The 15 million children in the United States who live in families below the poverty line are at risk for serious health problems ranging from chronic conditions such as cardiovascular disease and diabetes to mental health problems such as depression and substance use disorders. Many childhood interventions target low-income and high-risk children, with evidence that some early interventions improve adult health and wellbeing. However, little is known about whether, and how, the benefits of childhood interventions get transmitted across generations. This study asks whether children who benefit from early interventions grow up to become better parents and, subsequently, have children who experience fewer health problems, educational challenges, and emotional problems. We bring together two longstanding, ongoing, prospective intervention studies that follow panels of children into adulthood. Published findings show that each intervention has positive impact on a child?s adjustment, but it is not known whether this impact transfers to the next generation. The first is a quasi-experiment in which a positive income shock due to a casino opening resulted in an unearned cash transfer to American Indian children?s families. These families had already been participating in the Great Smoky Mountains Study (GSMS), an accelerated longitudinal cohort study now entering its fourth decade, with detailed measures available pre-intervention, post-intervention, and into adulthood. The second is the Fast Track (FT) Prevention Randomized Controlled Trial that randomly assigned 891 kindergarten children at risk for serious behavior problems to intervention and control conditions. Published findings indicate positive impact at least through age 26. Participants from both studies are now in their mid-30s and are currently completing or preparing for another wave of assessments with high rates of study retention. We will collect identical measures of risks to parenting, parenting environments, and parenting behaviors and information on the over 5000 offspring of these study members via a harmonized parent and offspring survey, a low-cost daily virtual assessment of parenting and child wellbeing, and high quality educational and birth records. We test whether the positive income shock, or separately, random assignment to the FT intervention in childhood, improves future parenting and, subsequently, offspring adjustment. For GSMS, we conduct an innovative population-wide extension to include all children aged 8 to 18 living in the counties where the income shock occurred. We test hypotheses about which subgroups (e.g., highest risk, females, those showing maximal initial impact) are most likely to likely to pass on benefits of the intervention to their own children, and which mechanisms mediate intervention impact. Our findings will inform prevention science by testing whether, for whom, and how, the effects of human capital interventions are transmitted across generations. Our findings speak directly to the costs and benefits of contemporary public policy as both interventions reflect features of policies and programs that currently serve millions of high-risk children and families in the United States.

Public Health Relevance

This project brings together two longstanding studies (Fast Track randomized control trial and Great Smoky Mountains Study) to test how successful childhood interventions influence future parenting and whether benefits persist into the next generation. Analyses will draw on new data collected from parent surveys, low- cost daily virtual assessments of parents and children, and high-quality education and birth records of the offspring. Findings will inform prevention efforts, developmental science, and policy by mapping how childhood interventions may be transmitted across generations.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD093651-01
Application #
9423684
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Esposito, Layla E
Project Start
2017-09-20
Project End
2022-06-30
Budget Start
2017-09-20
Budget End
2018-06-30
Support Year
1
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Duke University
Department
Type
Other Specialized Schools
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705