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Strengthening Families for Parents and Youth 10-14

Public Health & Prevention: Home- or Family-based
Benefit-cost methods last updated December 2018.  Literature review updated August 2018.
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Strengthening Families for Parents and Youth 10-14 (also known as the Iowa Strengthening Families Program) aims to reduce behavior problems and substance use by enhancing parenting skills, parent-child relationships, and family communication. Parents and youth attend weekly group sessions lasting two hours for seven weeks. Each session includes a separate, concurrent one-hour parent and youth skills-building session followed by a one-hour family session. A trained group leader uses Strengthening Families curriculum and videos to guide each session. The studies in this analysis included middle school students and their families. On average, 11 families participated in each group.
BENEFIT-COST
META-ANALYSIS
CITATIONS
The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2017). The chance the benefits exceed the costs are derived from a Monte Carlo risk analysis. The details on this, as well as the economic discount rates and other relevant parameters are described in our Technical Documentation.
Benefit-Cost Summary Statistics Per Participant
Benefits to:
Taxpayers $590 Benefits minus costs $1,372
Participants $218 Benefit to cost ratio $3.43
Others $1,164 Chance the program will produce
Indirect ($37) benefits greater than the costs 58 %
Total benefits $1,935
Net program cost ($564)
Benefits minus cost $1,372
1In addition to the outcomes measured in the meta-analysis table, WSIPP measures benefits and costs estimated from other outcomes associated with those reported in the evaluation literature. For example, empirical research demonstrates that high school graduation leads to reduced crime. These associated measures provide a more complete picture of the detailed costs and benefits of the program.

2“Others” includes benefits to people other than taxpayers and participants. Depending on the program, it could include reductions in crime victimization, the economic benefits from a more educated workforce, and the benefits from employer-paid health insurance.

3“Indirect benefits” includes estimates of the net changes in the value of a statistical life and net changes in the deadweight costs of taxation.
Detailed Monetary Benefit Estimates Per Participant
Benefits from changes to:1 Benefits to:
Taxpayers Participants Others2 Indirect3 Total
Crime $408 $0 $997 $206 $1,611
Labor market earnings associated with high school graduation $100 $220 $99 $0 $419
K-12 grade repetition $1 $0 $0 $0 $1
K-12 special education $26 $0 $0 $13 $39
Property loss associated with alcohol abuse or dependence $0 $1 $3 $0 $4
Health care associated with externalizing behavior symptoms $71 $20 $74 $36 $201
Costs of higher education ($16) ($24) ($7) ($8) ($56)
Mortality associated with smoking $0 $0 $0 ($6) ($7)
Mortality associated with alcohol $0 $1 $0 $6 $7
Adjustment for deadweight cost of program $0 $0 $0 ($283) ($283)
Totals $590 $218 $1,164 ($37) $1,935
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $500 2009 Present value of net program costs (in 2017 dollars) ($564)
Comparison costs $0 2009 Cost range (+ or -) 50 %
The per-participant cost includes the cost of staff time (including supervision, facilitation, and training), materials, incentives for families, and facility rental, as reported in Suter, C. (2010). Economic Evaluation of a Community-Based, Family-Skills Prevention Program (Master’s Thesis). Washington State University.
The figures shown are estimates of the costs to implement programs in Washington. The comparison group costs reflect either no treatment or treatment as usual, depending on how effect sizes were calculated in the meta-analysis. The cost range reported above reflects potential variation or uncertainty in the cost estimate; more detail can be found in our Technical Documentation.
Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)
The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.

^WSIPP’s benefit-cost model does not monetize this outcome.

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic in order to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the types of program impacts that were measured in the research literature (for example, crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases.

Adjusted effect sizes are used to calculate the benefits from our benefit cost model. WSIPP may adjust effect sizes based on methodological characteristics of the study. For example, we may adjust effect sizes when a study has a weak research design or when the program developer is involved in the research. The magnitude of these adjustments varies depending on the topic area.

