Summary: | PURPOSE: To review new evidence on the benefits and harms of behavioral interventions and counseling in health care settings to reduce child abuse and neglect and related health outcomes for the U.S. Preventive Services Task Force. DATA SOURCES: MEDLINE and PsycINFO (January 2002 to June 2012), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (second quarter 2012), Scopus, and reference lists were searched for English-language trials of the effectiveness of behavioral interventions and counseling and studies of any design about adverse effects. DATA SYNTHESIS: Eleven fair-quality randomized trials of interventions and no studies of adverse effects met inclusion criteria. A trial of risk assessment and interventions for abuse and neglect in pediatric clinics for families with children age 5 years and younger indicated reduced physical assault, Child Protective Services reports, medical care nonadherence, and immunization delay among screened children. Ten trials of early childhood home visitation reported reduced Child Protective Services reports, emergency department visits, hospitalizations, and self-reports of abuse and neglect or improved adherence to immunizations and well-child care, although results were inconsistent. LIMITATIONS: Trials were limited by heterogeneity, low adherence, high loss to followup, and lack of standardized measures. CONCLUSIONS: Risk assessment and behavioral interventions in pediatric clinics reduced abuse and neglect outcomes for young children. Early childhood home visitation also reduced abuse and neglect, but results were inconsistent. Additional research on interventions to prevent child abuse and neglect is needed
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