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

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.

Benefit–cost analysis of a randomized evaluation of Communities That Care: monetizing intervention effects on the initiation of delinquency and substance use through grade 12

“…CTC's emphasis on community collaboration and implementation of evidence-based prevention strategies is expected to not only result in significant reductions in youth delinquency and related problem behaviors, but also lead to substantial economic returns on these investments (Hawkins et al 2002; Kuklinski et al 2012). In fact, improved youth outcomes have been found in a community-randomized trial involving 12 matched pairs of communities in seven states and a panel of 4,407 youth followed longitudinally (Brown et al 2009; Hawkins et al 2008b).…”

Benefit-Cost Analysis of Crime Prevention Programs

“…Economic Analysis. The benefit-cost analysis by Kuklinski et al (2012) was based only on the reductions in smoking and delinquency. CTC reduced the onset of smoking by grade 8 by 38 percent and the onset of delinquency by grade 8 by 21 percent.…”

Financing prevention: opportunities for economic analysis across the translational research cycle

“…While a program may have a relatively low cost, compared to other programs, deciding whether it makes a good investment cannot be determined without understanding program impact [66]. Further, cost-effectiveness analyses are also limited by their tendency to focus on only a single outcome of interest [8]. As previously discussed, prevention strategies that intervene in early risk will often impact multiple domains of functioning (e.g., health, criminal justice, education, and labor outcomes) [5,7].…”

“…Infrastructure cost optimization-A particularly fruitful area of applied research in this category concerns modeling current prevention costs. Building on cost analyses of preventive interventions, financial projection models can be used to explore how cost will change based on local infrastructure and capacity [8,14]. Such estimates seek to consider local capacity and recognize nonlinearities surrounding the costs of intervention scale-up (e.g., nursing shortages, local volunteer availability, participant travel distance, etc.).…”

“…Early studies of prevention's economic impact highlight opportunities to reduce strain on social service systems and engage in strategic workforce development across the economy [5][6][7]. Now, researchers seek to understand how preventive interventions perform in the real world as well as quantify Bwhat it takes^to carry out effective prevention efforts [3,8]. Yet, researchers have struggled to translate these evaluations' estimates into actionable policy [9][10][11][12].…”