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This study is a secondary data analysis that extends knowledge about the effects of the early childhood Family Check-Up (FCU) intervention to trajectories of general psychopathology problems (p factor) across early and middle childhood, and effects on adolescent psychopathology and polydrug use. The Early Steps Multisite study (ClinicalTrials.gov Identifier NCT00538252) is a randomized controlled trial of the FCU and consists of a large, racially and ethnically diverse sample of children who grew up in low-income households in Pittsburgh, Pennsylvania; Eugene, Oregon; and Charlottesville, Virginia (n = 731; 49% female; 27.6% African American, 46.7% European American, 13.3% Hispanic/Latinx). To represent a comorbid presentation of internalizing and externalizing problems, we fit a bifactor model that included a general psychopathology (p) factor at eight ages in early childhood (ages 2-4), middle childhood (ages 7.5-10.5), and adolescence (age 14). Latent growth curve modeling was conducted to examine trajectories of the p factor across ages within the developmental periods of early and middle childhood. The effects of FCU on the reductions in growth in the childhood p factor had cascading effects on adolescent p factor (i.e., within-domain effect) and polydrug use (i.e., across-domain effect). Findings underscore the utility of the early FCU in preventing a host of maladaptive adolescent outcomes across diverse settings and populations.

This study examined caregivers' longitudinal reports of adolescent multiracial categorization across the ages of 9.5, 10.5, and 14 years, and adolescents' reports of their own multiracial categorization at the age of 14 years. A portion of caregivers' reports of adolescent multiracial status were inconsistent across the years of the study; some adolescents' and caregivers' responses differed when questions assessing multiracial status were phrased in different ways; and adolescent and caregiver reports did not always align when adolescents were 14 years old. Given these findings, we recommend that researchers consider using multiple methods of racial data collection and collapsing the results to report "estimated ranges" of racial representation in samples, rather than specific percentages. Furthermore, when racial data must be provided by a single informant in the context of early adolescence, we suggest that researchers should think critically about which group's perspective, adolescents' or caregivers', is more relevant to the research questions at hand.

Abstract: This longitudinal study of low‐income families tested neighborhood‐, family‐, and child‐centered promotive factors in early childhood, responses to an early family intervention, and their interactions as predictors of school‐entry levels of and early school‐age gains in academic skills. Using a racially‐diverse, low‐income sample (n = 527) from a randomized controlled trial of the Family Check‐Up (FCU) intervention and Bayesian multilevel regression modeling, we tested whether neighborhood cohesion, positive mother–child engagement, and child self‐regulation in early childhood (ages 2–5 years) and their interactions with FCU group assignment predicted the intercept and slope of academic skills across child age 5, 7.5, and 8.5 years. Higher positive mother–child engagement and child self‐regulation predicted higher academic skills at school entry. An interaction between the FCU intervention and positive mother–child engagement predicted gains in academic skills compared to national norms. The findings suggest the FCU intervention leveraged positive mother–child engagement in early childhood to promote academic skills, offering a potential avenue from which to prevent income achievement gaps before school entry.

Both maternal and paternal supportive parenting (i.e., sensitivity, warmth, stimulation, and engagement) across early childhood have been found to be associated with multiple domains of children's positive socioemotional functioning. However, few studies have considered how maternal and paternal supportive parenting may interact to impact child development. Thus, the present study assessed direct and moderated longitudinal relations between maternal and paternal supportive parenting in toddlerhood (24 and 36 months, respectively) and fathers' and teachers' reports of children's socioemotional and behavioral adjustment in first grade. Data were drawn from a large, sample of Norwegian parents and children (N = 455, 51% female, 49% male, 10% endorsed financial strain, 75% of fathers and 86% of mothers born in Norway). After controlling for child temperamental activity level and soothability in infancy, path analysis revealed that higher paternal supportive parenting was associated with fewer symptoms of father-reported child hyperactivity/impulsivity in first grade. In addition, a significant interaction between maternal and paternal supportive parenting was evident for three out of the four assessed outcomes (per both father- and teacher-reports): externalizing problems, hyperactivity/impulsivity symptoms, and social skills. Simple slope analyses revealed a negative relation between parental supportive parenting and children's externalizing (father-reported) and hyperactivity/impulsivity problems (father- and teacher-reported) when the child's other parent engaged in low levels of supportive parenting. Similarly, paternal supportive parenting was positively associated with children's social skills (father-report) when mothers engaged in low levels of supportive parenting. Results are discussed with implications for including both mothers and fathers in early childhood research, intervention, and social policy.

