David Ebbevi

Research problem and specific questions. This programme studies preventive interventions for child maltreatment. Specific questions are: What’s the effect and mechanisms of extended home visits on child maltreatment? What’s the effect of dental care follow-up on child medical outcomes and markers of child maltreatment? What’s the effect and mechanism of health assessment on medical outcomes in children interrogated by police at children’s advocacy centre? How do children, legal actors and social workers assess clinical examinations of children and what mechanisms control if they are ordered? What’s an effective best practice for forensic reporting of child physical abuse?Data and method. The programme covers four interventions: extended home visits, dental follow-up, health assessment, and guidelines for forensic reporting. RCT and quasi experimental designs are used. Effects and mechanisms are evaluated with mixed methods. Data sources are literature review, semi-structured interviews, documents, surveys, registry data, and medical records. A multitude of measurements capture maltreatment.Relevance and utilization. Children subject to abuse constitute a vulnerable group that remains invisible if they are not specifically targeted. Maltreatment impacts future health and socioeconomic status of the child. Therefore, maltreatment need to be prevented, discovered, and interrupted. The long-term effects of ongoing child maltreatment mean that interruption of maltreatment is a preventive health intervention. The programme is aligned with the national strategy against child maltreatment recently presented for consideration to the Swedish government. Findings are directly applicable to the work at the children’s advocacy centre. Assessment of implementation factors is part of evaluating intervention mechanisms and costs will be evaluated for new interventions. Dissemination will be performed through the institutional network of the programme participants.Plan for programme realisation. The programme will be hosted at Karolinska Institutet, Department of Clinical Science, Intervention and Technology, and operationally based on the children’s advocacy centre in Stockholm. Interventions are performed at the children’s health centre/children’s home, local family centre and the children’s advocacy centre. Most of the staff work clinically at the children’s advocacy centre and this programme funding would enable us to a establish a research group at the children’s advocacy centre focusing on interventions to prevent child maltreatment. The programme has a strong capacity building aim with 3 clinically active doctoral students and a transdisciplinary approach. A children’s panel and a stakeholder panel will be recruited. The funding will cover costs for salaries, representation, research participants and data management. The programme would enable us to reshape everyday operations from being reactive to fundamentally preventive and health promotive.