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      Universal violence and child maltreatment prevention programs for parents: a systematic review Translated title: Programas de Educación Parental de Prevención Universal de la Violencia y el Maltrato: una Revisión Sistemática

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          Abstract

          The present study aimed to review recent literature on universal violence and child maltreatment prevention programs for parents. The following databases were used: Web of Science, PsycINFO, PsycARTICLES, PubMed, LILACS, and SciELO. The keywords included the following: (Parenting Program or Parent Training or Parent Intervention) and (Maltreatment or Violence or Violence Prevention). For inclusion in this review, the programs had to be structured, working in groups of parents aiming to improve parenting practices. Twenty-three studies were included, and 16 different types of parenting programs were identified. Ninety-one percent of the studies were conducted in developed countries. All the programs focused on the prevention of violence and maltreatment by promoting positive parenting practices. Only seven studies were randomized controlled trials. All studies that evaluated parenting strategies (n = 18), reported after the interventions. The programs also effectively improved child behavior in 90% of the studies that assessed this outcome. In conclusion, parenting educational programs appear to be an important strategy for the universal prevention of violence and maltreatment against children. Future studies should assess the applicability and effectiveness of parenting programs for the prevention of violence against children in developing countries. Further randomized control trials are also required.

          Translated abstract

          El presente artículo pretende revisar la literatura actualizada acerca de los programas universales de educación parental de prevención de la violencia y el maltrato contra los niños. Las bases de datos utilizadas fueron Web of Science, PsycINFO, PsycARTICLES, PubMed, LILACS y SciELO, con las palabras clave: parenting program or parent training or parent intervention and maltreatment or violence or violence prevention. Los programas eran estructurados, trabajando en grupos de padres para mejorar las prácticas educativas. Se incluyeron 23 estudios. La mayoría se llevó a cabo en los países desarrollados (91%). Se identificaron 16 diferentes programas de promoción de las prácticas educativas para prevenir la violencia y el maltrato infantil. Sólo siete estudios eran ensayos controlados aleatorios. Todos los estudios que evaluaron las prácticas educativas demostraron una mejoría después de la intervención (n = 18). Los programas demostraron una mejora en el comportamiento de los niños en el 90% de los estudios que evaluaron este resultado. En conclusión, los programas educativos para padres demostraron ser una estrategia importante para la prevención universal de la violencia y el maltrato infantil. Se enfatiza la importancia de la implementación y evaluación de programas de educación parental en los países en desarrollo y más ensayos controlados aleatorios.

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          Interventions to prevent child maltreatment and associated impairment.

          Although a broad range of programmes for prevention of child maltreatment exist, the effectiveness of most of the programmes is unknown. Two specific home-visiting programmes-the Nurse-Family Partnership (best evidence) and Early Start-have been shown to prevent child maltreatment and associated outcomes such as injuries. One population-level parenting programme has shown benefits, but requires further assessment and replication. Additional in-hospital and clinic strategies show promise in preventing physical abuse and neglect. However, whether school-based educational programmes prevent child sexual abuse is unknown, and there are currently no known approaches to prevent emotional abuse or exposure to intimate-partner violence. A specific parent-training programme has shown benefits in preventing recurrence of physical abuse; no intervention has yet been shown to be effective in preventing recurrence of neglect. A few interventions for neglected children and mother-child therapy for families with intimate-partner violence show promise in improving behavioural outcomes. Cognitive-behavioural therapy for sexually abused children with symptoms of post-traumatic stress shows the best evidence for reduction in mental-health conditions. For maltreated children, foster care placement can lead to benefits compared with young people who remain at home or those who reunify from foster care; enhanced foster care shows benefits for children. Future research should ensure that interventions are assessed in controlled trials, using actual outcomes of maltreatment and associated health measures.
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            A multiple-levels-of-analysis perspective on resilience: implications for the developing brain, neural plasticity, and preventive interventions.

            Resilient functioning, the attainment of unexpected competence despite significant adversity, is among the most intriguing and adaptive phenomena of human development. Although growing attention has been paid to discovering the processes through which individuals at high risk do not develop maladaptively, the empirical study of resilience has focused predominantly on detecting the psychosocial determinants of the phenomenon. For the field of resilience to grow in ways that are commensurate with the complexity inherent to the construct, efforts to understand underlying processes will be facilitated by the increased implementation of interdisciplinary research designed within a developmental psychopathology framework. Research of this nature would entail a consideration of psychological, biological, and environmental-contextual processes from which pathways to resilience might eventuate (known as equifinality), as well as those that result in diverse outcomes among individuals who have achieved resilient functioning (know as multifinality). The possible relation between the mechanisms of neural plasticity and resilience and specific suggestions concerning research questions needed to examine this association are discussed. Examples from developmental neuroscience and molecular genetics are provided to illustrate the potential of incorporating biology into the study of resilience. The importance of adopting a multiple-levels-of-analysis perspective for designing and evaluating interventions aimed at fostering resilient outcomes in persons facing significant adversity is emphasized.
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              Child maltreatment prevention: a systematic review of reviews

              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.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                inter
                Psychosocial Intervention
                Psychosocial Intervention
                Colegio Oficial de Psicólogos de Madrid (Madrid, Madrid, Spain )
                1132-0559
                2173-4712
                April 2016
                : 25
                : 1
                : 27-38
                Affiliations
                orgnameUniversity of Sao Paulo orgdiv1Ribeirao Preto Medical School orgdiv2Department of Neurosciences and Behavior Brazil
                Article
                S1132-05592016000100004
                10.1016/j.psi.2015.10.003

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 61, Pages: 12
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