Neighborhood-level collective efficacy protects Black youth from substance use; however, neighborhood research does not account for the entirety of adolescents' exposure or their perceptions of space which may be critical to understanding the role of context in substance use. To address this limitation, the SPIN Project recruited 65 Black adolescents (M(SD) = 15.32(1.06)) to complete four brief surveys each day for a month describing their perceptions of spaces and marijuana use. Multilevel negative binomial models were estimated to test the relationship between an individual's perceptions of collective efficacy and the marijuana used during a day, and if the location of the observations moderated these relationships. Findings indicated that the perceptions of collective efficacy protected adolescents from marijuana use when occurring within their home neighborhood, but not outside of it; thereby suggesting important variations in adolescents' perceptions based on the location that matter for Black youth marijuana use.

Maternal depression is a well-established risk factor for the development of depression in offspring. As such, reducing maternal depression may be key to effective prevention efforts to reduce offspring's depression. Based on the broad risk represented by maternal depression, examining cross-over effects of parent-focused interventions on maternal depression is important. The present study examined improvements in maternal depression as a mediator of the long-term effects of the Family Check-Up (FCU) prevention program on youth depression across three randomized controlled trials. The FCU is a family-focused intervention originally designed to reduce youth problem behaviors, particularly conduct problems and substance use, but has also been found to have cross-over effects on other youth problem behaviors, including internalizing symptoms. We utilized integrative data analysis that allows for powerful tests of prevention effects across trials, specifically moderated nonlinear factor analysis, to integrate data across three trials: one trial initiated in early childhood and two in early adolescence. Using a latent growth modeling approach, we first examined direct effects of the FCU on changes in maternal depression. Then we examined the mediating effect of maternal depression on changes in both parent and youth reports of youth depression. A significant intervention effect on maternal depression was observed across the three trials, with the FCU predicting improvements in maternal depression. In turn, such improvements predicted a reduction in the growth in both parent and youth reports of youth depressive symptoms across 10 years post baseline. These results demonstrate the utility in addressing cross-over effects of family-focused interventions in reducing the long-term development of depression in youth through mediating pathways.

This study employed integrative data analysis techniques to examine the long-term effects of the family check-up (FCU) on changes in youth suicide risk using three randomized prevention trials, including one trial initiated in early childhood and two initiated in early adolescence. Data were harmonized across studies using moderated nonlinear factor analysis, and intervention effects were tested using an autoregressive latent trajectory model examining changes in suicide risk across long-term follow-up. Across trials, significant long-term effects of the FCU on reductions in suicide risk were observed, although differences between intervention and control group trajectories declined over time. No moderation of intervention effects was observed by youth gender or race/ethnicity or across samples. While results offer further support for the benefits of the FCU for suicide risk reduction, they also suggest that such effects may wane over time, underscoring the need for continued development of the FCU to enhance longer-term durability of effects on suicide-related behaviors.

