Utilizing the longitudinal Early Steps Multisite (ESM) prevention trial of diverse, low-income families (N=731) from three geographic areas across the United States, investigators plan to take advantage of the 18-year-long prospective dataset in conjunction with new mental health assessments to examine risk and resilience factors for at-risk emerging adults. In this Diversity Supplement, Dr. Vincent Chirimwami and colleagues are examining direct, interactive, and cascading effects on mental health outcomes, including mental health care utilization for those who are experiencing mental health symptomatology, and the long-term preventive effects of the Family Check-Up, in the context of growing up in poverty.