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Cited by 511Child Abuse and TraumaChild Abuse and Related TraumaChild Welfare and Adoption

Child maltreatment prevention: a systematic review of reviews

Open access
Mikton, Christopher, Butchart, Alexander·2009·Bulletin of the World Health Organization
DOI 10.2471/blt.08.057075PMC PMC2678770
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Abstract

OBJECTIVE: To synthesize recent evidence from systematic and comprehensive reviews on the effectiveness of universal and selective child maltreatment prevention interventions, evaluate the methodological quality of the reviews and outcome evaluation studies they are based on, and map the geographical distribution of the evidence. METHODS: A systematic review of reviews was conducted. The quality of the systematic reviews was evaluated with a tool for the assessment of multiple systematic reviews (AMSTAR), and the quality of the outcome evaluations was assessed using indicators of internal validity and of the construct validity of outcome measures. FINDINGS: The review focused on seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups. Four of the seven - home-visiting, parent education, abusive head trauma prevention and multi-component interventions - show promise in preventing actual child maltreatment. Three of them - home visiting, parent education and child sexual abuse prevention - appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to the methodological shortcomings of the reviews and outcome evaluation studies they draw on. An analysis of the geographical distribution of the evidence shows that outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low- and middle-income countries and make up only 0.6% of the total evidence base. CONCLUSION: Evidence for the effectiveness of four of the seven main types of interventions for preventing child maltreatment is promising, although it is weakened by methodological problems and paucity of outcome evaluations from low- and middle-income countries.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review of reviews synthesized 26 reviews on universal and selective child maltreatment prevention interventions and found promising evidence for four of seven intervention types, but the evidence is weakened by methodological shortcomings and a near-total absence of outcome evaluations from low- and middle-income countries. Only 0.6% of the 298 included outcome-evaluation publications were from middle-income countries, and none were from low-income countries.

Key findings

  • Of 3299 titles identified, 26 reviews met inclusion criteria; they summarized 298 publications on primarily single outcome evaluation studies and another 85 reviews and commentaries.
  • Four of seven intervention types — home visiting, parent education, abusive head trauma prevention, and multi-component interventions — showed promise for preventing actual child maltreatment. Three — home visiting, parent education, and child sexual abuse prevention — appeared effective in reducing risk factors, though conclusions were tentative.
  • Geographic distribution: 296 of 298 publications (99.4%) were from high-income countries (around 83% from the USA); two (0.6%) were from middle-income countries (a sex abuse prevention programme in China and kangaroo mother care/mother–child bond in Colombia); none were from low-income countries.
  • Quality: mean AMSTAR score for the 15 systematic reviews was 6.3 (SD 1.88); 3 reviews were low quality, 10 moderate, and 2 high. Of 298 publications, 140 (47%) used randomized controlled designs, 82 (27.5%) non-randomized controlled designs, and 45 (15.1%) had no control group; direct measures of child maltreatment were used in less than one-third, while 64.4% used risk factors.

Methods

  • Systematic review of reviews searching English and non-English databases including Medline, PsychINFO, Embase, CINAHL, Social Sciences Citation Index, Science Citation Index, LILACS, ERIC, NCJRS, Campbell Library, Cochrane Library, WorldWideScience, KoreaMed, IndMED, and Google, plus reference lists and 10 international experts.
  • Inclusion required reviews published January 2000–July 2008 evaluating universal or selective interventions (not indicated interventions) with outcomes of physical abuse, sexual abuse, neglect, or emotional abuse by a parent or caretaker; bullying and witnessing intimate partner violence were excluded.
  • Two reviewers independently screened 25% of studies and assessed full texts; review quality was assessed with AMSTAR, and outcome evaluations were assessed for internal validity (randomized controlled, non-randomized controlled, no control group) and construct validity of outcome measures (direct, proxy, or risk-factor measures), with geographical mapping.