Integrative data analysis (IDA) was used to derive developmental models of depression, externalizing problems, and self-regulatory processes in three prevention trials of the Family Check-Up and one longitudinal, community-based study of girls over a 10-year span covering early to late adolescence (N = 4,773; 74.9% female, 41.7% white). We used moderated nonlinear factor analysis to create harmonized scores based on all available items for a given participant in the pooled dataset while accounting for potential differences in both the latent factor and the individual items as a function of observed covariates. We also conducted latent growth model analyses to examine developmental trajectories of risk. Results indicated a bidirectional relationship between depression and externalizing problems, with greater baseline externalizing problems and depression predicting growth in inhibitory control difficulties. Furthermore, initial level of inhibitory control difficulties was associated with growth in depression. We did not, however, find a relationship between early inhibitory control difficulties and growth in externalizing problems. This work illustrates the utility of IDA techniques to harmonize data across multiple studies to identify risk factors for the development of depression and externalizing problems that can be targeted by prevention efforts.

Genetic studies show that children's reading achievement is in part genetically influenced, and intervention studies show that reading achievement can be increased by environmental interventions. However, correlational and mean-level analytic strategies are rarely integrated into achievement research, potentially leading to misinterpretation of results. The parent-offspring adoption design offers a novel opportunity to examine the independent and joint roles of genetic and rearing environmental contributions. The sample included 344 adopted children in first grade and their biological and adoptive parents. Results indicated that adoptees' reading scores were correlated with their biological parents' scores, but not with their adoptive parents' scores, suggesting genetic influences. In addition, examination of mean scores indicated that adoptees' scores were significantly greater than their biological parents' (p's < 0.001) for all subtests, suggesting promotive effects of the rearing environment. This pattern was present even when biological parents scored >1 standard deviation below the biological parent mean on achievement.

The thrifty phenotype and fetal overnutrition hypotheses are two developmental hypotheses that originated from the "developmental origins of health and disease" (DOHaD) perspective. The DOHaD posits that exposures experienced prenatally and early in life may influence health outcomes through altering form and function of internal organs related to metabolic processes. Obesity risk and early pubertal timing might be influenced by similar mechanisms. The thrifty phenotype hypothesis is primarily characterized by experiencing a deprivation of nutrients during gestation paired with an energy rich postnatal environment. The fetal overnutrition hypothesis says that obesity experienced prenatally will be associated with increased lifetime risk of obesity in the offspring. Both hypotheses were tested by examining developmental pathways from genetic and prenatal risk through early growth trajectories (birth to 7 years) to pubertal timing at age 11 years. Participants included 361 children adopted at birth (57% male; 57% non-Hispanic White, 11% Black, 9% Hispanic; adoptive family income Mdn = $70,000-$100,000, birth family income Mdn = <$15,000). Associations between boys' childhood body mass index (BMI) and pubertal timing were confounded by genetics, prenatal risk, and early growth. The thrifty phenotype hypothesis was partially supported for boys' childhood BMI (at ages 4 to 7 years). Both hypotheses were partially supported for girls' childhood BMI but not pubertal timing. A novel Gene x Prenatal Risk interaction showed that genetic risk predicted girls' childhood BMI most strongly at adequate compared with at excessive levels of gestational weight gain.

Objectives: The purpose of this study is to determine Emergency Medicine (EM) resident productivity (as measured by patients per hour) over the course of the COVID-19 pandemic compared to the prior training environment.Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted medical education throughout the United States. As a result, many EM residents began residency with atypical clinical experiences. In addition, Emergency Department (ED) patient volumes decreased during the early months of the pandemic.Methods: This is a retrospective observational cohort study conducted at an urban, academic medical center with an established EM residency program. Data was collected from electronic medical records between July 1, 2017 and October 31, 2021. EM residents completing full, consecutive years of residency were included in the sample. Classes prior to 2020 were defined as a control group. Due to the structure of the residency, only shifts at the academic medical center during first and second year of residency (PGY1 and PGY2) were included. Productivity was defined as total primary patient encounters divided by aggregate scheduled shift hours. To allow comparison of the most recent data, analysis was performed on the first four months (July-October) of each academic year. The data was analyzed using descriptive statistics, including standard deviation and t-tests.Results: A total of 63 residents were included in this analysis of the first four months of each training year from 2017-2021. Prior to COVID-19, PGY1 residents evaluated 0.75±0.23 patients per hour and PGY2 residents evaluated 1.46±0.11 patients per hour (p

