McCabe George, Godwin Jennifer W, Rothenberg W Andrew, Goulter Natalie, Lansford Jennifer E
Duke University, Center for Child and Family Policy, Durham, USA.
Flinders University, College of Education, Psychology, & Social Work, Flinders Institute for Mental Health & Wellbeing, Adelaide, Australia.
Prev Sci. 2024 Oct 11. doi: 10.1007/s11121-024-01736-0.
Early preventive interventions can improve outcomes in childhood, but the most effective interventions can continue to deliver benefits through the life course. The Fast Track intervention, a randomized controlled trial for children at risk of conduct problems, has lowered psychopathology, substance use problems, and criminality and elevated happiness at age 25. However, research has not studied whether the intervention's effects continue further into established adulthood. In addition, little is known about the mechanisms through which the intervention may affect adult outcomes. We attempted to answer both questions by simultaneously estimating the intervention's direct effect on adult outcomes at age 31 and the intervention's indirect effects on those outcomes via interpersonal, intrapersonal, and academic competencies gained through the intervention. Participants included the Fast Track intervention (n = 445; 72.4% male) and high-risk control samples (n = 446; 66.4% male). Direct and total effects of random assignment to Fast Track on age 31 outcomes were not significant. However, our analyses showed that Fast Track's improvements to interpersonal and intrapersonal skills in childhood served as catalysts for better life outcomes at age 31. Higher interpersonal skills led to fewer externalizing, internalizing, and substance use problems, reduced criminality and sexual partners, in addition to increased general health and full-time employment. Improved intrapersonal skills led to greater strength. There were no significant indirect pathways via academic skills. Our findings inform understanding of how a childhood preventive intervention can improve adjustment and behaviors into established adulthood.
早期预防性干预可以改善儿童时期的结果,但最有效的干预措施可以在整个生命过程中持续带来益处。“快车道”干预是一项针对有行为问题风险儿童的随机对照试验,该试验降低了25岁时的精神病理学、物质使用问题和犯罪率,并提高了幸福感。然而,研究尚未探讨该干预措施的效果是否会在成年期进一步持续。此外,对于该干预措施可能影响成年期结果的机制知之甚少。我们试图通过同时估计该干预措施对31岁成年期结果的直接影响以及该干预措施通过干预获得的人际、个人和学术能力对这些结果的间接影响来回答这两个问题。参与者包括“快车道”干预组(n = 445;72.4%为男性)和高危对照组(n = 446;66.4%为男性)。随机分配到“快车道”组对31岁结果的直接和总体影响并不显著。然而,我们的分析表明,“快车道”干预在儿童时期对人际和个人技能的改善成为31岁时更好生活结果的催化剂。更高的人际技能导致外化、内化和物质使用问题减少,犯罪率和性伴侣减少,此外还提高了总体健康水平和全职就业率。个人技能的提高带来了更大的力量。通过学术技能没有显著的间接途径。我们的研究结果有助于理解儿童预防性干预如何改善成年期的适应和行为。