Adversity profiles among Canadian families: A secondary data analysis of a randomized controlled trial of the Family Check-Up®.

Despite widespread implementation of early childhood mental health prevention programs in Canada, variation in response across family adversity contexts remains unclear. Using data from the first Canadian randomized controlled trial of the Family Check-Up® (FCU®), this study examines what works for whom and why. In a sample of 206 caregivers and their two-to four-year-old children (M = 3.42, SD = 0.87; 88.3% White; 57.3% male) we identified four profiles: Socioeconomically Disadvantaged/Low Social Support (30.68%), Low Adversity (31.18%), Caregiver Mental Health Vulnerabilities (20.57%), and High Cumulative Adversity (17.6%). FCU® participation was associated with lower externalizing behaviors across profiles except for the Socioeconomically Disadvantaged/Low Social Support group, with the strongest effect observed among males in the High Cumulative Adversity profile (ß = -0.525, p = .002, 95% CI [-0.861, -0.189]). No effects were found for internalizing behaviors. Findings highlight the need to consider family risk factors and child sex when evaluating prevention programs.