Article Text

Download PDFPDF
Improving child protection: a systematic review of training and procedural interventions
  1. Y H Carter1,
  2. M J Bannon2,
  3. C Limbert3,
  4. A Docherty4,
  5. J Barlow1
  1. 1Warwick Medical School, University of Warwick, Coventry, UK
  2. 2Oxford Department of Postgraduate Medical and Dental Education, Headington, Oxford, UK
  3. 3University of Wales, Cardiff, UK
  4. 4Redditch and Bromsgrove Primary Care Trust, Redditch, UK
  1. Correspondence to:
    Prof. Y H Carter
    Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK


Aim: To synthesise published evidence regarding the effectiveness of training and procedural interventions aimed at improving the identification and management of child abuse and neglect by health professionals.

Methods: Systematic review for the period 1994 to 2005 of studies that evaluated child protection training and procedural interventions. Main outcome measures were learning achievement, attitudinal change, and clinical behaviour.

Results: Seven papers that examined the effectiveness of procedural interventions and 15 papers that evaluated training programmes met the inclusion criteria. Critical appraisal showed that evaluation of interventions was on the whole poor. It was found that certain procedural interventions (such as the use of checklists and structured forms) can result in improved recording of important clinical information and may also alert clinical staff to the possibility of abuse. While a variety of innovative training programmes were identified, there was an absence of rigorous evaluation of their impact. However a small number of one-group pre- and post-studies suggest improvements in a range of attitudes necessary for successful engagement in the child protection process.

Conclusion: Current evidence supports the use of procedural changes that improve the documentation of suspected child maltreatment and that enhance professional awareness. The lack of an evidence based approach to the implementation of child protection training may restrict the ability of all health professionals to fulfil their role in the child protection process. Formal evaluation of a variety of models for the delivery of this training is urgently needed with subsequent dissemination of results that highlight those found to be most effective.

  • child protection
  • procedural intervention
  • systematic review
  • training

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Published Online First 23 March 2006

  • Competing interests: none declared

Linked Articles

  • Précis
    BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health