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.

中文翻译：

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快速通道干预对下一代儿童结局的代际影响：一项预先注册的随机临床试验

客观的：

作者试图确定向儿童时期的个人提供的快速心理健康干预是否减少了这些人的子女的心理健康问题以及对健康服务的需求。

方法：

作者研究了 18 年后，对 1 年级至 10 年级的一代儿童（第 2 代；G2）进行快速通道分配是否会减少家长报告的心理健康问题以及这些儿童的孩子（第 3 代；G3）的健康服务使用情况。控制组。快速通道干预结合了 1-10 年级的家长行为管理培训、儿童社会认知技能辅导、家访和课堂社会生态变化，以改善 G2 儿童中新出现的行为问题。本研究对快速通道参与者的 1,057 名 G3 儿童（N=581 干预组，N=476 对照组）进行了评估。

结果：

与随机分配到对照组的 G2 父母的 G3 儿童相比，G2 父母的 G3 儿童被随机分配到快速通道干预组，使用的普通住院服务和住院或门诊心理健康服务更少。其中一些影响是经过调节的：随机化到快速通道预测 25 岁的 G2 成年人中内化问题更少，体罚的使用也更少，这随后预测到 G3 儿童中一般住院服务的使用和门诊心理健康服务的使用更少。 G2父母34岁。这两组的 G3 儿童在使用其他卫生服务或心理健康措施方面没有显着差异。

结论：

快速通道与代际间一般住院服务以及住院和门诊心理健康服务的使用率较低有关，但对家长报告的儿童心理健康的影响在代际间并不明显。投资于儿童心理健康干预措施可以减轻各代人的服务使用负担。