The current evidence to determine the positive or negative effects of primary care intervention to prevent child maltreatment is still insufficient, according to a United States Preventive Services Task Force (USPSTF) recommendation update published in JAMA.

The USPSTF released an update to their 2013 recommendations for primary care interventions for child maltreatment prevention, ordering a review of the evidence associated with such maltreatment interventions for children and adolescents without maltreatment signs or symptoms.

The USPSTF reported that nearly 676,000 children in the United States experienced abuse, neglect, or both in 2016. Of these children, 75% experienced neglect, 18% experienced physical abuse, and 8% experienced sexual abuse. Of the abused children, nearly 14% experienced more than 1 form of maltreatment. Some children (0.25%) died due to maltreatment.

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Primary care interventions, such as home visitation programs, provided limited and inconsistent evidence for preventing child maltreatment, suggesting low certainty for the extent of benefits and harms associated with such interventions.

In the official report, the authors concluded, “In 2013, the USPSTF found insufficient evidence to assess the balance of benefits and harms of primary care interventions to prevent child maltreatment” and that “the current recommendation reaffirms this position.”

USPSTF authors also included information on recommendations from other organizations, stating that “there are varying recommendations related to the primary prevention of child maltreatment.”

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“In 2013, the American Academy of Family Physicians concluded that the current evidence is insufficient to assess the balance of benefits and harms of primary care interventions to prevent child maltreatment,” they continued. “The American Academy of Pediatrics has no recommendations on preventive interventions but strongly recommends clinician involvement in preventing child maltreatment and provides guidance and information on risk factors, protective factors, and clinical management.”


Curry SJ, Krist AH, Owens DK, et al; for the US Preventive Services Task Force. Interventions to prevent child maltreatment: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(20):2122-2128.