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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 2017.  Literature review updated April 2012.
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Strengthening Families for Parents and Youth 10-14 (also known as the Iowa Strengthening Families Program) is a family-based program that attempts to reduce behavior problems and substance use by enhancing parenting skills, parent-child relationships, and family communication. The seven-week intervention is designed for 6th grade students and their families.
The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2016). 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 $1,378 Benefits minus costs $4,547
Participants $2,505 Benefit to cost ratio $6.45
Others $1,833 Chance the program will produce
Indirect ($335) benefits greater than the costs 76 %
Total benefits $5,381
Net program cost ($835)
Benefits minus cost $4,547
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 $273 $0 $644 $135 $1,052
Labor market earnings associated with high school graduation $1,223 $2,693 $1,240 $0 $5,156
K-12 grade repetition $5 $0 $0 $3 $8
K-12 special education $2 $0 $0 $1 $3
Property loss associated with alcohol abuse or dependence $0 $2 $4 $0 $6
Health care associated with disruptive behavior disorder $2 $1 $2 $1 $5
Costs of higher education ($126) ($190) ($57) ($62) ($436)
Adjustment for deadweight cost of program $0 $0 $0 ($412) ($412)
Totals $1,378 $2,505 $1,833 ($335) $5,381
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $754 2009 Present value of net program costs (in 2016 dollars) ($835)
Comparison costs $0 2009 Cost range (+ or -) 10 %
Costs are based on unit costs provided in Suter, C. (2010). Economic Evaluation of a Community-Based, Family-Skills Prevention Program (Master’s Thesis). Washington State University. Our estimate includes Suter's total cost per program, divided by average number of families per program in the study.
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.

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 before end of middle school 11 1 153 -0.147 0.184 13 -0.147 0.184 23 -0.387 0.036
Alcohol use in high school 11 1 152 -0.080 0.234 15 -0.080 0.234 25 -0.210 0.359
Cannabis use in high school 11 1 152 -0.332 0.328 15 -0.332 0.328 25 -0.874 0.011
Disruptive behavior disorder symptoms 11 2 283 -0.008 0.103 13 -0.004 0.053 16 -0.055 0.741
Illicit drug use in high school 11 1 151 -0.120 0.152 15 -0.120 0.152 25 -0.317 0.038
Internalizing symptoms 11 2 191 -0.129 0.102 13 -0.094 0.088 15 -0.339 0.001
Smoking in high school 11 1 152 -0.199 0.219 15 -0.199 0.219 25 -0.523 0.019

Citations Used in the Meta-Analysis

Gottfredson, D., Kumpfer, K., Polizzi-Fox, D., Wilson, D., Puryear, V., Beatty, P., & Vilmenay, M. (2006). The Strengthening Washington D.C. Families Project: A randomized effectiveness trial of family-based prevention. Prevention Science, 7(1), 57-74.

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.

Spoth, R.L., Redmond, C., & Shin, C. (2001). Randomized trial of brief family interventions for general populations: Adolescent substance use outcomes 4 years following baseline. Journal of Consulting and Clinical Psychology, 69(4), 627-642.

Spoth, R.L., Clair, S., Shin, C., & Redmond, C. (2006). Long-term effects of universal preventive interventions on methamphetamine use among adolescents. Archives of Pediatrics & Adolescent Medicine, 160(9), 876-882.

Trudeau, L., Spoth, R., Randall, G., & Azevedo, K. (2007). Longitudinal effects of a universal family-focused intervention on growth patterns of adolescent internalizing symptoms and polysubstance use: Gender comparisons. Journal of Youth and Adolescence, 36(6), 725-740.