Differential Mental Health Effects of Neighborhood Relocation Among Youth in Vulnerable Families:  Results From a Randomized Trial

Figure 1. Moving to Opportunity trial (MTO) youth enrollment, intervention allocation, and attrition. *The 2002 interim survey yielded an 89% effective response rate (RR) using a 2-stage follow-up sampling strategy, calculated as RR = MRR + SRR × (1 − MRR), where MRR indicates the RR for the main sample (respondents initially responding to the 2002 survey interview request); SRR, the RR for the subsample (a second attempt to find every 3 in 10 hard-to-reach families initially nonresponsive in 2002).¹⁵ RAD indicates Restricted Access Data.

Figure 2. Moving to Opportunity trial intervention effects on mean difference in psychological distress 4 to 7 years after baseline modified by gender and health vulnerability. A, Linear regression intention-to-treat (ITT) estimates. B, Adherence-adjusted estimates of intervention effects from the second-stage instrumental variable (IV) analysis. The primary hypothesis tested whether the intervention × health vulnerability interaction coefficient was significantly different from zero. Intervention × health vulnerability interaction results for ITT were β (SE) = 0.223 (0.092); 95% CI, 0.042 to 0.404; P = .02 and for IV were β (SE) = 0.478 (0.192); 95% CI, 0.102 to 0.854; P = .01. Models were adjusted for the covariates listed in Table 2 plus the intervention × baseline health vulnerability interaction. Subgroup sample size is 875 for nonvulnerable girls, 551 for vulnerable girls, 761 for nonvulnerable boys, and 642 for vulnerable boys. Error bars represent 95% CI for the mean.

Figure 3. Moving to Opportunity trial intervention effects on mean difference in behavior problems 4 to 7 years after baseline modified by gender and health vulnerability. A, Linear regression intention-to-treat (ITT) estimates. B, Adherence-adjusted estimates of intervention effects from the second-stage instrumental variable (IV) analysis. The primary hypothesis test tested whether the intervention × health vulnerability interaction coefficient was significantly different from zero. Intervention × health vulnerability interaction results for ITT were β (SE) = 0.122 (0.090); 95% CI, −0.054 to 0.298; P = .17 and for IV were β (SE) = 0.279 (0.183); 95% CI, −00.079 to 0.638; P = .13. Models were adjusted for the covariates listed in Table 2 plus the intervention × baseline health vulnerability interaction. Subgroup sample size is 875 for nonvulnerable girls, 551 for vulnerable girls, 761 for nonvulnerable boys, and 642 for vulnerable boys. Error bars represent 95% CI for the mean.

Figure 4. Moving to Opportunity trial intervention effects on mean difference in behavior problems 4 to 7 years after baseline modified by gender and health vulnerability, by site. A, Linear regression intention-to-treat estimates by site. B, Adherence-adjusted estimates of intervention effects from second-stage instrumental variable analysis by site. NVB indicates nonvulnerable boys; NVG, nonvulnerable girls; VB, vulnerable boys; and VG, vulnerable girls. The primary hypothesis tested whether the intervention × health vulnerability interaction coefficient was significantly different from zero. Models were adjusted for the covariates listed in Table 2 plus the intervention × baseline health vulnerability interaction. Subgroup sample sizes are as follows: nonvulnerable girls: 145 for Baltimore, 165 for Boston, 193 for Chicago, 193 for Los Angeles, and 179 for New York; vulnerable girls: 79 for Baltimore, 133 for Boston, 113 for Chicago, 56 for Los Angeles, and 170 for New York; nonvulnerable boys: 136 for Baltimore, 136 for Boston, 161 for Chicago, 191 for Los Angeles, and 137 for New York; and vulnerable boys: 88 for Baltimore, 141 for Boston, 134 for Chicago, 90 for Los Angeles, and 189 for New York. Error bars represent 95% CI for the mean.