Impact of the fast track prevention program on health services use by conduct-problem youth.

Journal Article (Journal Article)


We tested the impact of the Fast Track conduct disorder prevention program on the use of pediatric, general health, and mental health services in adolescence.

Patients and methods

Participants were 891 public kindergarten boys and girls screened from a population of 9594 children and found to be at risk for conduct disorder. They were assigned randomly (by school) to intervention or control conditions and were followed for 12 years. Intervention lasted 10 years and included parent training, child social-cognitive skills training, reading tutoring, peer-relations enhancement, and classroom curricula and management. Service use was assessed through annual interviews of parents and youth.


Youth assigned to preventive intervention had significantly reduced use of professional general health, pediatric, and emergency department services relative to control youth on the basis of parent-report data. For control-group youth, the odds of greater use of general health services for any reason and general health services use for mental health purposes were roughly 30% higher and 56% higher, respectively. On the basis of self-report data, the intervention reduced the likelihood of outpatient mental health services among older adolescents for whom odds of services use were more than 90% higher among control-group youth. No differences were found between intervention and control youth on the use of inpatient mental health services. Statistical models controlled for key study characteristics, and potential moderation of the intervention effect was assessed.


Random assignment to the Fast Track prevention program is associated with reduced use of general health and outpatient mental health services in adolescents. Future studies should examine the mechanism of this impact and service use patterns as subjects reach young adulthood.

Full Text

Duke Authors

Cited Authors

  • Jones, D; Godwin, J; Dodge, KA; Bierman, KL; Coie, JD; Greenberg, MT; Lochman, JE; McMahon, RJ; Pinderhughes, EE

Published Date

  • January 2010

Published In

Volume / Issue

  • 125 / 1

Start / End Page

  • e130 - e136

PubMed ID

  • 20008428

Pubmed Central ID

  • PMC3534731

Electronic International Standard Serial Number (EISSN)

  • 1098-4275

International Standard Serial Number (ISSN)

  • 0031-4005

Digital Object Identifier (DOI)

  • 10.1542/peds.2009-0322


  • eng