Screening children for family violence: A review of the evidence for the US Preventive Services Task Force

Peggy Nygren, Heidi D. Nelson, Jonathan Klein

    Research output: Contribution to journalReview articlepeer-review

    39 Scopus citations

    Abstract

    BACKGROUND: We wanted to evaluate the benefits and harms of screening children in primary health care settings for abuse and neglect resulting from family violence by examining the evidence on the performance of screening instruments and the effectiveness of interventions. METHODS: We searched for relevant studies in MEDLINE, PsycINFO, CINAHL, ERIC, Cochrane Controlled Trials Register, and reference lists. English language abstracts with original data about family violence against children focusing on screening and interventions initiated or based in health care settings were included. We extracted selected information about study design, patient populations and settings, methods of assessment or intervention, and outcome measures, and applied a set of criteria to evaluate study quality. RESULTS: All instruments designed to screen for child abuse and neglect were directed to parents, particularly pregnant women. These instruments had fairly high sensitivity but low specificity when administered in high-risk study populations and have not been widely tested in other populations. Randomized controlled trials of frequent nurse home visitation programs beginning during pregnancy that address behavioral and psychological factors indicated improved abuse measures and outcomes. No studies were identified about interventions in older children or harms associated with screening and intervention. CONCLUSIONS: No trials of the effectiveness of screening in a health care setting have been published. Clinician referrals to nurse home visitation during pregnancy and in early childhood may reduce abuse in selected populations. There are no studies about harms of screening and interventions.

    Original languageEnglish (US)
    Pages (from-to)161-169
    Number of pages9
    JournalAnnals of family medicine
    Volume2
    Issue number2
    DOIs
    StatePublished - 2004

    Keywords

    • Child abuse
    • Child neglect
    • Domestic violence/prevention and control
    • Evidence-based medicine
    • Review, academic

    ASJC Scopus subject areas

    • Family Practice

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