Intergenerational Persistence of Treatment Effects

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PROJECT SUMMARY 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.