Systematic Review: Child Maltreatment Prevention Interventions for Immigrant and Refugee Populations

Background and Purpose: The Family First Prevention Services Act (FFPSA) has renewed emphasis on the prevention of maltreatment in federally reimbursable evidence-based, trauma-informed programs. There is growing recognition that many interventions have not been designed, tested, and implemented with ethnically, culturally, and linguistically diverse groups, who are often at disproportionate risk for child abuse and neglect and are the least likely to have access to adequate services. Immigrants and refugees represent a particularly vulnerable population in need of interventions that consider their unique ethnic, cultural, and linguistic experiences, and exposure to distinct stressors and traumas. Many “gold standard” interventions have not been tested or utilized with immigrant populations, which has serious implications for providing quality, culturally responsive services to this population. In order to address this gap, we conducted a systematic review of maltreatment prevention interventions with evidence relevance for immigrant and refugee populations.

Methods: 6 research databases (i.e., Social Work Abstracts, SocINDEX, CINAHL Complete, PubMed, and PsycINFO), the Child Welfare Information Gateway Database, and the California Evidence-Based Clearinghouse were searched, utilizing keywords associated with immigrants and refugees and interventions. Data abstraction was completed by three researchers. We analyzed interventions according to whether they were translated or adapted for immigrant groups, were designed with or by people of color, were studied with immigrant groups, addressed systemic/environmental issues, and targeted key prevention issues (e.g., child health/behavioral health, family relationships/parenting, substance misuse, domestic violence).

Results: A total of 65 interventions were identified. 31 had a true experimental design, but of those, only 2 were knowingly designed by people of color (POC), 6 were designed or fully adapted for immigrant groups, 23 were translated into languages other than English, and 10 contained components that address systematic/socio-political issues beyond individual or family issues. Of 40 interventions that had some relevance for immigrants (e.g., some level of adaptation, created by POC, incorporate a systemic/ecological approach, etc.), only 4 are well-supported by research evidence and reimbursable by Title IV-E according to the FFPSA. Of 21 interventions that were fully adapted or designed for immigrants or refugees, none have sufficient research evidence to be well supported and reimbursable by Title IV-E and none address domestic violence.

Conclusions and Implications: Provided the unique experiences of immigrant populations and their cultural and linguistic needs, there are very few maltreatment prevention interventions available and supported through federal funding that consider these particular needs. While many gold-standard interventions were translated, concern exists over whether translation is sufficient to meet the cultural and contextual needs of this population. Given the prevalence of domestic violence concerns within immigrant and refugee populations, the lack of domestic violence interventions designed or adapted by and for immigrants is particularly concerning. In order to truly include immigrants and refugees in renewed investments in maltreatment prevention, emphasis is needed on supporting the design and experimentation of evidence-based, culturally appropriate interventions for immigrant and refugee families by researchers and interventionists representative of those populations.