WSIPP may also adjust the second ES measurement. Research shows the magnitude of some effect sizes decrease over time. For those effect sizes, we estimate outcome-based adjustments which we apply between the first time ES is estimated and the second time ES is estimated. We also report the unadjusted effect size to show the effect sizes before any adjustments have been made. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured Treatment age No. of effect sizes Treatment N Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis Unadjusted effect size (random effects model)
First time ES is estimated Second time ES is estimated
ES SE Age ES SE Age ES p-value
Alcohol use in high school 12 2 514 -0.045 0.098 13 -0.045 0.098 18 -0.080 0.414
Alcohol use before end of middle school 12 2 223 -0.022 0.136 12 -0.022 0.136 14 -0.058 0.680
Cannabis use in high school 12 1 147 -0.035 0.224 13 -0.035 0.224 18 -0.091 0.690
Cannabis use before end of middle school 12 1 61 0.121 0.262 12 0.121 0.262 14 0.121 0.644
Crime 12 1 161 -0.055 0.118 13 -0.055 0.118 23 -0.144 0.223
Externalizing behavior symptoms 12 3 675 -0.037 0.061 13 -0.020 0.038 16 -0.072 0.235
Illicit drug use in high school 12 1 367 -0.025 0.293 13 -0.025 0.293 18 -0.025 0.933
Illicit drug use before end of middle school 12 1 62 0.000 0.261 12 0.000 0.261 14 0.000 1.000
Internalizing symptoms 12 1 161 -0.027 0.118 13 -0.027 0.118 15 -0.071 0.549
Smoking in high school 12 2 514 0.010 0.125 13 0.010 0.125 18 -0.072 0.735
Smoking before end of middle school 12 1 62 0.000 0.261 12 0.000 0.261 14 0.000 1.000
Substance use^ 12 1 161 -0.005 0.118 13 n/a n/a n/a -0.012 0.919
Youth binge drinking 12 1 367 -0.071 0.253 13 -0.071 0.253 23 -0.071 0.781

Citations Used in the Meta-Analysis

Baldus, C., Thomsen, M., Sack, P. M., Bröning, M., Arnaud, N., Daubmann, A., & Thomasius, R. (2016). Evaluation of a German version of the Strengthening Families Programme 10-14: A randomized controlled trial. European Journal of Public Health, 26, 953–959.

Foxcroft, D.R., Callen, H., Davies, E.L., & Okulicz-Kozaryn, K. (2017). Effectiveness of the Strengthening Families Programme 10–14 in Poland: Cluster randomized controlled trial. European Journal of Public Health, 27(3), 494-500.

Riesch, S.K., Brown, R.L., & Anderson, L.S. (2012). Strengthening Families Program (10–14): Effects on the family environment. Western Journal of Nursing Research, 34, 340–376.

Spoth, R., Redmond, C., & Lepper, H. (1999). Alcohol initiation outcomes of universal family-focused preventive interventions: One- and two-year follow-ups of a controlled study. Journal of Studies on Alcohol, 13, 103-111.

Spoth, R., Reyes, M.L., Redmond, C., & Shin, C. (1999). Assessing a public health approach to delay onset and progression of adolescent substance use: Latent transition and loglinear analyses of longitudinal family preventive intervention outcomes. Journal of Consulting and Clinical Psychology, 67(5), 619-630.

Spoth, R.L., Redmond, C., & Shin, C. (2000). Reducing adolescents' aggressive and hostile behaviors: Randomized trial effects of a brief family intervention 4 years past baseline. Archives of Pediatrics & Adolescent Medicine, 154(12), 1248-1258.

Trudeau, L., Spoth, R.L., Randall, G.K., Mason, W.A., & Shin, C. (2012). Internalizing symptoms: Effects of a preventive intervention on developmental pathways from early adolescence to young adulthood. Journal of Youth and Adolescence, 41(6), 788-801.