Intellectual performance is highly heritable and robustly predicts lifelong health and success but the earliest manifestations of genetic effects on this asset are not well understood. This study examined whether early executive function (EF) or verbal performance mediate genetic influences on subsequent intellectual performance, in 561 U.S.-based adoptees (57% male) and their birth and adoptive parents (70% and 92% White, 13% and 4% African American, 7% and 2% Latinx, respectively), administered measures in 2003-2017. Genetic influences on children's academic performance at 7 years were mediated by verbal performance at 4.5 years ([beta] = 0.22, 95% CI [0.08, 0.35], p = 0.002) and not via EF, indicating that verbal performance is an early manifestation of genetic propensity for intellectual performance.

Family systems research has identified two key processes (spillover and compensatory), linking interparental relationship quality to the parent-child relationship. However, previous research has focused on the parent as the sole initiator and had not often considered the role of the child in these processes. The present study adds to the literature by leveraging a genetically informed design to examine possible child evocative effects on spillover and compensatory processes. Participants were from a longitudinal parent-offspring adoption sample of 361 linked sets of adoptive parents of an adopted child (57% male), and the child's birth parents. Adoptive parents reported on child pleasure and anger at 18 months and the interparental relationship at 27 months. Parent-child interactions were observed at child age 6 years, and heritable influences were assessed via birth mother self-report at 5 months. Our results indicated a dampening effect where higher interparental warmth at child age 27 months was associated with less adoptive mother-child coercion at child age 6 years, and a compensatory effect where higher interparental conflict was associated with more adoptive father-child positive engagement. Moreover, our results indicated child-driven effects via both genetic and environmental pathways. Specifically, higher levels of birth mother negative affect (heritable characteristic) were associated with lower levels of adoptive father-child coercion. Also, child anger was positively associated with interparental conflict, and child pleasure was positively associated with interparental warmth. These findings support findings from the family literature with evidence of compensatory mechanisms, while also highlighting the active role children play in shaping family interactions.

The current study explored early adolescent child-level predictors (physical aggression, impulsivity, empathy) and contextual-level predictors (peer deviance, neighborhood dangerousness) of violent and nonviolent antisocial behavior (AB) in late adolescence. Additionally, we tested the moderating role of rejecting parenting on these associations based on the importance of parent-child relationships in early adolescence and documented bidirectional associations between parenting and our predictor variables. Participants (N = 272) came from the Pitt Mother and Child Project, a longitudinal study of high-risk boys. Higher levels of early adolescent physical aggression significantly predicted late adolescent engagement in both nonviolent and violent crimes. Peer deviance, impulsivity, and neighborhood dangerousness were also associated with later juvenile AB. Rejecting parenting moderated several of these associations. Results support the predictive validity of several early adolescent child- and contextual-level variables--particularly early adolescent aggression--for subsequent engagement in both violent and nonviolent AB.

Understanding the role of negative emotionality in the development of executive functioning (EF) and language skills can help identify developmental windows that may provide promising opportunities for intervention. In addition, because EF and language skills are, in part, genetically influenced, intergenerational transmission patterns are important to consider. The prospective parent-offspring adoption design used in this study provides a unique opportunity to examine the intergenerational transmission of EF and language skills. Participants were 561 children adopted around the time of birth. Accounting for birth mother EF and language contributions, we examined the role of child negative emotionality in toddlerhood (age 9 to 27 months) and childhood (age 4.5 to 7 years) on child EF and language skills in first grade (age 7 years). There was continuity in EF from age 27 months to 7 years, and in language ability from age 27 months to 7 years, with no cross-lagged effects between child EF and language ability. Negative emotionality at age 9 months predicted lower EF and lower language abilities at age 7 years, and growth in negative emotionality from age 4.5 to 7 years predicted lower child EF at age 7 years. Overall, findings suggested that lower negative emotionality at age 9 months was associated with higher toddler and child EF and language skills and that preventing growth in negative emotionality from age 4.5 to 7 years may lead to improvements in child EF.

