Considerations in Applying Benefit-Cost Analysis to Preventive Interventions for Children, Youth, and Families Workshop Summary (2014) / Chapter Skim
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3 Assessing the Costs and Benefits of Interventions
3 Assessing the Costs and Benefits of Interventions
Pages 21-34
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From page 21... ...
Two speakers at the workshop looked specifically at the costing of interventions, while one explored the valuing of benefits. AN INGREDIENTS APPROACH TO COSTING PREVENTIVE INTERVENTIONS1 Benefit-cost analyses tend to use calipers to measure effects and witching rods to measure costs, said Henry Levin.
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Standards for benefit-cost analyses will not be easy to develop, Levin acknowledged, but they may help answer these questions. The Ingredients Cost Method Levin uses what he called the "ingredients cost method" to determine costs.
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ventions may argue that th cost nothing hey or very little, but th ingredients cost method demonstrate that their co y he s d es ost may be fairly high For example, some inte b h. erventions sim mply reallocaate resources from one program to another (e.g.
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From page 24... ...
COST ANALYSIS FOR PLANNING PURPOSES2 Whether with expanded home-visiting programs, school violence prevention efforts, or early learning initiatives, robust cost estimates are needed to support prevention efforts that can effectively meet public health needs and reduce the strain on overburdened service systems, said Max Crowley. In particular, by demonstrating the resources needed for prevention, cost analyses are inextricably linked to efforts to take interventions to scale.
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To successfully deliver preventive programs and replicate the effectiveness of trials, this local capacity must be deliberately built through training and technical assistance, Crowley said, which can require significant resources. "If we don't budget for infrastructure, we can undermine the whole prevention effort." Infrastructure building can be divided into three main areas: adoption capacity, implementation capacity, and sustainability capacity.
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When these costs are not captured, they can threaten program planning and place an unexpected burden on service systems, possibly derailing an entire program. Participant Costs When prevention programs seek parental support, as is often the case with family-based programs, this support represents a cost, Crowley pointed out.
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From page 27... ...
Self-report interviews can identify losses of service, but they can fail to capture the complexity of program costs, especially in the context of increasingly dynamic preventive efforts that are delivered across substantial periods of time. However, with the development of more robust data collection systems, particularly through new technological supports, the field can dramatically extend the science around prevention costs, Crowley observed.
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Prevention programs, especially for children, youth, and families, are increasingly in the spotlight, Crowley observed. Well-done cost analyses can describe these investments and help communities decide which investments to make.
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Previous benefit-cost analyses of early childhood interventions have found benefits in a variety of economic and societal sectors. For example, evaluations of the Perry Preschool Project have found lower crime rates, less retention and special education use in school, and increased lifetime earnings (Belfield et al., 2006)
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In thinking about how to monetize benefits, a decision has to be made between determining how to value key study outcomes that may be indirectly linked to dollar amounts and focusing on the extent to which a program affects true economic outcomes. The answer to this question depends largely on the nature of the program, the age of the participants, and the outcomes that are targeted.
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Examples of the Approach As an example of identifying potential outcomes, Jones described a hypothetical middle school preventive intervention program aimed at improving social skills and decreasing substance use in adolescents.
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Prior research provided common methods for valuing outcomes in school programs, which helped the researchers determine what measures to include for this age group at posttest and follow‐up assessment. These measures included use of special education services, class grades, grade retention, reported substance use, and use of other school services (including disciplinary and counseling services)
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. Ideally, this research could help explain how these factors collectively influence future adult outcomes and how they are best measured in economic evaluations.
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"The future is bright," Jones concluded. Economic evaluations for family, child, and youth programs will only get better in the coming years.
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