Limitations

  • Stated in the paper: further non-English language databases might have identified additional reviews; a recent Lancet review was not included because it appeared after completion; for four reviews it was not possible to separate conclusions from the small number of “indicated” interventions included; three methodological quality dimensions of outcome evaluation studies — treatment fidelity, statistical conclusion validity, and descriptive validity — were not assessed; and only easily accessible grey literature was searched, excluding theses, dissertations, and conference proceedings.
  • Evident from the text: the evidence base is overwhelmingly from high-income, English-speaking countries, so the authors state it cannot be assumed that current evidence applies outside high-income countries; many included studies lacked control groups or used risk-factor outcomes rather than direct maltreatment measures, and the reviews themselves were only of moderate quality on average, making effectiveness conclusions tentative.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2471/blt.08.057075

Cites

59 of 59 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 32 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Four of the seven intervention types-home visiting, parent education, abusive head trauma prevention, and multi-component interventions-show promise in preventing actual child maltreatment.

    “Four of the seven -home-visiting, parent education, abusive head trauma prevention and multi-component interventions -show promise in preventing actual child maltreatment.”
    • Also stated in: § Discussion · plain
      “There is evidence that four of the seven types of universal and selective interventions examined in the 26 reviews are promising for preventing actual child maltreatment: home visiting, parent education, abusive head trauma prevention and multi-component programmes”
    Quote in the paperSubstantial claim
  • Findingown data

    The review identified seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups.

    “The review focused on seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups.”
    • Also stated in: § Overall · plain
      “The following seven main types of interventions were included in at least two of the 26 reviews and are the most widely implemented and evaluated types of interventions.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Two meta-analyses reported small and medium effect sizes for parent education programmes on the basis of both risk factors and direct measures of child maltreatment.

    “Two of the meta-analyses reported small and medium effect sizes for parent education programmes on the basis of both risk factors and direct measures of child maltreatment.12,13”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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    • cites [13]

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  • Findingcitation

    Two studies that measured future sexual abuse as an outcome reported mixed results.

    “Two studies that measured future sexual abuse as an outcome reported mixed results.39,40”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [39]

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    • cites [40]

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  • Findingown data

    There is evidence that four of the seven main types of universal and selective interventions to prevent actual child maltreatment are promising.

    “There is evidence that four of the seven main types of universal and selective interventions to prevent actual child maltreatment are promising”
    • Also stated in: § Resumen Prevención del maltrato infantil: revisión sistemática de las revisiones · plain
      “Cuatro de las siete (visitas a domicilio, educación de los padres, prevención de los traumatismos craneales por maltrato e intervenciones con múltiples componentes) fueron prometedoras para evitar que se produzca el maltrato infantil.”
    Quote in the paperSubstantial claim
  • May combine two claims. 32
  • Classified as probably not a substantial claim. 13
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingown data

    Home visiting, parent education, and child sexual abuse prevention appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to methodological shortcomings of the reviews and outcome evaluation studies.

    “Three of them -home visiting, parent education and child sexual abuse prevention -appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to the methodological shortcomings of the reviews and outcome evaluation studies they draw on.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low- and middle-income countries and make up only 0.6% of the total evidence base.

    “An analysis of the geographical distribution of the evidence shows that outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low-and middle-income countries and make up only 0.6% of the total evidence base.”
    • Also stated in: § Geographical distribution of the evidence · plain
      “Of the 298 publications on outcome evaluation studies included in the reviews, 296 (99.4%) were on studies in high-income countries (around 83% in the USA), two (0.6%) in middleincome countries -a study on a sex abuse prevention programme in China and another on kangaroo mother care and the mother-child bond in Colombia -and none in low-income countries”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Of 3299 titles identified, 26 met the inclusion criteria.

    “Of the 3299 titles identified through the search strategy, 26 met the inclusion criteria (Table 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Overall, the reviews suggest that early home visitation programmes are effective in reducing risk factors for child maltreatment, but whether they reduce direct measures is less clear-cut.

    “Overall, these reviews suggest that early home visitation programmes are effective in reducing risk factors for child maltreatment, but whether they reduce direct measures is less clear-cut.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Early childhood home visitation was the most extensively evaluated type of intervention, with 17 of 26 reviews summarizing evidence based on 149 publications on individual outcome studies.

    “Of the 26 reviews that satisfied the inclusion criteria, 17 summarized evidence on early childhood home visitation programmes (Table 1) based on 149 publications on individual outcome studies and several further reviews.This made it the most extensively evaluated type of intervention.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The 26 included reviews summarized 298 publications on primarily single outcome evaluation studies and another 85 reviews and commentaries.

