Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Prevention Science
Published in: Prevention Science 2/2012

01-04-2012

Cost-Benefit Analysis of Communities That Care Outcomes at Eighth Grade

Authors: Margaret R. Kuklinski, John S. Briney, J. David Hawkins, Richard F. Catalano

Published in: Prevention Science | Issue 2/2012

Login to get access

Abstract

This paper presents a cost-benefit analysis of the Communities That Care (CTC) prevention system, a public health approach to reducing risk, enhancing protection, and reducing the prevalence of adolescent health and behavior problems community wide. The analysis is based on outcomes from a panel of students followed from Grade 5 through Grade 8 in a randomized controlled trial involving 24 communities in 7 states. Previous analyses have shown that CTC prevented the initiation of cigarette smoking, alcohol use, and delinquency by the end of 8th grade in CTC communities compared to controls. This paper estimates long-term monetary benefits associated with significant intervention effects on cigarette smoking and delinquency as compared to the cost of conducting the intervention. Under conservative cost assumptions, the net present benefit is $5,250 per youth, including $812 from the prevention of cigarette smoking and $4,438 from the prevention of delinquency. The benefit-cost ratio indicates a return of $5.30 per $1.00 invested. Under less conservative but still viable cost assumptions, the benefit-cost ratio due to prevention of cigarette smoking and delinquency increases to $10.23 per $1.00 invested. Benefits from CTC’s reduction in alcohol initiation as well as broader inclusion of quality-of-life gains would further increase CTC’s benefit-cost ratio. Results provide evidence that CTC is a cost-beneficial preventive intervention and a good investment of public dollars, even under very conservative cost and benefit assumptions.
Literature
Aos, S., Lieb, R., Mayfield, J., Miller, M., & Pennucci, A. (2004). Benefits and costs of prevention and early intervention programs for youth (Publication No. 04-07-3901). Olympia: Washington State Institute for Public Policy.
Barnett, W. S. (1993). Economic evaluation of home visiting programs. The Future of Children, 3, 93–112.CrossRef
Barnett, W. S., & Masse, L. N. (2007). Comparative benefit–cost analysis of the Abecedarian Program and its policy implications. Economics of Education Review, 26, 113–125.CrossRef
Belfield, C. R., Nores, M., Barnett, S., & Schweinhart, L. (2006). The High/Scope Perry Preschool Program: Cost–benefit analysis using data from the age-40 followup. The Journal of Human Resources, 41, 162–190.
Breslau, N., & Peterson, E. L. (1996). Smoking cessation in young adults: Age at initiation of cigarette smoking and other suspected influences. American Journal of Public Health, 86, 214–220.PubMedCrossRef
Brown, E. C., Graham, J. W., Hawkins, J. D., Arthur, M. W., Baldwin, M. M., Oesterle, S., et al. (2009). Design and analysis of the Community Youth Development Study longitudinal cohort sample. Evaluation Review, 33, 311–334.PubMedCrossRef
Caulkins, J. P., Rydell, C. P., Everingham, S. S., Chiesa, J., & Bushway, S. (1999). An ounce of prevention, a pound of uncertainty: The cost-effectiveness of school-based drug prevention programs. Santa Monica, CA: RAND.
Cohen, M. A., & Piquero, A. R. (2009). New evidence on the monetary value of saving a high risk youth. Journal of Quantitative Criminology, 25, 25–49.CrossRef
Fagan, A. A., Hanson, K., Hawkins, J. D., & Arthur, M. W. (2008). Implementing effective community-based prevention programs in the Community Youth Development Study. Youth Violence and Juvenile Justice, 6, 256–278.CrossRef
Flay, B. R., Biglan, A., Boruch, R. F., Castro, F. G., Gottfredson, D., Kellam, S., et al. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6, 151–175.PubMedCrossRef
Foster, E. M., Dodge, K. A., & Jones, D. (2003). Issues in the economic evaluation of prevention programs. Applied Developmental Science, 7, 76–86.PubMedCrossRef
Foster, E. M., Johnson-Shelton, D., & Taylor, T. K. (2007). Measuring time costs in interventions designed to reduce behavior problems among children and youth. American Journal of Community Psychology, 40, 64–81.PubMedCrossRef
Grant, B. F. (1998). Age at smoking onset and its association with alcohol consumption and DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse, 10, 59–73.PubMedCrossRef
Hawkins, J. D., Catalano, R. F., Arthur, M. W., Egan, E., Brown, E. C., Abbott, R. D., et al. (2008). Testing Communities That Care: The rationale, design and behavioral baseline equivalence of the Community Youth Development Study. Prevention Science, 9, 178–190.PubMedCrossRef
Hawkins, J. D., Oesterle, S., Brown, E. C., Arthur, M. W., Abbott, R. D., Fagan, A. A., et al. (2009). Results of a type 2 translational research trial to prevent adolescent drug use and delinquency: A test of Communities That Care. Archives of Pediatrics and Adolescent Medicine, 163, 789–798.PubMedCrossRef