A growing literature suggests that adversity is associated with later altered brain function, particularly within the corticolimbic system that supports emotion processing and salience detection (e.g., amygdala, prefrontal cortex [PFC]). Although neighborhood socioeconomic disadvantage has been shown to predict maladaptive behavioral outcomes, particularly for boys, most of the research linking adversity to corticolimbic function has focused on family-level adversities. Moreover, although animal models and studies of normative brain development suggest that there may be sensitive periods during which adversity exerts stronger effects on corticolimbic development, little prospective evidence exists in humans. Using two low-income samples of boys (n = 167; n = 77), Census-derived neighborhood disadvantage during early childhood, but not adolescence, was uniquely associated with greater amygdala, but not PFC, reactivity to ambiguous neutral faces in adolescence and young adulthood. These associations remained after accounting for several family-level adversities (e.g., low family income, harsh parenting), highlighting the independent and developmentally specific neural effects of the neighborhood context. Furthermore, in both samples, indicators measuring income and poverty status of neighbors were predictive of amygdala function, suggesting that neighborhood economic resources may be critical to brain development.

ObjectivesInsufficient sleep can increase risk for adverse psychological and physical outcomes. Parental monitoring of daily activities is associated with youth health behaviors. We examined parental monitoring of waking and bedtime behaviors and sleep in a community sample of high-risk youth.MethodsOne-hundred sixty-five 10- to 14-year-olds from low-socioeconomic status families participated (11.8 years ±1.16, 52% female; 78% Black/African American). Parents and youth evaluated parental monitoring of waking activities. Parent expectations about bedtime and parent knowledge about adolescent's bedtime and sleep routine were independently rated. Youth sleep was assessed via parent report and actigraphy over 7 days.ResultsMore parental knowledge about bedtime was associated with longer parent-reported sleep duration (β = .18, P  .05). Parental monitoring of waking and bedtime behaviors was not associated with sleep duration variability (P values > .05).ConclusionsParental monitoring of waking activities may indirectly influence adolescent sleep via increased structure and felt security in the parent-adolescent relationship. Youth perception of monitoring may be particularly relevant for youth sleep duration.

The present study uses a parent-offspring adoption design to examine the dual roles of heritable and environmental influences on children's mathematics achievement. Linked sets (N=195) of adopted children, adoptive parents, and birth parents each completed a measure of mathematics fluency (i.e., simple computational operations). Birth parent mathematics achievement and adoptive father mathematics achievement positively correlated with child achievement scores at age 7, whereas adoptive mother and adopted child mathematics achievement scores were not significantly associated with one another. Additionally, findings demonstrated no significant effects of gene-environment interactions on child mathematics achievement at age 7. These results indicate that both heritable and rearing environmental factors contribute to children's mathematics achievement and identify unique influences of the paternal rearing environment on mathematics achievement in middle childhood.

This study examined the interrelated and longitudinal impacts of parent-child shared book reading, parenting stress, and early relational health, as measured by both parental warmth and parent sensitivity, from infancy to toddlerhood. To extend findings from previous studies of collateral effects that have been conducted in parenting interventions, we examined parenting behaviors in a broader context to determine whether shared book reading would confer collateral benefits to the parent and parent-child relationship beyond those expected (i.e., language and literacy). It was hypothesized that positive parent-child interactions, such as shared reading, would have positive impacts on parent outcomes such as parenting stress, parental warmth, and sensitivity. The sample consisted of 293 low-income mothers and their children who participated in a randomized controlled trial. Shared book reading, parenting stress, and parental warmth were assessed when children were 6 and 18 months old. We computed a series of cross-lagged structural equation models to examine longitudinal interrelations among these three factors. Results indicated that shared book reading at 6 months was associated with increases in observed and reported parental warmth and observed sensitivity and decreases in parenting stress at 18 months, controlling for baseline risk factors and treatment group status. These findings suggest that early parent-child book reading can have positive collateral impacts on parents' stress and the parent-child relationship over time.

