However, for both child abuse and parent stress, the average effect sizes were not different from zero, suggesting a
lack of evidence for effects in these areas.108 Earlier meta - analytic reviews have also noted the
lack of sizable effects in preventing child maltreatment — again
citing the different intensity
of surveillance
of families in the treatment versus
control groups as an explanation (though the authors did report that home visiting was associated with an approximately 25 percent reduction in the rate
of childhood injuries).109 Another review focusing on the
quality of the home environment also found evidence for a significant overall effect
of home - visiting programs.110 More recently, Harriet MacMillan and colleagues published a review
of interventions to prevent child maltreatment, and identified the Nurse - Family Partnership and Early Start programs as the most effective with regard to preventing maltreatment and childhood injuries.