Understanding Who Benefits Most from Family-Based Prevention: Differential Intervention Effects for Families with Low Income.

Abstract

Multicomponent family-based interventions can mitigate the adverse effects of poverty on family functioning. However, benefits are not uniform across families. Limited research has examined how distinct constellations of poverty-related risk shape engagement with and responsiveness to preventive interventions. Using a person-centered approach, this study tested whether pre-intervention risk classes predicted differential engagement with and response to the Fatherhood, Relationship, and Marriage Education (FRAME) intervention, a program based on the Family Stress Model and designed to strengthen parental coping, couple relationships, and parenting practices. Participants were 301 mother-father-child triads with household incomes at or below 200% of the federal poverty level. Building on prior research that identified four latent risk classes, we examined whether class membership predicted session attendance and moderated intervention effects on family relational and behavioral outcomes assessed six months post-intervention using combined mother and father reports. Results indicated heterogeneity in both engagement and intervention response. Families characterized by moderate economic stress and elevated parental depressive symptoms demonstrated the highest attendance and the most favorable response, particularly for couple relationship quality. Families in the lowest and highest risk classes received few benefits, with the lowest risk group experiencing adverse effects on some outcomes. Sensitivity analyses suggested additional gender-specific patterns, indicating that mothers' and fathers' responses may differ within certain risk classes. These findings highlight the value of identifying multidimensional risk classes when evaluating preventive interventions and support precision approaches to intervention delivery.