    “The 26 reviews included summarized 298 publications on primarily single outcome evaluation studies and another 85 reviews and commentaries.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    Research on the effectiveness of universal and selective interventions appears to be almost exclusively the affair of English-speaking, high-income countries.

    “Yet research on the effectiveness of universal and selective interventions appears to be almost exclusively the affair of English-speaking, highincome countries.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Evidence on the three remaining types-child sexual abuse prevention, media-based interventions, and social support and mutual aid groups-is either insufficient or mixed.

    “The evidence, in relation to actual child mistreatment, on the three remaining types -child sexual abuse prevention, media-based interventions and social support and mutual aid groups -is either insufficient or mixed.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Other reviews concluded that while evidence shows improvements in risk factors for child maltreatment from parent education, evidence of an effect on actual child maltreatment remains insufficient.

    “Other reviews concluded, however, that while the evidence shows improvements in risk factors for child maltreatment, evidence of an effect on actual child maltreatment remains insufficient.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Reviews are all but unanimous that school-based interventions to prevent child sexual abuse are effective at strengthening protective factors against this type of abuse, and that evidence about whether such programmes reduce actual sexual abuse is lacking.

    “These reviews are all but unanimous in the finding that, on the one hand, school-based interventions to prevent child sexual abuse are effective at strengthening protective factors against this type of abuse (e.g.knowledge of sexual abuse and protective behaviours) and, on the other, that evidence about whether such programmes reduce actual sexual abuse is lacking.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Direct measures of child maltreatment were used in less than one-third of the publications on outcome evaluations, and in around 64.4% of them risk factors were used as an indicator; the proportion of direct measures was highest (44.3%) for early home visiting, 17.4% for parent education, and 2.7% for child sexual abuse prevention, for which only risk factors were included in around 97% of studies

    “Direct measures of child maltreatment were used in less than one-third of the publications on outcome evaluations (Table 4), and in around 64.4% of them, risk factors were used as an indicator of child maltreatment.The proportion of direct measures was highest (44.3%) for early home visiting programmes, considerably lower (17.4%) for parent education programmes, and exceedingly low for child”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Of the 298 publications on outcome evaluation studies, 296 (99.4%) were on studies in high-income countries (around 83% in the USA), two (0.6%) in middle-income countries, and none in low-income countries; 290 (almost 97.3%) were on studies in English-speaking countries.

    “Of the 298 publications on outcome evaluation studies included in the reviews, 296 (99.4%) were on studies in high-income countries (around 83% in the USA), two (0.6%) in middleincome countries -a study on a sex abuse prevention programme in China and another on kangaroo mother care and the mother-child bond in Colombia -and none in low-income countries (Fig. 1).Of all publications, 290 (almost 97”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Two methodological weaknesses of the outcome evaluation studies were repeatedly highlighted in the reviews themselves: weak internal validity and inappropriate outcome measures.

    “Two methodological weaknesses of the outcome evaluation studies were repeatedly highlighted in the reviews themselves: weak internal validity and inappropriate outcome measures.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The analysis of internal validity showed that some 15% of the publications included in the reviews failed to use a control group, and that for child sexual abuse prevention and parenting education the proportion increased to 18.9% and 23.9%, respectively.

    “The analysis of internal validity showed that some 15% of the publications included in the reviews failed to use a control group, and that for child sexual abuse prevention and parenting education the proportion increased to 18.9% and 23.9%, respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The four promising intervention types are home visiting, parent education, prevention of abusive head trauma, and multi-component interventions.

    “Cuatro de las siete (visitas a domicilio, educación de los padres, prevención de los traumatismos craneales por maltrato e intervenciones con múltiples componentes) fueron prometedoras para evitar que se produzca el maltrato infantil.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Three reviews, including a total of seven publications, discussed multi-component interventions, and a meta-analysis found the effect size of multi-component interventions to be 0.58.

    “Three reviews, which included a total of seven publications, discussed multi-component interventions”
    • Also stated in: § Multi-component interventions · plain
      “A metaanalysis found the effect size of multicomponent interventions to be 0.58.14”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Two reviews focused on social support and mutual aid groups aimed to strengthen parents' social network; MacLeod & Nelson found an effect size of 0.38 for interventions that used risk factors for child maltreatment as an outcome, whereas Barlow et al. conclude that such interventions are not effective.

