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, including812 from the prevention of cigarette smoking and 4,438 from the prevention of delinquency. The benefit–cost ratio indicates a return of5.30 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 to10.23 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.
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, including812 from the prevention of cigarette smoking and 4,438 from the prevention of delinquency. The benefit–cost ratio indicates a return of5.30 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 to10.23 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.
- Content Type Journal Article
- Pages 1-12
- DOI 10.1007/s11121-011-0259-9
- Authors
- Margaret R. Kuklinski, Social Development Research Group, School of Social Work, University of Washington, 9725 Third Avenue N.E., Suite 401, Seattle, WA 98115, USA
- John S. Briney, Social Development Research Group, School of Social Work, University of Washington, 9725 Third Avenue N.E., Suite 401, Seattle, WA 98115, USA
- J. David Hawkins, Social Development Research Group, School of Social Work, University of Washington, 9725 Third Avenue N.E., Suite 401, Seattle, WA 98115, USA
- Richard F. Catalano, Social Development Research Group, School of Social Work, University of Washington, 9725 Third Avenue N.E., Suite 401, Seattle, WA 98115, USA
- Journal Prevention Science
- Online ISSN 1573-6695
- Print ISSN 1389-4986