Early Childhood Education and Adult Depression: An Attrition Reanalysis With Inverse Propensity Score Weighting

Abstract

In a previous study of the Child-Parent Centers (CPC) education program, preschool participation was linked to a 4.6 percentage point reduction (26%) in depressive symptoms at ages 22-24 over the matched comparison group enrolling the usual programs. The present study reanalyzed these data in the Chicago Longitudinal Study to address potential attrition bias since more than a quarter of the sample was missing on the outcome. Using inverse probability weighting (IPW) involving 32 predictors of sample retention, findings for the 1,142 participants growing up in high-poverty neighborhoods indicated that CPC participation was associated with a 7.1 percentage point reduction (95% CI = [-9.7, -5.4]) in one or more depressive symptoms (39% reduction over the comparison group). Although this marginal effect was within the confidence interval of the original study (95% CI = [-9.5, 0.3]), the 54% increase in the point estimate is substantial and of practical significance, suggesting underestimation in the prior study. Alternative analysis of different predictors and IPW models, including adjustments for program selection and attrition together, yielded similar results. Findings indicate that high-quality early childhood programs continue to be an important strategy for the prevention of depression and its debilitating effects on individuals and families.

Keywords: behavioral health care and policy; depression; design and evaluation of programs and policies; early childhood education; inverse probability weighting; measurement; methodological development; preschool.

Figure 1.

Adjusted rates of depressive symptoms in adulthood for three Child-Parent Centers preschool and comparison group contrasts. Note. Percentages for the current study are based on the models in Tables 4 and 5. p Values for the group differences are .038, .057, and .011, respectively. The unadjusted model includes no covariates or adjustments. National average is for U.S. Black adults from the National Health and Nutrition Examination Survey (NHANES) 2005–2006, using a Patient Health Questionnaire (PHQ) score of 10 or higher. The incidence rates (over the past 2 weeks) for all adults and those below the federal poverty line were 4.7% and 11%, respectively.