Affective motivators have been targeted in many theories as playing a critical role in adolescents' decisions to participate in a variety of risky behaviours that may have life-altering consequences. In this study, we examined the role of several of these affective motivators across low and high experience groups to determine their perceived in¯uence on the desire to participate in each of ® ve risky behaviours (drinking alcohol, using drugs, having sex, smoking cigarettes, and skipping school). The affective motivators included those that: (a) promote risky behaviours by enhancing pleasant affective states (sensation seeking, social/emotional), (b) promote risky behaviours by reducing or avoiding negative affective states (negative emotions, tension reduction), and (c) deter risky behaviours by avoiding anticipated regret (e.g. of harming future). Results showed that the perceived motivational strength of the affective goals differed substantially between low and high experience groups and across the different risky behaviours. Adolescents with less experience were much more focused on avoiding the negative affective consequences associated with regretting unfavourable future outcomes. In contrast, adolescents with more experience participating in a risky behaviour held stronger beliefs that participation in the behaviour could both enhance positive and reduce negative affective states. We describe how the perceived importance of these motives varies across the risky behaviours, and offer insights into the likely motivational changes that occur as an adolescent moves from no experience to chronic experience engaging in risky behaviours.
Although school-based mental health screening and treatment programs have been proposed as a viable means of reaching youth with unmet mental health needs, no previous reports have attempted to comprehensively document the costs of such programs. The purposes of this report are (1) to estimate the cost of a school-based mental health screening and treatment program in a real-world school setting, and (2) to outline the methods and procedures that should be employed by future investigators to explore the costs of such programs. The program, located in a middle school in a low-income, largely Hispanic neighborhood in New York City, aimed to screen all students in Grades 6-8 for anxiety, depression, and substance use disorders. Most students in need of treatment were referred to the school-based treatment program, where social workers offered individual and group counseling. Economic evaluation methods and a before/after study design were used to assess the costs of the screening and treatment programs for 3 years of operation. Costs were estimated from the societal perspective, which includes all measurable program costs regardless of who bears the costs, and the school perspective, which includes only costs that would be borne directly by a school operating these programs. Data primarily came from administrative records and staff interviews. The total cost ranged from 106,125 dollars to 172,018 dollars for the screening program and from 420,077 dollars to 468,320 dollars for the treatment program. The cost of the screening program ranged from 149 dollars to 234 dollars per student and the cost of the treatment program ranged from 90 dollars to 115 dollars per session. These costs were estimated from the perspective of society. Applying economic cost analysis methods in a real-world school setting is challenging, but the process can generate useful estimates. Cost analyses and cost-effectiveness studies are needed in this area.
In order to efficiently allocate scarce prevention resources, policymakers need information about the economic costs of school-based substance use prevention programs. The objective of this paper is to outline economic cost analysis methods and demonstrate their applicability to school-based prevention programs. As an example, the paper focuses on estimating the economic cost of ALPHA, an intensive school-based substance use prevention program. The cost of ALPHA is compared to the costs of 3 elementary school programs that were alternatives to ALPHA. We collected cost information for 3 years, using a cost questionnaire that was completed by program and school budget officers and school principals. The program costs obtained from these sources were modified to conform to well-established economic cost analysis principles.
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