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Intergenerational Effects of the Fast Track Intervention on Next-Generation Child Outcomes: A Preregistered
W Andrew Rothenberg1, Jennifer E Lansford1, Jennifer W Godwin1
1Center for Child and Family Policy, Duke University, Durham, N.C. (Rothenberg, Lansford, Godwin, Dodge, Copeland, Odgers, Rybinska); Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami (Rothenberg); Department of Psychiatry, University of Vermont, Burlington (Copeland); Department of Psychological Science, University of California, Irvine (Odgers); Simon Fraser University, Burnaby, and British Columbia Children's Hospital, Vancouver (McMahon).
Insights
The Fast Track intervention in childhood reduced healthcare service use in the next generation. This intergenerational impact on service utilization highlights the long-term benefits of early mental health support.
Area of Science:
- Psychology
- Public Health
- Developmental Psychology
Background:
- Early childhood interventions can have long-lasting effects.
- Mental health interventions aim to reduce future problems and service needs.
- Intergenerational impacts of childhood interventions are not fully understood.
Purpose of the Study:
- To determine if the Fast Track mental health intervention in childhood reduces mental health problems and healthcare service use in the subsequent generation.
- To examine the intergenerational effects of a childhood intervention on mental health service utilization.
Main Methods:
- Longitudinal study evaluating Generation 3 (G3) children whose Generation 2 (G2) parents participated in the Fast Track intervention or a control group.
- The Fast Track intervention included parent training, child tutoring, and home/school support.
- 1,057 G3 children were assessed, with parents randomized to intervention (N=581) or control (N=476).
Main Results:
- G3 children of Fast Track-exposed G2 parents used fewer general inpatient services and fewer inpatient/outpatient mental health services.
- Intervention effects were partially mediated by reduced internalizing problems and corporal punishment in G2 adults.
- No significant differences were found in other health services or parent-reported mental health measures for G3 children.
Conclusions:
- The Fast Track intervention demonstrated intergenerational benefits by reducing healthcare service use.
- While direct mental health improvements were not evident across generations, service utilization decreased.
- Investing in early childhood mental health interventions can alleviate future healthcare burdens.
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.
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