    “Two reviews focused on social support and mutual aid groups aimed to strengthen parents' social network.MacLeod & Nelson found an effect size of 0.38 for interventions that used risk factors for child maltreatment as an outcome, 14 whereas Barlow et al. conclude that such interventions are not effective.9”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14]

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    • cites [9]

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  • May combine two claims. The quote only partly states this claim.

    Findingcitation

    Three reviews focused on media-based interventions and surveyed a total of five publications; two found evidence mixed or insufficient, while MacLeod & Nelson found a large effect size (1.26) in reduction of risk factors.

    “MacLeod & Nelson, based on two studies (only one of which was included in the two other reviews) found a large effect size (1.26) in the reduction of risk factors for child maltreatment for this type of intervention.14”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [25]

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    • cites [33]

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    • cites [14]

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  • May combine two claims.

    Findingown data

    Three of the reviews were of low quality (AMSTAR 0-4), 10 were of moderate quality (5-8), and two were of high quality (9-11); the overall mean AMSTAR score for the 15 systematic reviews was 6.3 (SD 1.88).

    “Three of the reviews were of low quality (i.e.AMSTAR scores between 0-4), 10 were of moderate quality (5-8), and two, including the Cochrane Review by Zwi et al., were of high quality (9-11) 16 (Table 2).The overall mean AMSTAR score for the 15 systematic reviews included in this study was 6.3 (standard deviation, SD: 1.88).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16]

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  • May combine two claims.

    Findingown data

    Minimum standards for the research designs of included studies were specified in 17 of the 24 reviews; in six of the 11 reviews that included studies with no control group, such studies comprised 20% or more of the total, and in one case as much as 50%; in 11 of 24 reviews, the proportion of outcome evaluations in which risk factors for child abuse were the outcome measure was at least half.

    “The minimum standards for the research designs of the studies included were specified in 17 of the 24 reviews (excluding the reviews of reviews).In six of the 11 reviews that included studies with no control group, the latter comprised 20% or more of the total, and in one case, as much as 50%, In 11 of 24 reviews, the proportion of outcome evaluations in which risk factors for child abuse were the”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Non-randomized controlled designs were used in about 27.5% of the publications overall and in 21.5%, 39.1% and 31.1% of the publications on home visiting, parent education and child sexual abuse prevention, respectively.

    “Non-randomized controlled designs were used in about 27.5% of the publications overall and in 21.5%, 39.1% and 31.1% of the publications on home visiting, parent education and child sexual abuse prevention, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Child maltreatment has strong, long-lasting effects on brain architecture, psychological functioning, mental health, health risk behaviours, social functioning, life expectancy and health-care costs.

    “retrospective and prospective studies have established that child maltreatment has strong, long-lasting effects on brain architecture, psychological functioning, mental health, health risk behaviours, social functioning, life expectancy and health-care costs.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [1]

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Both reviewers assessed the full text of all reviews against inclusion criteria, and uncertainties were discussed until consensus was reached in all cases.

    “Both reviewers assessed the full text of all reviews in light of the inclusion criteria.Uncertainties were discussed and consensus was reached in all cases.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Epidemiological data on and policies and programmes against child maltreatment are conspicuously lacking in most low- and middle-income countries.

    “epidemiological data on and policies and programmes against child maltreatment are conspicuously lacking in most low-and middle-income countries”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [8]

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  • May combine two claims.

    Premisecitation

    Child maltreatment is a truly global phenomenon that occurs in some low- and middle-income countries at higher rates than in wealthier countries.

    “epidemiological studies have clearly established that child maltreatment is not peculiar to the West but a truly global phenomenon that occurs in some lowand middle-income countries at higher rates than in wealthier countries.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [5]

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    A second reviewer independently screened 25% of the studies identified and previously screened by the first reviewer.

    “A second reviewer independently screened 25% of the studies identified and previously screened by the first reviewer.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Treating and later trying to remedy the effects of child maltreatment are both less effective and more costly than preventing it in the first place.

    “evidence strongly suggests that treating and later trying to remedy the effects of child maltreatment are both less effective and more costly than preventing it in the first place.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7]

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  • May combine two claims.

    Premisecitation

    AMSTAR has good reliability and validity.

