and the Netherlands, with qualified professionals. In 8 of the 11 trials, interventions were delivered in face-to-face workshops or seminars, and in 3 trials interventions were delivered as self-paced e-learning modules. Interventions were developed by experts and delivered by specialist facilitators, content area experts, or interdisciplinary teams. Only 3 of the 11 included studies were conducted in the past 10 years. Primary outcomes Three studies measured the number of cases of child abuse and neglect via participants' self-report of actual cases reported, three months after training. The results of one study (42 participants) favoured the intervention over waitlist, but the evidence is very uncertain (standardised mean difference (SMD) 0.81, 95% confidence interval (CI) 0.18 to 1.43; very low-certainty evidence). Three studies measured the number of cases of child abuse and neglect via participants' responses to hypothetical case vignettes immediately after training. A meta-analysis of two studies (87 participants) favoured training over no training or waitlist for training, but the evidence is very uncertain (SMD 1.81, 95% CI 1.30 to 2.32; very low-certainty evidence). We identified no studies that measured the number of cases of child abuse and neglect via official records of reports made to child protection authorities, or adverse effects of training. Secondary outcomes Four studies measured professionals' knowledge of reporting duty, processes, and procedures postintervention. The results of one study (744 participants) may favour the intervention over waitlist for training (SMD 1.06, 95% CI 0.90 to 1.21; low-certainty evidence). Four studies measured professionals' knowledge of core concepts in all forms of child abuse and neglect postintervention. A meta-analysis of two studies (154 participants) favoured training over no training, but the evidence is very uncertain (SMD 0.68, 95% CI 0.35 to 1.01; very low-certainty evidence). Three studies measured professionals' knowledge of core concepts in child sexual abuse postintervention. A meta-analysis of these three studies (238 participants) favoured training over no training or waitlist for training, but the evidence is very uncertain (SMD 1.44, 95% CI 0.43 to 2.45; very low-certainty evidence). One study (25 participants) measured professionals' skill in distinguishing reportable and non-reportable cases postintervention. The results favoured the intervention over no training, but the evidence is very uncertain (SMD 0.94, 95% CI 0.11 to 1.77; very low-certainty evidence). Two studies measured professionals' attitudes towards the duty to report child abuse and neglect postintervention. The results of one study (741 participants) favoured the intervention over waitlist, but the evidence is very uncertain (SMD 0.61, 95% CI 0.47 to 0.76; very low-certainty evidence).

Authors' conclusions: The studies included in this review suggest there may be evidence of improvements in training outcomes for professionals exposed to training compared with those who are not exposed. However, the evidence is very uncertain. We rated the certainty of evidence as low to very low, downgrading due to study design and reporting limitations. Our findings rest on a small number of largely older studies, confined to single professional groups. Whether similar effects would be seen for a wider range of professionals remains unknown. Considering the many professional groups with reporting duties, we strongly recommend further research to assess the effectiveness of training interventions, with a wider range of child-serving professionals. There is a need for larger trials that use appropriate methods for group allocation, and statistical methods to account for the delivery of training to professionals in workplace groups.

Trial registration: ClinicalTrials.gov NCT02225301 NCT00844571 NCT03758794 NCT03185728.

PubMed Disclaimer

Conflict of interest statement

Kerryann Walsh (KW): has declared that she was not a co‐author on any study included in this review. However, she has previously co‐authored studies with an author who is a co‐author on a study included in this review (Mathews 2017), which was funded by Penn State University (the researchers had complete control over the study designs, methods, data analysis, and interpretation of data).

Elizabeth Eggins (EE): has declared that she is an Editor with the Campbell Collaboration Crime and Justice Group, a position supported with funding from the Campbell Collaboration Secretariat. EE has been a co‐author on several Campbell and industry‐funded reviews related to child welfare, none of which are directly related to this review.

Lorelei Hine (LH): has declared that she has no conflicts of interest.

Ben Mathews (BM): has declared that he was a co‐author and investigator (but not lead investigator) on one of the studies included in this review (Mathews 2017), funded by Penn State University. The researchers of this study had complete control over the study design, methods, data analysis, and interpretation.

Maureen C Kenny (MK): has declared that she was not a co‐author on any study included in this review, but that she has previously co‐authored studies with the authors of two studies included in this review: Alvarez 2010, partially funded by the National Institute of Drug Abuse, US National Institutes of Health, and Mathews 2017, funded by Penn State University; to MK's knowledge, the researchers of both studies had complete control over the study design, methods, data analysis, and interpretation of data.

Sarah Howard: has declared that she has no conflicts of interest.

Natasha Ayling: has declared that she has no conflicts of interest.

Elizabeth Dallaston: has declared that she has no conflicts of interest.

Elizabeth Pink: has declared that she has no conflicts of interest.

Dimitrios Vagenas: has declared that he has no conflicts of interest.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Forest plot of the comparison: training versus no training or waitlist control: number of reported cases of child abuse and neglect (assessed via vignette responses).
5
5
Forest plot of the comparison: training versus no training: knowledge of core concepts in child abuse and neglect (all forms of child abuse and maltreatment generally).
6
6
Forest plot of the comparison: training versus no training or waitlist: knowledge of core concepts in child abuse and neglect (child sexual abuse specifically).
1.1
1.1. Analysis
Comparison 1: Number of reported cases of child abuse and neglect, Outcome 1: Number of reported cases of child abuse and neglect (vignettes)
1.2
1.2. Analysis
Comparison 1: Number of reported cases of child abuse and neglect, Outcome 2: Number of reported cases of child abuse and neglect (vignettes), adjusted for clustering
2.1
2.1. Analysis
Comparison 2: Knowledge of the reporting duty, processes, and procedures, Outcome 1: Knowledge of reporting duty, processes, and procedures
3.1
3.1. Analysis
Comparison 3: Knowledge of core concepts in child abuse and neglect, Outcome 1: Child abuse/maltreatment (general)
3.2
3.2. Analysis
Comparison 3: Knowledge of core concepts in child abuse and neglect, Outcome 2: Child abuse/maltreatment (general), adjusted for clustering
3.3
3.3. Analysis
Comparison 3: Knowledge of core concepts in child abuse and neglect, Outcome 3: Child sexual abuse (specific)
3.4
3.4. Analysis
Comparison 3: Knowledge of core concepts in child abuse and neglect, Outcome 4: Child sexual abuse (specific), adjusted for clustering
3.5
3.5. Analysis
Comparison 3: Knowledge of core concepts in child abuse and neglect, Outcome 5: Child sexual abuse (specific, non‐randomised CBA)
4.1
4.1. Analysis
Comparison 4: Skills in distinguishing cases, Outcome 1: Skills in distinguishing cases
5.1
5.1. Analysis
Comparison 5: Attitudes towards the duty to report child abuse and neglect, Outcome 1: Attitudes towards the duty to report child abuse and neglect
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD011775

References

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