Attention control (AC) is thought to play an important role in the development of inhibitory control (IC) in children, yet there are few longitudinal studies of this association. This study used a prospective parent-child adoption design (N = 361 children) to examine whether maternal warmth at child age 27 months moderated the link between AC during infancy and IC during childhood. Tobit regression analyses indicated that low levels of infant AC at 9 months predicted low levels of IC at 6 years, controlling for birth parent IC, prenatal risk, infant distress to limitations, child sex, and openness of adoption. Adoptive mother warmth at 27 months moderated this association. In the context of higher levels of maternal warmth, the longitudinal association between low AC and low IC was attenuated. Thus, high levels of early maternal warmth may help diminish the effects of extant risk for IC deficits.

Functional connectivity between the amygdala and the prefrontal cortex is critical for socioemotional processing, particularly during face processing. Though processing others' emotions is important for a myriad of complex social behaviors, more research is needed to understand how different types of emotional facial expressions differentially elicit connectivity of the amygdala with widespread neural regions. Moreover, though prior studies have reported cross-sectional associations between altered amygdala-prefrontal cortex functional connectivity and internalizing symptoms (e.g., depression, anxiety), few studies have examined whether amygdala functional connectivity is prospectively related to changes in these symptoms, with little work focusing on low-income men living in stressful contexts. The current study used psycho-physiological interaction analyses at the within-subjects level to examine how amygdala connectivity differed while participants viewed fearful, angry, and neutral faces. We used structural equation modeling at the between-subjects level, using extracted parameter estimates, to test whether amygdala connectivity during face processing predicted increases in internalizing psychopathology over time, controlling for earlier symptoms. An urban sample of 167 young men from low-income families was employed. Results indicated that negative connectivity between the amygdala and prefrontal regions was modulated by emotional face type. Neuronal activity in the cingulate and frontal cortices was connected to amygdala reactivity during fearful and neutral, but not angry, face processing. Moreover, weaker left amygdala-left middle frontal gyrus negative connectivity when viewing fearful faces and stronger right amygdala-left inferior frontal gyrus negative connectivity when viewing neutral faces at age 20 both predicted increases in internalizing behaviors from age 20 to age 22. Our findings show that amygdala-prefrontal cortex connectivity can predict the persistence of internalizing symptoms among high-risk participants over time but suggest that these patterns may differ depending on the emotional stimuli examined.

BackgroundAlthough resting heart rate (RHR) and empathy are independently and negatively associated with violent behavior, relatively little is known about the interplay between these psychophysiological and temperament-related risk factors.MethodsUsing a sample of 160 low-income, racially diverse men followed prospectively from infancy through early adulthood, this study examined whether RHR and empathy during early adolescence independently and interactively predict violent behavior and related correlates in late adolescence and early adulthood.ResultsControlling for child ethnicity, family income, and child antisocial behavior at age 12, empathy inversely predicted moral disengagement and juvenile petitions for violent crimes, while RHR was unrelated to all measures of violent behavior. Interactive effects were also evident such that among men with lower but not higher levels of RHR, lower empathy predicted increased violent behavior, as indexed by juvenile arrests for violent offenses, peer-reported violent behavior at age 17, self-reported moral disengagement at age 17, and self-reported violent behavior at age 20.ConclusionsImplications for prevention and intervention are considered. Specifically, targeting empathic skills among individuals at risk for violent behavior because of specific psychophysiological profiles may lead to more impactful interventions.