    “AMSTAR, a measurement tool for the assessment of multiple systematic reviews that has good reliability and validity.36,37”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [36]

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Evidence for effectiveness of each main type of intervention was graded independently by two reviewers using an adaptation of a pre-existing system, with no disagreements.

    “Evidence for the effectiveness of each main type of intervention was graded independently by two reviewers (Table 1) with an adaptation of a pre-existing system, 35 and there were no disagreements.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35]

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  • May combine two claims.

    Premisecitation

    The empirical examination of surveillance bias suggests that its importance is often exaggerated and that it rarely substantially alters findings.

    “The empirical examination of surveillance bias, a problem affecting outcome measures in home visiting evaluations, suggests that its importance is often exaggerated and that it rarely substantially alters findings.45”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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  • May combine two claims.

    Interpretationown data

    The mean number of times individual publications were included in the reviews was 1.68, which suggests that searches were less than comprehensive.

    “Furthermore, the mean number of times individual publications were included in the reviews was 1.68, which suggests that searches were less than comprehensive.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: The number of times individual publications were included in the reviews serves as a rough proxy for the comprehensiveness of reviews' search strategies.

  • May combine two claims.

    Interpretationnone given

    When a particular type of intervention is judged promising, it may mean that only a single programme has been unambiguously shown to be effective, as is the case for home-visiting programmes.

    “It is important to emphasize that when a particular type of intervention is judged to be promising, it may mean that only a single programme has been unambiguously shown to be effective, as is the case for home-visiting programmes.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A comprehensive hospital-based parent education programme in New York State was found to reduce the incidence of abusive head trauma by 47%.

    “The programme was found to reduce the in-cidence of abusive head trauma by 47%”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41]

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Only the most easily accessible grey literature was searched.

    “Lastly, only the most easily accessible grey literature was searched.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    In the case of four reviews, it was not possible to separate the conclusions derived from the small number of 'indicated' interventions included.

    “Third, in the case of four reviews it was not possible to separate the conclusions derived from the small number of”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationnone given

    Methods and standards for developing sound and effective child maltreatment prevention interventions are available and have been successfully applied.

    “Methods and standards for developing sound and effective child maltreatment Special theme -Childhood injuries and violence Review on child maltreatment prevention Christopher Mikton & Alexander Butchart prevention interventions are available and have been successfully applied.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    This study has revealed a woeful imbalance in the geographic distribution of child maltreatment prevention research: over 99% of the publications were on studies conducted in high-income countries, a parallel of the 10/90 gap in other areas of health research.

    “This study has revealed a woeful imbalance in the geographic distribution of child maltreatment prevention research: over 99% of the publications were on studies conducted in highincome countries, a parallel of the 10/90 gap in other areas of health research.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Three methodological quality dimensions of outcome evaluation studies-treatment fidelity, statistical conclusion validity, and descriptive validity-were not assessed.

    “Fourth, three other methodological quality dimensions of outcome evaluation studies -namely, treatment fidelity, statistical conclusion validity and descriptive validity -were not assessed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50]

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The main conclusions of a recent Lancet review reinforce the main messages of this review.

    “However, its main conclusions -e.g. that more controlled trials using actual outcomes of maltreatment are needed -reinforce the main messages of this review.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49]

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    A recent review published in the Lancet was not included because it appeared after this review was completed.

    “Second, a recent review published in the Lancet was not included, since it appeared after this review was completed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Although the quality of the non-randomized controlled studies was not assessed here, the internal validity of the research designs of most of these studies is generally considered to be weak.

    “Although the quality of the non-randomized controlled studies was not assessed here, the internal validity of the research designs of most of these studies is generally considered to be weak.43,44”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [43]

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41 of 41

  • The authors state this as an assumption.

    The number of times individual publications were included in the reviews serves as a rough proxy for the comprehensiveness of reviews' search strategies.

    “The number of times individual publications were included in the reviews also served as a rough proxy for the comprehensiveness of reviews' search strategies.”

  • The paper relies on this without support.

    When the country where a study was carried out could not be determined, the authors' institutional affiliation is a valid proxy for the country.

    “In 10 (4%) of the 298 publications it was not possible to determine the country where the study was carried out, so the authors' institutional affiliation was used as a proxy instead.”

