The purpose of the FLP was to study the early development of children living in rural, largely poor communities who are at risk regarding later successful adjustment and are under-researched. Participants lived in six rural counties, three in North Carolina and Pennsylvania. Around 1,300 newborn infants and their families were recruited at baseline in 2003 and 2004. Families were enrolled in the study at the hospital on the day after their infant was born. Data collection consisted of home visits, childcare visits, and phone calls. Families were visited annually for follow-ups. In 2016, FLP joined the Environmental Influences on Child Health Outcomes (ECHO) Program to become the FLP-ECHO project. The goal of the ECHO Program—which includes 72 cohorts throughout the USA—is to understand the effects of a broad range of early environmental influences on child health and development. This study phase includes data collection from participants aged 16 and 18.