“…In this study we enrolled a large and diverse national sample of adolescents with ZIP Code level data/ census tract/ to examine neighborhood-level characteristics i.e., age, race, ethnicity, and income). Similar to the literature we found that addressing ethnicity and income can play a significant role in improving the efficacy of interventions in RCTs ( Kraemer et al, 2008 , Sims et al, 2020 , Johnson Lyons et al, 2022 ). Importantly, neighborhoods may operate in ways that enable the behaviors of individuals or restrict access to preventive care or health resources ( Diez Roux and Mair, 2010 , Akinyemiju et al, 2013 ), further exacerbating adverse health outcomes.…”