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Guiding Good Choices (formerly Preparing for the Drug Free Years)

Public Health & Prevention: Home- or Family-based
Benefit-cost methods last updated December 2017.  Literature review updated June 2014.
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Guiding Good Choices (formerly known as Preparing for the Drug-Free Years) is a skills-training program for middle school students and their parents typically implemented outside normal school hours. The five-session drug resistance and education program, implemented one night per week for five weeks, aims to improve parent-child interactions that reduce the risk for substance use initiation. Sessions typically last two hours each and include a mix of group discussions, workbook activities, role plays, and multimedia presentations. Program content includes education about the prevalence of substance use and risk and protective factors associated with use, and the development of strategies in the home to prevent use (Session 1), establishing expectations and guidelines within the home regarding substance use (Session 2), education and opportunities to practice refusal skills (Session 3), managing family conflict and constructively handling disputes between family members (Session 4), and strategies for engaging the adolescent in family activities and ways to create supportive networks among parents (Session 5). Parents are required to attend all five sessions while the adolescent is required to attend Session 3.
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 $558 Benefits minus costs $1,195
Participants $824 Benefit to cost ratio $2.77
Others $737 Chance the program will produce
Indirect ($251) benefits greater than the costs 56 %
Total benefits $1,869
Net program cost ($674)
Benefits minus cost $1,195
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 $86 $0 $206 $43 $335
Labor market earnings associated with high school graduation $383 $843 $392 $0 $1,618
K-12 grade repetition $4 $0 $0 $2 $6
Health care associated with smoking $126 $41 $155 $62 $384
Property loss associated with alcohol abuse or dependence $0 $2 $3 $0 $5
Costs of higher education ($41) ($62) ($18) ($20) ($141)
Adjustment for deadweight cost of program $0 $0 $0 ($337) ($337)
Totals $558 $824 $737 ($251) $1,869
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $655 2013 Present value of net program costs (in 2016 dollars) ($674)
Comparison costs $0 2012 Cost range (+ or -) 10 %
Per-family cost data for this five-week program come from Spoth, R.L., Guyll, M., & Day, S.X. (2002). Universal family-focused interventions in alcohol-use disorder prevention: Cost-effectiveness and cost-benefit analyses of two interventions. Journal of Studies on Alcohol and Drugs, 63(2), 219.
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 in high school 11 1 146 -0.085 0.117 16 -0.085 0.117 18 -0.256 0.030
Cannabis use in high school 11 1 143 -0.101 0.301 16 -0.101 0.301 18 -0.305 0.345
Illicit drug use in high school 11 2 361 -0.027 0.164 16 -0.027 0.164 26 -0.082 0.619
Internalizing symptoms 11 1 149 -0.078 0.180 18 -0.057 0.142 20 -0.237 0.189
Smoking in high school 11 1 144 -0.062 0.138 16 -0.062 0.138 18 -0.187 0.175

Citations Used in the Meta-Analysis

Mason, W.A., Kosterman, R., Hawkins, J.D., Haggerty, K.P., & Spoth, R.L. (2003). Reducing adolescents' growth in substance use and delinquency: Randomized trial effects of a parent-training prevention intervention. Prevention Science, 4(3), 203-212.

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.

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., Trudeau, L., Guyll, M., Shin, C., & Redmond, C. (2009). Universal intervention effects on substance use among young adults mediated by delayed adolescent substance initiation. Journal of Consulting and Clinical Psychology, 77(4), 620-32.