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Fast Track prevention program

Public Health & Prevention: Community-based
Benefit-cost methods last updated December 2017.  Literature review updated March 2018.
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Fast Track is a comprehensive, long-term prevention program intended to address risk factors associated with antisocial development among children with externalizing behavior problems. The program is delivered for ten years, between grades one through ten. Fast Track services include a classroom-based social-emotional learning program, consultation and support for teachers, behavior-management training for parents, social-cognitive skills training for children, peer coaching and mentoring, and individualized academic skills tutoring.
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 (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 $927 Benefits minus costs ($89,307)
Participants $2,072 Benefit to cost ratio ($0.44)
Others $569 Chance the program will produce
Indirect ($30,946) benefits greater than the costs 0 %
Total benefits ($27,377)
Net program cost ($61,930)
Benefits minus cost ($89,307)
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 $194 $0 $426 $97 $717
K-12 grade repetition ($22) $0 $0 ($11) ($34)
K-12 special education ($279) $0 $0 ($141) ($420)
Labor market earnings associated with alcohol abuse or dependence $923 $2,033 $0 $17 $2,974
Property loss associated with alcohol abuse or dependence $0 $3 $6 $0 $9
Health care associated with major depression $111 $36 $137 $55 $339
Adjustment for deadweight cost of program $0 $0 $0 ($30,963) ($30,963)
Totals $927 $2,072 $569 ($30,946) ($27,377)
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $5,828 2004 Present value of net program costs (in 2016 dollars) ($61,930)
Comparison costs $0 2004 Cost range (+ or -) 10 %
The program is delivered over a ten-year period. We estimated annual per-participant costs from Foster et al. (2006). Can a costly intervention be cost-effective? An analysis of violence prevention. Archives of General Psychiatry, 63(11), 1284-1291.
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 disorder 7 1 445 -0.085 0.089 24 -0.085 0.089 34 -0.225 0.044
Antisocial personality disorder^ 7 1 445 -0.118 0.089 24 n/a n/a n/a -0.309 0.022
Anxiety disorder 7 1 445 -0.054 0.089 24 -0.028 0.109 26 -0.143 0.375
Attention-deficit/hyperactivity disorder symptoms 7 1 445 -0.099 0.089 24 0.000 0.006 25 -0.261 0.096
Cannabis use^ 7 1 445 -0.063 0.089 24 n/a n/a n/a -0.166 0.317
Crime 7 1 445 -0.034 0.067 24 -0.034 0.067 34 -0.090 0.288
Disruptive behavior disorder symptoms 7 1 445 -0.024 0.067 18 -0.011 0.035 21 -0.063 0.576
Emergency department visits 7 1 445 -0.057 0.089 18 0.000 0.086 20 -0.150 0.050
Grade point average^ 7 1 445 -0.008 0.067 16 n/a n/a n/a -0.021 0.756
High school graduation 7 1 445 0.007 0.089 18 0.007 0.089 18 0.018 0.860
Illicit drug use^ 7 1 445 -0.125 0.089 24 n/a n/a n/a -0.330 0.021
K-12 grade repetition 7 1 445 0.030 0.067 16 0.030 0.067 16 0.079 0.515
K-12 special education 7 1 445 0.038 0.067 16 0.038 0.067 16 0.101 0.580
Major depressive disorder 7 1 445 -0.089 0.089 24 -0.046 0.109 26 -0.234 0.102

Citations Used in the Meta-Analysis

Bierman, K.L., Coie, J., Dodge, K., Greenberg, M., Lochman, J., McMohan, R., & Pinderhughes, E. (2013). School outcomes of aggressive-disruptive children: Prediction from kindergarten risk factors and impact of the Fast Track prevention program. Aggressive Behavior, 39(2), 114-130.

Conduct Problems Prevention Research Group. (2011). The effects of the Fast Track preventive intervention on the development of conduct disorder across childhood. Child Development, 82(1), 331-345.

Dodge, K.A., Bierman, K.L., Coie, J.D., Greenberg, M.T., Lochman, J.E., McMahon, R.J., . . . Conduct Problems Prevention Research Group. (2015). Impact of early intervention on psychopathology, crime, and well-being at age 25. The American Journal of Psychiatry, 172(1), 59-70.

Jones, D., Godwin, J., Dodge, K. A., Bierman, K. L., Coie, J. D., Greenberg, M. T., . . . Pinderhughes, E. E. (2010). Impact of the fast track prevention program on health services use by conduct-problem youth. Pediatrics, 125(1), e130-e136.