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Project Northland

Public Health & Prevention: Community-based
Benefit-cost methods last updated December 2019.  Literature review updated March 2019.
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Project Northland is a multilevel, universal intervention designed to prevent substance use among adolescents in middle school. The 6th grade home component targets parent-child communication via homework assignments, group discussions, and the establishment of a communitywide task force. The 7th grade school-based curriculum, which focuses on improving resistance skills and social norms regarding teen alcohol use, includes class discussions, games, and role plays. The 8th grade components include the peer-led Powerlines curriculum, a mock town meeting, and a community action project. Our review of Project Northland is limited to the 6th-8th grade implementation model and does not include the Class Action high school component.
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 (2018). 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 $94 Benefits minus costs $175
Participants $177 Benefit to cost ratio $2.73
Others $41 Chance the program will produce
Indirect ($36) benefits greater than the costs 53 %
Total benefits $276
Net program cost ($101)
Benefits minus cost $175
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 $14 $0 $34 $7 $54
Labor market earnings associated with problem alcohol use $74 $175 $0 $0 $249
Property loss associated with problem alcohol use $0 $1 $1 $0 $1
Health care associated with problem alcohol use $6 $1 $6 $3 $16
Mortality associated with problem alcohol $0 $1 $0 $4 $5
Adjustment for deadweight cost of program $0 $0 $0 ($50) ($50)
Totals $94 $177 $41 ($36) $276
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $35 2018 Present value of net program costs (in 2018 dollars) ($101)
Comparison costs $0 2018 Cost range (+ or -) 20 %
The per-student cost includes the cost of providing training and materials to teachers, the cost of program-related teacher time that occurs outside of regular school hours, the cost of substitute teacher time while teachers attend off-site training, and other school staff time required for program implementation. The cost includes $638 (2019 dollars) for 3-year curriculum and materials, and training cost of $5,000 plus $2,200 for trainer travel (personal communication with Debra Hemphill, Hazelden Publishing, June 6 , 2019). We assume two teachers per grade in a school will deliver the program, and include two days of substitute time per teacher at the state-funded rate of $151.86 per day (personal communication from Financial Resources staff at the Office of the Superintendent of Public Instruction, July 2019) to allow teachers to attend training. We include 50% of a school counselor at each school with an annual salary of $84,240 (based on the School District Personnel Summary Reports 2017–18 School Year) to coordinate the program, and assume student populations of the prototypical Washington middle school (RCW 28A.150.260).
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 high school 12 1 1401 -0.018 0.037 16 -0.018 0.037 18 -0.056 0.131
Alcohol use before end of middle school 12 4 4111 -0.046 0.029 14 -0.046 0.029 14 -0.108 0.026
Cannabis use before end of middle school 12 1 950 -0.020 0.061 14 -0.020 0.061 14 -0.059 0.330
Problem alcohol use 12 1 1401 -0.011 0.037 16 -0.011 0.037 26 -0.033 0.375
Smoking before end of middle school 12 1 950 -0.059 0.061 14 -0.059 0.061 14 -0.179 0.004

Citations Used in the Meta-Analysis

Komro, K.A., Perry, C.L., Veblen-Mortenson, S., Farbakhsh, K., Toomey, T.L., Stigler, M.H., Jones-Webb, R., . . . Williams, C.L. ( 2008). Outcomes from a randomized controlled trial of a multi-component alcohol use preventive intervention for urban youth: Project Northland Chicago. Addiction, 103(4), 606-618.

Perry, C.L. et al. (1996). Project Northland: Outcomes of a communitywide alcohol use prevention program during early adolescence. American Journal of Public Health, 86(7), 956-965.

Perry, C.L., Williams, C.L., Komro, K.A., Veblen-Mortenson, S., Stigler, M.H., Munson, K.A., et al. (2002). Project Northland: Long-term outcomes of community action to reduce adolescent alcohol use. Health Education Research, 17(1), 117-132.

West, B., Abatemarco, D., Ohman-Strickland, P.A., Zec, V., Russo, A., & Milic, R. (2008). Project Northland in Croatia: results and lessons learned. Journal of Drug Education, 38(1), 55-70.