  • The paper relies on this without support.

    The typology of seven main types of interventions reflects the typology used by the reviews themselves.

    “This typology reflects that used by the reviews themselves.”

  • The paper relies on this without support.

    Neither theses and dissertations nor conference proceedings is, in general, an important source of systematic and other reviews.

    “The two main types of grey literature excluded were theses and dissertations and conference proceedings, neither of which is, in general, an important source of systematic and other reviews.”

  • The paper relies on this without support.

    In low- and middle-income countries, child maltreatment represents a greater health burden and slows economic and social development to a greater extent than in high-income countries.

    “In low-and middle-income countries, child maltreatment represents a greater health burden and slows economic and social development to a greater extent than in high-income countries.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • The middle-income publication share is misrounded

    Minor

    Two of 298 publications constitute 0.7% to one decimal place, rather than the reported 0.6%.

    Reported 0.6 · recomputed 0.671141

  • The percentage with an undetermined study country is overstated

    Minor

    Ten of 298 publications constitute about 3.4%, or 3% rounded to a whole percent, rather than 4%.

    Reported 4 · recomputed 3.355705

  • Parent-education design percentage is misrounded

    Minor

    In Table 3, 3 of 46 parent-education publications are classified as "Other," which is 6.5% to one decimal place, not 6.4%.

    Reported 6.4 · recomputed 6.521739

  • The French abstract names only three of its stated four promising interventions

    Minor

    The French abstract says four intervention types are promising but lists only three; the English abstract includes multi-component interventions as the fourth.

4 of 4

Cites

Flagged first, then by citations

2 of the 61 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. Runyan DK, Eckenrode J. International perspectives on the epidemiology of child neglect and abuse. Annales Nestle 2004;62:1-12.
  2. Bull J, McCormick G, Swann C, Mulvihill C. Ante-and post-natal home- visiting programmes: a review of reviews [Evidence briefing]. London: Health Development Agency; 2004.
  3. Klevens J. Prevention of inflicted childhood neurotrauma: what we know, what we don't, and what we need to know. In: Reece R, Nicholson C, eds. Inflicted childhood neurotrauma: proceedings of a multi-disciplinary, modified, evidence-based conference. Elkgrove Village, IL: American Academy of Pediatrics; 2003. pp. 269-279.
  4. Hébert M, Tourigny M. Child sexual abuse prevention: a review of evaluative studies and recommendations for program development. In: Shohov SP, ed. Advances in psychology research, volume 32. New York, NY: Nova Science Publishers; 2004. pp. 111-143.
  5. MacMillan HL, Jamieson E, Wathen C, Boyle M, Walsh C, Omura J, et al. Development of a policy-relevant child maltreatment research strategy. Milbank Q 2007;85:337-74. PMID:17517119 doi:10.1111/j.1468- 0009.2007.00490.x · DOI

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Authors
Mikton, C., & Butchart, A.
Affiliations
World Health Organization (CH)
Corresponding author
Mikton, Christopher
ORCID
Venue
Bulletin of the World Health Organization
Publisher
WHO Press
Published
2009-05-01
Volume
87
Issue
5
Pages
353-361
ISSN
0042-9686 (ISSN-L)
DOI
10.2471/blt.08.057075
PMC
PMC2678770
OpenAlex
W2157032433
Semantic Scholar
491155daaf34cbbde3de3128f8d181ad1672e1bf
Cited by
511
References
61
Citations by year
2026: 19 · 2025: 14 · 2024: 35 · 2023: 28 · 2022: 31 · 2021: 23 · 2020: 36 · 2019: 30 · 2018: 48 · 2017: 41 · 2016: 36 · 2015: 50 · 2014: 35 · 2013: 24 · 2012: 24
FWCI
2.77
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Bulletin of the World Health Organization (publishedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • UWE Research Repository (UWE Bristol) (submittedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child Abuse and Related Trauma
  • Social Sciences › Safety Research › Child Welfare and Adoption
Keywords
child abuse prevention, home visiting, parent education, child sexual abuse prevention, multicomponent intervention, media-based interventions, low- and middle-income countries, quality of evidence, outcome measurement
MeSH terms
Child, Child Abuse, Humans, Review Literature as Topic, Databases, Bibliographic

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