Previous studies demonstrate that boys' monoamine oxidase A (MAOA) genotype interacts with adverse rearing environments in early childhood, including punitive discipline, to predict later antisocial behavior. Yet the mechanisms by which MAOA and punitive parenting interact during childhood to amplify risk for antisocial behavior are not well understood. In the present study, hostile attributional bias and aggressive response generation during middle childhood, salient aspects of maladaptive social information processing, were tested as possible mediators of this relation in a sample of 187 low-income men followed prospectively from infancy into early adulthood. Given racial-ethnic variation in MAOA allele frequencies, analyses were conducted separately by race. In both African American and Caucasian men, those with the low-activity MAOA allele who experienced more punitive discipline at age 1.5 generated more aggressive responses to perceived threat at age 10 relative to men with the high-activity variant. In the African American subsample only, formal mediation analyses indicated a marginally significant indirect effect of maternal punitiveness on adult arrest records via aggressive response generation in middle childhood. The findings suggest that maladaptive social information processing may be an important mechanism underlying the association between MAOA × Parenting interactions and antisocial behavior in early adulthood. The present study extends previous work in the field by demonstrating that MAOA and harsh parenting assessed in early childhood interact to not only predict antisocial behavior in early adulthood, but also predict social information processing, a well-established social-cognitive correlate of antisocial behavior.

Using a cohort of 310 low-income male adolescents living in an urban community and followed prospectively from 18 months through adolescence (ages 15-18 years), the current study examined whether individual, family, and community risk factors from ages 18 to 42 months were associated with adolescents' violent behavior, as indexed by juvenile petitions. Results of multivariate analyses indicated that although family income was the only factor to discriminate those with no arrest record from those with nonviolent arrests, rejecting parenting, child oppositional behavior, emotion regulation, and minority status during the toddler period contributed unique variance in distinguishing male adolescents arrested for violent behavior compared to those never arrested and those arrested for nonviolent behavior. Implications for prevention efforts are discussed.

Several studies suggest that neighborhood deprivation is a unique risk factor in child and adolescent development of problem behavior. We sought to examine whether previously established intervention effects of the Family Check-Up (FCU) on child conduct problems at age 7.5 would persist through age 9.5, and whether neighborhood deprivation would moderate these effects. In addition, we examined whether improvements in parent-child interaction during early childhood associated with the FCU would be related to later reductions in child aggression among families living in the highest risk neighborhoods. Using a multisite cohort of at-risk children identified on the basis of family, child, and socioeconomic risk and randomly assigned to the FCU, intervention effects were found to be moderated by neighborhood deprivation, such that they were only directly present for those living at moderate versus extreme levels of neighborhood deprivation. In addition, improvements in child aggression were evident for children living in extreme neighborhood deprivation when parents improved the quality of their parent-child interaction during the toddler period (i.e., moderated mediation). Implications of the findings are discussed in relation to the possibilities and possible limitations in prevention of early problem behavior for those children living in extreme and moderate levels of poverty.

Several studies suggest that neighborhood deprivation is a unique risk factor in child and adolescent development of problem behavior. We sought to examine whether previously established intervention effects of the Family Check-Up (FCU) on child conduct problems at age 7.5 would persist through age 9.5, and whether neighborhood deprivation would moderate these effects. In addition, we examined whether improvements in parent-child interaction during early childhood associated with the FCU would be related to later reductions in child aggression among families living in the highest risk neighborhoods. Using a multisite cohort of at-risk children identified on the basis of family, child, and socioeconomic risk and randomly assigned to the FCU, intervention effects were found to be moderated by neighborhood deprivation, such that they were only directly present for those living at moderate versus extreme levels of neighborhood deprivation. In addition, improvements in child aggression were evident for children living in extreme neighborhood deprivation when parents improved the quality of their parent-child interaction during the toddler period (i.e., moderated mediation). Implications of the findings are discussed in relation to the possibilities and possible limitations in prevention of early problem behavior for those children living in extreme and moderate levels of poverty.