Hawkins, J. D., Oesterle, S., Brown, E. C., Monahan, K. C., Abbott, R. D., Arthur, M. W., et al. (in press). Sustained decreases in risk exposure and youth problem behaviors after installation of the Communities That Care prevention system in a randomized trial. Archives of Pediatrics and Adolescent Medicine, available online Oct 3, 2011; doi:10.​1001/​archpediatrics.​2011.​183.
Heckman, J. J., & Masterov, D. V. (2007). The productivity argument for investing in young children. Review of Agricultural Economics, 29, 446–493.CrossRef
Heckman, J. J., Moon, S. H., Pinto, R., Savelyev, P. A., & Yavitz, A. (2010). The rate of return to the High/Scope Perry Preschool Program. Journal of Public Economics, 94, 114–128.PubMedCrossRef
Karoly, L. A., Kilburn, M. R., & Cannon, J. S. (2005). Early childhood interventions: Proven results, future promise. Santa Monica, CA: RAND.
McCollister, K. E., French, M. T., & Fang, H. (2010). The cost of crime to society: New crime-specific estimates for policy and program evaluation. Drug and Alcohol Dependence, 108, 98–109.PubMedCrossRef
Miller, T. R., & Hendrie, D. (2008). Substance abuse dollars and cents: A cost-benefit analysis (DHHS Publication No. (SMA) 07–4298). Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration.
Miller, T. R., Cohen, M. A., & Wiersema, B. (1996). Victim costs and consequences: A new look. National Institute of Justice Research Report, NCJ 155282. Washington, DC: National Institute of Justice.
Miller, T. R., Levy, D. T., Spicer, R. S., & Taylor, D. M. (2006). Societal costs of underage drinking. Journal of Studies on Alcohol, 67, 519–528.PubMed
National Research Council and Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. (M. E. O’Connell, T. F. Boat, & K.W. Warner, Eds.). Washington, DC: The National Academies Press.
Piquero, A., Hawkins, J. D., & Kazemian, L. (in press). Criminal career patterns between adolescence and emerging adulthood. In R. Loeber & D. P. Farrington (Eds.), Transitions from juvenile delinquency to adult crime: Criminal careers, justice policy and prevention. Oxford: Oxford University Press.
Plotnick, R. D., Young, D. S., Catalano, R. F., & Haggerty, K. P. (1998). Benefits and costs of a family-focused methadone treatment and drug abuse prevention program: Preliminary findings. In W. J. Bukoski & R. I. Evans (Eds.), NIDA Research Monograph: Vol. 176. Cost benefit/cost effectiveness research of drug abuse prevention: Implications for programming and policy (pp. 161–183). Rockville, MD: National Institute on Drug Abuse.
Reynolds, A. J., Temple, J. A., White, B. A. B., Ou, S.-R., & Robertson, D. L. (2011). Age-26 cost-benefit analysis of the Child-Parent Center early education program. Child Development, 82, 379–404.PubMedCrossRef
Sanchez-Meca, J., Marin-Martinez, F., & Chacon-Moscoso, S. (2003). Effect-size indices for dichotomized outcomes in meta-analysis. Psychological Methods, 8, 448–467.PubMedCrossRef
Sloan, F. A., Ostermann, J., Conover, C., Taylor, D. H., Jr., & Picone, G. (2004). The price of smoking. Cambridge, MA: MIT.
Spoth, R. L., Guyll, M., & Day, S. X. (2002). Universal family-focused interventions in alcohol-use disorder prevention: Cost-effectiveness and cost-benefit analyses of two interventions. Journal of Studies on Alcohol, 63, 219–228.PubMed
Spoth, R., Greenberg, M., & Turrisi, R. (2008). Preventive interventions addressing underage drinking: State of the evidence and steps toward public health impact. Pediatrics, 121(Suppl. 4), S311–336.CrossRef
Temple, J. A., & Reynolds, A. J. (2007). Benefits and costs of investments in preschool education: Evidence from the Child–Parent Centers and related programs. Economics of Education Review, 26, 126–144.CrossRef
Zerbe, R. O., Plotnick, R. D., Kessler, R. C., Pecora, P. J., Hiripi, E., O'Brien, K., et al. (2009). Benefits and costs of intensive foster care services: The Casey Family Programs compared to state services. Contemporary Economic Policy, 27, 308–320.CrossRef
Metadata
Title
Cost-Benefit Analysis of Communities That Care Outcomes at Eighth Grade
Authors
Margaret R. Kuklinski
John S. Briney
J. David Hawkins
Richard F. Catalano
Publication date
01-04-2012
Publisher
Springer US
Published in
Prevention Science / Issue 2/2012
Print ISSN: 1389-4986
Electronic ISSN: 1573-6695
DOI
https://doi.org/10.1007/s11121-011-0259-9

Other articles of this Issue 2/2012

Prevention Science 2/2012 Go to the issue

OriginalPaper

Aboriginal Community-Centered Injury Surveillance: A Community-Based Participatory Process Evaluation

OriginalPaper

Maternal Early Life Risk Factors for Offspring Birth Weight: Findings from the Add Health Study

OriginalPaper

Growth in Alcohol Use as a Developmental Predictor of Adolescent Girls’ Sexual Risk-Taking

OriginalPaper

Alcohol Expectancies and Risky Drinking Behaviors Among High School Athletes: “I’d Rather Keep My Head in the Game”

OriginalPaper

Effect of a Dissonance-Based Prevention Program on Risk for Eating Disorder Onset in the Context of Eating Disorder Risk Factors

OriginalPaper

Clustering of Unhealthy Behaviors in the Aerobics Center Longitudinal Study