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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

A gloomy picture: a meta-analysis of randomized controlled trials reveals disappointing effectiveness of programs aiming at preventing child maltreatment

BMC Public Health > Ausgabe 1/2015
Saskia Euser, Lenneke RA Alink, Marije Stoltenborgh, Marian J. Bakermans-Kranenburg, Marinus H. van IJzendoorn
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2387-9) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SE carried out the literature search and coding of studies, and drafted the manuscript. SE and MHvIJ performed the analyses. MS carried out the literature search and coding of studies. LRA, MJBK and MHvIJ conceived of the study, contributed to the study design, analysis, interpretation of data, and drafting or revision of the manuscript. All authors read and approved the final manuscript.



Consistent findings about the effectiveness of parent programs to prevent or reduce child maltreatment are lacking.


In the present meta-analysis we synthesized findings from 27 independent samples from randomized controlled trials (RCTs) on the effectiveness of 20 different intervention programs aimed at (i) preventing the occurrence of child maltreatment in the general population or with at-risk but non-maltreating families, or (ii) reducing the incidence of child maltreatment in maltreating families.


A significant combined effect on maltreatment (d = 0.13; N = 4883) disappeared after the trim-and-fill approach that takes into account publication bias against smaller studies without significant outcomes. However, moderator analyses showed that larger effect sizes were found for more recent studies, studies with smaller samples, programs that provide parent training instead of only support, programs that target maltreating instead of at-risk families, and programs with a moderate length (6–12 months) or a moderate number of sessions (16–30).


More RCTs are needed to further unravel which factors are associated with program effectiveness. Because currently existing programs appeared to only reduce and not prevent child maltreatment, efforts in the field of preventive intervention should also focus on the development and testing of preventive programs for families at risk for child maltreatment.
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