Can we measure success in preventing child abuse? Issues in policy, programming and research.

Can we measure success in preventing child abuse? As the field of child abuse and neglect prevention matures intellectually and as more and more agencies require evaluative research to substantiate claims of programmatic success, this issue is emerging with ever growing vigor. This paper reviews efforts to set prevention goals in the United States, e.g., by the federal government's Surgeon General's Report on Health Promotion and Disease Prevention and by the National Committee for the Prevention of Child Abuse. For such goal setting to be defensible and socially productive, it must be linked to a research base. This research base is growing and maturing. The home health visitor concept, in particular, has received clear and powerful support as a preventive strategy. However, many issues remain concerning other strategies. Of equal or greater importance are the many difficulties we face in documenting base rates of maltreatment with which to assess the impact of preventive interventions. Questions remain about the adequacy of infant mortality data, child injury rates, and the validity of officially reported cases of child maltreatment. The paper reviews the data available to clarify and resolve these issues, and outlines a strategy for assessing success of efforts to reduce severity and incidence of child abuse in the United States. These efforts are presented in the context of a series of principles regarding child abuse prevention, e.g., the difference between prevention linked to broad social and economic reforms versus preventive programming targeted at ameliorating the lives of high-risk families in the absence of broad socioeconomic change.