|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$2,749||Benefits minus costs||$9,913|
|Participants||$3,575||Benefit to cost ratio||$62.80|
|Others||$3,128||Chance the program will produce|
|Indirect||$620||benefits greater than the costs||76 %|
|Net program cost||($160)|
|Benefits minus cost||$9,913|
|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|
Alcohol use disorder
Clinical diagnosis of alcohol use disorder or symptoms measured on a validated scale.
Antisocial personality disorder^
Clinical diagnosis of antisocial personality disorder or symptoms measured on a validated scale.
Clinical diagnosis of an anxiety disorder (e.g., general anxiety, panic, social anxiety, obsessive compulsive disorder) or symptoms measured on a validated scale.
Attention-deficit/hyperactivity disorder symptoms
Clinical diagnosis of attention-deficit/hyperactivity disorder (ADHD) or symptoms measured on a validated scale.
Externalizing behavior symptoms
Symptoms of externalizing behavior (e.g., aggressive, hostile, or disruptive behavior) measured on a validated scale.
High school graduation
On-time completion of high school with a diploma (excluding GED attainment).
Illicit drug use disorder
Clinical diagnosis of illicit drug use disorder or symptoms measured on a validated scale. When possible, we exclude cannabis/marijuana use disorder from this outcome.
Major depressive disorder
Clinical diagnosis of major depression or symptoms measured on a validated scale.
Smoking tobacco on a regular basis.
Smoking before end of high school
Any smoking of tobacco by the end of high school, typically between ages 14 and 18.
Smoking before end of middle school
Any smoking of tobacco by the end of middle school, typically by age 13.
Thinking about and/or planning death by suicide.
An attempt to die by suicide resulting in survival.
|7||1||178||-0.118||0.173||20||n/a||n/a||n/a||-0.309||0.106||Click to expand||Click to collapse|
|Detailed Monetary Benefit Estimates Per Participant|
|Affected outcome:||Resulting benefits:1||Benefits accrue to:|
|High school graduation||Labor market earnings associated with high school graduation||$1,559||$3,663||$2,000||$0||$7,222|
|Costs of higher education||($240)||($363)||($109)||($120)||($832)|
|Regular smoking||Mortality associated with smoking||$3||$6||$0||$107||$116|
|Alcohol use disorder||Property loss associated with alcohol abuse or dependence||$0||$4||$8||$0||$13|
|Anxiety disorder||K-12 grade repetition||$3||$0||$0||$1||$4|
|Externalizing behavior symptoms||Criminal justice system||$116||$0||$261||$58||$434|
|K-12 special education||$371||$0||$0||$185||$556|
|Health care associated with externalizing behavior symptoms||$938||$265||$968||$469||$2,641|
|Program cost||Adjustment for deadweight cost of program||$0||$0||$0||($80)||($80)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$73||2011||Present value of net program costs (in 2018 dollars)||($160)|
|Comparison costs||$0||2011||Cost range (+ or -)||10 %|
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
|Benefits Minus Costs Over Time (Cumulative 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 discounted dollars. 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.|
Breeman, L.D., van Lier, P.A., Wubbels, T., Verhulst, F.C., van der Ende, J., Maras, A., . . . Tick, N.T. (2016). Effects of the Good Behavior Game on the behavioral, emotional, and social problems of children with psychiatric disorders in special education settings. Journal of Positive Behavior Interventions, 18(3), 156–167.
Furr-Holden, C.D.M., Ialongo, N.S., Anthony, J.C., Petras, H., & Kellam, S.G. (2004). Developmentally inspired drug prevention: Middle school outcomes in a school-based randomized prevention trial. Drug and Alcohol Dependence, 73(2), 149.
Healthy Child Manitoba. (2016). Improving the early mental health and well-being of Manitoba’s children: First findings from the province wide pilot and evaluation of PAX.
Huizink, A.C., van Lier, P.A.C., & Crijnen, A.A.M. (2009). Attention Deficit Hyperactivity Disorder symptoms mediate early-onset smoking. European Addiction Research, 15(1), 1-9.
Ialongo, N., Poduska, J., Werthamer, L., & Kellam, S. (2001). The distal impact of two first-grade preventive interventions on conduct problems and disorder in early adolescence. Journal of Emotional and Behavioral Disorders, 9(3), 146-160.
Kellam, S.G., & Anthony, J.C. (1998). Targeting early antecedents to prevent tobacco smoking: Findings from an epidemiologically based randomized field trial. American Journal of Public Health, 88(10), 1488-1495.
Kellam, S.G., Reid, J., & Balster, R.L. (2008). Effects of a universal classroom behavior program in first and second grades on young adult problem outcomes. Drug and Alcohol Dependence, 95(Suppl. 1), S1-S4.
Kellam, S.G., Ialongo, N.S., Wang, W., Mackenzie, A.C.L., Brown, C.H., Ompad, D.C., Or, F., Ialongo, N., Poduska, J., & Windham, A. (2014). The impact of the Good Behavior Game, a universal classroom-based preventive intervention in first and second grades, on high-risk sexual behaviors and drug abuse and dependence disorders into young adulthood. Prevention Science, 15, 6-18.
Petras, H., Kellam, S.G., Poduska, J.M., Brown, C.H., Muthen, B.O., & Ialongo, N.S. (2008). Developmental epidemiological courses leading to antisocial personality disorder and violent and criminal behavior: Effects by young adulthood of a universal preventive intervention in first- and second-grade classrooms. Drug and Alcohol Dependence, 95(Suppl. 1), S45-S59.
Smith, E.P., Osgood, D.W., Oh, Y., & Caldwell, L.C. (2018). Promoting afterschool quality and positive youth development: Cluster randomized trial of the PAX Good Behavior Game. Prevention Science, 19(2), 159-173.
Storr, C.L., Ialongo, N.S., Kellam, S.G., & Anthony, J.C. (2002). A randomized controlled trial of two primary school intervention strategies to prevent early onset tobacco smoking. Drug and Alcohol Dependence, 66(1), 51-60.
Vuijk, P., van Lier, P.A.C., Crijnen, A.A.M., & Huizink, A.C. (2007). Testing sex-specific pathways from peer victimization to anxiety and depression in early adolescents through a randomized intervention trial. Journal of Affective Disorders, 100(1-3), 221-226.
Wilcox, H.C., Kellam, S.G., Brown, C.H., Poduska, J.M., Ialongo, N.S., Wang, W., & Anthony, J.C. (2008). The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts. Drug and Alcohol Dependence, 95(Suppl. 1), S60-S73.
Witvliet, M., van Lier, P.A.C., Cuijpers, P., & Koot, H.M. (2009). Testing links between childhood positive peer relations and externalizing outcomes through a randomized controlled intervention study. Journal of Consulting and Clinical Psychology, 77(5), 905-915.