Minority children living in disadvantaged neighborhoods are at high risk for school dropout, delinquency and poor health, largely due to the negative impact of poverty and stress on parenting and child development. This study evaluated a population-level, family-centered, school-based intervention designed to promote learning, behavior and health by strengthening parenting, early childhood classroom quality, and child self-regulation during early childhood. Ten schools in urban districts serving primarily low-income Black students were randomly assigned to intervention or a “pre-kindergarten education as usual” control condition. Intervention included a family program (13-week behavioral parenting intervention and concurrent group for children) and professional development for early childhood teachers. The majority (88%) of the pre-kindergarten population (N=1050; age 4) enrolled in the trial and nearly 60% of parents in intervention schools participated in the family program. This study evaluated intervention impact on parenting (knowledge, positive behavior support, behavior management, involvement in early learning) and child conduct problems over a 2-year period (end of kindergarten). Intent-to-treat analyses found intervention effects on knowledge, positive behavior support and teacher-rated parent involvement in early learning. For the highest-risk families, intervention also resulted in increased parent-rated involvement in early learning and decreased harsh and inconsistent behavior management. Among boys at high risk for problems based on baseline behavioral dysregulation (age 4, 23% of sample), intervention led to lower rates of conduct problems at age 6. Family-centered intervention at the transition to school has potential to improve population health and break the cycle of disadvantage for low-income, minority families.

Youth conduct problems, delinquency, and substance abuse pose serious consequences for the youth themselves, their victims and families, and the broader society. The widespread impact of these problem behaviors highlights the importance of preventing and treating them effectively. Despite this need, an emerging literature has demonstrated that certain intervention programs for these problem behaviors, particularly those that have used group-delivery formats, have produced iatrogenic effects. The potential for intervention to produce negative outcomes raises several ethical implications and dilemmas. In this article, the author provides illustrative examples of iatrogenic effects of interventions that target youth conduct problems, delinquency, and substance abuse; discusses the relevant ethical implications raised by these outcomes; and suggests recommendations to prevent, detect, and respond to their occurrence.

We examined the extent to which maternal antisocial behavior (ASB) is directly related to child conduct problems and social competence and assessed the potential mediating role of negative parenting. The sample included 93 adolescent mothers and their children (44 boys, 49 girls). Mothers retrospectively reported about their ASB since the child's birth, through Grade 2. Negative parenting was coded during a parent-child interaction task (PCIT) at Grade 2. Teachers assessed child outcomes at Grade 3. Maternal ASB during the child's life was directly related to parenting and both child outcomes. In the overall sample, negative parenting partially mediated the relation between maternal ASB and child conduct problems. However, the pattern of relations differed by sex. For boys, maternal ASB was directly related to conduct problems, independent of parenting. For girls, maternal ASB was strongly related to parenting but not conduct problems. Negative parenting did not mediate the relation between maternal ASB and child social competence. Implications for intervention and future research are discussed.

Asian American (ASA) children experience high rates of mental health problems. Although there is a pressing need to utilize population approaches, emerging frameworks from the fields of public and population health have not been applied to ASA children. This paper addresses this gap by first discussing applications of the National Prevention Strategy (NPS), a population strategy developed from the Social Determinants of Health perspective, to guide ASA prevention work. Next, we provide a practical example to illustrate how the NPS can be applied to prevention program design (using ParentCorps as an example) and dissemination and implementation processes to broadly address ASA children's mental health needs. Finally, we present preliminary data on the feasibility of applying this population strategy to ASA families and a framework for researchers who are considering disseminating and implementing evidence-based programs to ASA or ethnic minority pediatric populations.

Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions (EBIs) are not available in SSA. This study investigated the implementation quality and effectiveness of one component of an EBI from a developed country (United States) to a SSA country (Uganda). The EBI component, Professional Development, was provided by trained Ugandan mental health workers to Ugandan primary school teachers. It included large group experiential training and small group coaching to introduce and support a range of evidence-based practices (EBPs) to create nurturing and predictable classroom experiences. The study was guided by the Consolidated Framework for Implementation Research, the Teacher Training Implementation Model and the RE-AIM evaluation framework. Effectiveness outcomes were studied using a cluster randomized design, in which 10 schools were randomized to intervention and wait-list control conditions. A total of 79 early childhood teachers participated. Teacher knowledge and use of evidence-based practices (EBPs) were assessed at baseline and immediately post-intervention (4–5 months later). A sample of 154 parents was randomly selected to report on child behavior at baseline and post-intervention. Linear mixed effect modeling was applied to examine effectiveness outcomes. Findings support the feasibility of training Ugandan mental health professionals to provide Professional Development for Ugandan teachers. Professional Development was delivered with high levels of fidelity and resulted in improved teacher EBP knowledge and use of EBPs in the classroom, and child social competence.

Numerous studies indicate that children of adolescent mothers are at an increased risk for a variety of negative outcomes, even after controlling for diverse social and health factors. However, relatively less research has examined positive adjustment in these children, or protective factors associated with such adjustment. We examined the prediction of positive behavioral, social, and academic adjustment at Grade 3 in a sample of 100 children born to adolescent mothers, followed longitudinally since the children were 1 year old. Individualized testing and parent and teacher ratings were used to measure adjustment outcomes. Predictor variables were selected from characteristics of the child and parenting/family context. Logistic regression analyses indicated that aspects of children's positive adjustment in Grade 3 were predicted by a number of child and parenting/family variables measured at least 4 to 5 years earlier. Significant predictors included lower levels of child externalizing behavior, more advanced language development, lower levels of maternal depressive symptoms, and higher levels of positive parenting. Implications for preventive intervention and future research are discussed.

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