Intergenerational Effects of the Fast Track Intervention on Next-Generation Child Outcomes : A Preregistered Randomized Clinical Trial

OBJECTIVE: The authors sought to determine whether the Fast Track mental health intervention delivered to individuals in childhood decreased mental health problems and the need for health services among the children of these individuals.

METHODS: The authors examined whether Fast Track assignment in one generation of children (generation 2; G2) from grades 1 through 10 reduced parent-reported mental health problems and health services use in these children's children (generation 3; G3) 18 years later relative to a control group. The Fast Track intervention blended parent behavior-management training, child social-cognitive skills tutoring, home visits, and classroom social-ecology changes across grades 1-10 to ameliorate emerging conduct problems among the G2 children. For this study, 1,057 G3 children of Fast Track participants (N=581 intervention group, N=476 control group) were evaluated.

RESULTS: G3 children of G2 parents who were randomized to the Fast Track intervention group used fewer general inpatient services and fewer inpatient or outpatient mental health services compared with G3 children of G2 parents randomized to the control group. Some of these effects were mediated: randomization to Fast Track predicted fewer internalizing problems and less use of corporal punishment among G2 adults at age 25, which subsequently predicted less general inpatient service use and outpatient mental health service use among the G3 children by the time the G2 parents were 34 years old. There were no significant differences between G3 children from these two groups on the use of other health services or on mental health measures.

CONCLUSIONS: Fast Track was associated with lower use of general inpatient services and inpatient and outpatient mental health services intergenerationally, but effects on parent-reported mental health of the children were not apparent across generations. Investing in interventions for the mental health of children could reduce service use burdens across generations.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:181

Enthalten in:

The American journal of psychiatry - 181(2024), 3 vom: 01. März, Seite 213-222

Sprache:

Englisch

Beteiligte Personen:

Rothenberg, W Andrew [VerfasserIn]
Lansford, Jennifer E [VerfasserIn]
Godwin, Jennifer W [VerfasserIn]
Dodge, Kenneth A [VerfasserIn]
Copeland, William E [VerfasserIn]
Odgers, Candice L [VerfasserIn]
McMahon, Robert J [VerfasserIn]
Rybinska, Anna [VerfasserIn]
Conduct Problems Prevention Research Group [VerfasserIn]

Links:

Volltext

Themen:

Childhood Intervention
Conduct Disorders
Health Service Use
Intergenerational Effects
Journal Article
Mental Health
Prevention
Randomized Controlled Trial

Anmerkungen:

Date Completed 04.03.2024

Date Revised 27.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1176/appi.ajp.20220927

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368111164