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November 27, 2018

Preventing Maltreatment of Children

Author Affiliations
  • 1University of Colorado School of Medicine, Aurora
JAMA. 2018;320(20):2085-2086. doi:10.1001/jama.2018.18704

In this issue of JAMA, the US Preventive Services Task Force (USPSTF) presents its 2018 recommendation on primary care interventions to prevent child maltreatment.1 This report is accompanied by the evidence review that supports the statement and that involved examination of 22 clinical trials involving more than 11 000 children.2 Most of the trials involved home visiting. The outcomes included subsequent emergency department visits, hospitalizations, child development, school performance, reports to Child Protective Services, injuries, failure to thrive, behavioral symptoms, and prevention of death. Even though there were differences between intervention and control groups in some studies, the overall assessment and conclusion of the task force was that “the current evidence is insufficient to assess the balance of benefits and harms of primary care interventions to prevent child maltreatment (I statement),”1 a recommendation that may disappoint many advocates working toward prevention of this important clinical and societal problem.