TY - JOUR
T1 - Supporting Strategic Investment in Social Programs
T2 - a Cost Analysis of the Family Check-Up
AU - Kuklinski, Margaret R.
AU - Crowley, D. Max
AU - Dishion, Thomas J.
AU - Wilson, Melvin N.
AU - Pelham, William E.
AU - Shaw, Daniel S.
N1 - Funding Information:
This research was supported by National Institute on Drug Abuse (NIDA) grant number DA036832 to authors Dishion, Shaw, and Wilson. Additional support was provided by grants from NIDA (DA039772) and the National Institute on Alcohol Abuse and Alcoholism (AA026768). This paper’s content is solely the authors’ responsibility and does not necessarily represent official views of study funders, who played no role in the study design; data collection, analysis and interpretation; writing of the report; or decision to submit the article for publication.
Publisher Copyright:
© 2020, Society for Prevention Research.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - High-quality evidence about the costs of effective interventions for children can provide a foundation for fiscally responsible policy capable of achieving impact. This study estimated the costs to society of the Family Check-up, an evidence-based brief home-visiting intervention for high-risk families implemented in the Early Steps multisite efficacy trial. Intervention arm families in three sites were offered 4 consecutive years of intervention, when target children were ages 2 through 5. Data for estimating total, average, and marginal costs and family burden (means and standard deviations, 2015 USD, discounted at 3% per year) came from a detailed database that prospectively documented resource use at the family level and a supplemental interview with trial leaders. Secondary analyses evaluated differences in costs among higher and lower risk families using repeated measures analysis of variance. Results indicated annual average costs of $1066 per family (SD = $400), with time spent by families valued at an additional $84 (SD = $99) on average. Costs declined significantly from ages 2 through 5. Once training and oversight patterns were established, additional families could be served at half the cost, $501 (SD = $404). On the margin, higher risk families cost more, $583 (SD = $444) compared to $463 (SD = $380) for lower risk families, but prior analyses showed they also benefited more. Sensitivity analyses indicated potential for wage-related cost savings in real-world implementation compared to the university-based trial. This study illustrates the dynamics of Family Check-up resource use over time and across families differing in risk.
AB - High-quality evidence about the costs of effective interventions for children can provide a foundation for fiscally responsible policy capable of achieving impact. This study estimated the costs to society of the Family Check-up, an evidence-based brief home-visiting intervention for high-risk families implemented in the Early Steps multisite efficacy trial. Intervention arm families in three sites were offered 4 consecutive years of intervention, when target children were ages 2 through 5. Data for estimating total, average, and marginal costs and family burden (means and standard deviations, 2015 USD, discounted at 3% per year) came from a detailed database that prospectively documented resource use at the family level and a supplemental interview with trial leaders. Secondary analyses evaluated differences in costs among higher and lower risk families using repeated measures analysis of variance. Results indicated annual average costs of $1066 per family (SD = $400), with time spent by families valued at an additional $84 (SD = $99) on average. Costs declined significantly from ages 2 through 5. Once training and oversight patterns were established, additional families could be served at half the cost, $501 (SD = $404). On the margin, higher risk families cost more, $583 (SD = $444) compared to $463 (SD = $380) for lower risk families, but prior analyses showed they also benefited more. Sensitivity analyses indicated potential for wage-related cost savings in real-world implementation compared to the university-based trial. This study illustrates the dynamics of Family Check-up resource use over time and across families differing in risk.
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U2 - 10.1007/s11121-019-01077-3
DO - 10.1007/s11121-019-01077-3
M3 - Article
C2 - 31902038
AN - SCOPUS:85077520333
VL - 21
SP - 256
EP - 267
JO - Prevention Science
JF - Prevention Science
SN - 1389-4986
IS - 2
ER -
