Background

Home visiting programs are widely endorsed for preventing child maltreatment. Yet, knowledge is lacking on what and how individual program components are related to the effectiveness of these programs.

Objective

The aim of this meta-analysis was to increase this knowledge by summarizing findings on effects of home visiting programs on child maltreatment and by examining potential moderators of this effect, including a range of program components and delivery techniques.

Methods

A literature search yielded 77 studies (N=48,761) examining the effectiveness of home visiting programs, producing 174 effect sizes. In total, 35 different program components and delivery techniques were coded.

Results

A small but significant overall effect was found (d=0.135, 95 % CI (0.084, 0.187), p<0.001). Programs that focused on improving parental expectations of the child or parenthood in general (d = 0.308 for programs with this component versus d = 0.112 for programs without this component), programs targeting parental responsiveness or sensitivity to a child’s needs (d = 0.238 versus d = 0.064), and programs using video-based feedback (d = 0.397 versus d = 0.124) yielded relatively larger effects. Providing practical and instrumental assistance was negatively associated with program effectiveness (d=0.044 versus d = 0.168). Further, program effects were larger when percentages of non-Caucasians/non-Whites in samples and follow-up durations increased.

Conclusions

In general, home visiting programs can prevent child maltreatment only to a small extent. However, implementing specific components and techniques can improve program effectiveness.

中文翻译：

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与家访计划对虐待儿童的影响相关的组成部分：元分析综述

背景

家访计划被广泛认可以防止虐待儿童。然而，缺乏关于个别计划组成部分与这些计划的有效性相关的知识和方式。

客观的

这项荟萃分析的目的是通过总结家访计划对虐待儿童的影响的研究结果，并通过检查这种影响的潜在调节因素，包括一系列计划组成部分和交付技术，来增加这种知识。

方法

一项文献检索产生了 77 项研究 ( N = 48,761)，考察了家访计划的有效性，产生了 174 个效应量。总共对 35 个不同的程序组件和交付技术进行了编码。

结果

发现了一个小但显着的整体效应（d = 0.135，95 % CI (0.084, 0.187)，p <0.001）。专注于提高父母对孩子或一般父母身份的期望的项目（d = 0.308 有这个组成部分的项目，d = 0.112 没有这个组成部分的项目），针对父母对孩子需求的反应或敏感性的项目（d = 0.238 对d = 0.064），而使用基于视频的反馈（d = 0.397 对d = 0.124）的程序产生了相对较大的效果。提供实用和有用的援助与计划有效性呈负相关（d=0.044 与d = 0.168）。此外，当样本中非白种人/非白人的百分比和随访时间增加时，计划效果更大。

结论

一般来说，家访计划只能在很小程度上防止虐待儿童。但是，实施特定的组件和技术可以提高计划的有效性。