Does a maternal history of childhood maltreatment influence prevention program impact on child outcomes? Exploratory findings from a randomized controlled trial in British Columbia, Canada
In brief
Maternal maltreatment history altered home-visiting program effects on two child outcomes
In an exploratory analysis of a Canadian trial involving 739 young mothers, 73% reported childhood maltreatment. That history changed the Nurse-Family Partnership's effects on child injuries and maternally reported language at age 2, but not on other outcomes studied; the analysis does not establish which families benefited more or why.
- Journal
- Child abuse & neglect (Q1)
- Published
- 3 November 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Nicole L A Catherine, Yufei Zheng, Hui Xie, Harriet MacMillan, Michael Boyle, Rosemary Lever, et al.
- PMID
- 42976439
- DOI
- 10.1016/j.chiabu.2026.108395
Why clinicians should know about it
- Picked for Public Health, Environmental and Occupational Health (top studies of the week, 8 November 2026): Randomized evaluation of a home-visiting child maltreatment prevention programme
Abstract
BACKGROUND: Nurse-home visiting programs starting prenatally are a promising approach for preventing child maltreatment including injuries. Understanding which families benefit the most can inform policies to ensure greater impact and efficiency. OBJECTIVE: We investigated whether maternal history of childhood maltreatment (CM) moderated Nurse-Family Partnership (NFP) impact on child outcomes. PARTICIPANTS AND SETTING: We utilized secondary data from the Canadian NFP randomized controlled trial (RCT) involving 739 mothers aged 14-24 years and their 737 children in British Columbia (data collected 2013-2019). METHODS: Baseline data, including maternal CM history, were collected during pregnancy and before random assignment to existing services or NFP plus existing services. Data on main child outcome indicators: injuries (emergency department events), problem behaviour and language (maternal report) and language and cognition (in-home observations) were collected at age two years. RESULTS: Many maternal participants reported CM exposure (73.1%), including 57% medium-to-severe and 41.8% severe thresholds. CM history significantly moderated NFP impacts on selected child outcomes including injuries (adjusted differences in rate differences =102.92, 95% CI: 15.18, 193.45) and language via maternal report (adjusted differences in mean differences = -82.52, 95% CI: -150.77, -14.27). CONCLUSIONS: A maternal history of CM moderated NFP impacts on injuries and language, but not all child outcomes examined. Researchers are encouraged to harness existing RCT data to learn how prevention program outcomes vary across populations. Policymakers may then apply this nuanced guidance to inform the refinement of prevention programs for families with unmet needs, fulfilling the ethical obligation to ensure that programs are effective for all.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.