Skip to main content
Erschienen in: Prevention Science 4/2015

01.05.2015

Cost-Benefit Analysis of a Preventive Intervention for Divorced Families: Reduction in Mental Health and Justice System Service Use Costs 15 Years Later

verfasst von: Patricia M. Herman, Nicole E. Mahrer, Sharlene A. Wolchik, Michele M. Porter, Sarah Jones, Irwin N. Sandler

Erschienen in: Prevention Science | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Abstract

This cost-benefit analysis compared the costs of implementing the New Beginnings Program (NBP), a preventive intervention for divorced families to monetary benefits saved in mental healthcare service use and criminal justice system costs. NBP was delivered when the offspring were 9–12 years old. Benefits were assessed 15 years later when the offspring were young adults (ages 24–27). This study estimated the costs of delivering two versions of NBP, a single-component parenting-after-divorce program (Mother Program, MP) and a two-component parenting-after-divorce and child-coping program (Mother-Plus-Child Program, MPCP), to costs of a literature control (LC). Long-term monetary benefits were determined from actual expenditures from past-year mental healthcare service use for mothers and their young adult (YA) offspring and criminal justice system involvement for YAs. Data were gathered from 202 YAs and 194 mothers (75.4 % of families randomly assigned to condition). The benefits, as assessed in the 15th year after program completion, were $1630/family (discounted benefits $1077/family). These 1-year benefits, based on conservative assumptions, more than paid for the cost of MP and covered the majority of the cost of MPCP. Because the effects of MP versus MPCP on mental health and substance use problems have not been significantly different at short-term or long-term follow-up assessments, program managers would likely choose the lower-cost option. Given that this evaluation only calculated economic benefit at year 15 and not the previous 14 (nor future years), these findings suggest that, from a societal perspective, NBP more than pays for itself in future benefits.
Literatur
Zurück zum Zitat Afifi, T. O., Boman, J., Fleisher, W., & Sareen, J. (2009). The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample. Child Abuse & Neglect, 33(3), 139–147. doi:10.1016/j.chiabu.2008.12.009.CrossRef Afifi, T. O., Boman, J., Fleisher, W., & Sareen, J. (2009). The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample. Child Abuse & Neglect, 33(3), 139–147. doi:10.​1016/​j.​chiabu.​2008.​12.​009.CrossRef
Zurück zum Zitat Aos, S., Phipps, P., Barnoski, R. & Lieb, R. (2001). The comparative costs and benefits of programs to reduce crime, version 4.0. Olympia, WA, Washington State Institute for Public Policy. Aos, S., Phipps, P., Barnoski, R. & Lieb, R. (2001). The comparative costs and benefits of programs to reduce crime, version 4.0. Olympia, WA, Washington State Institute for Public Policy.
Zurück zum Zitat Barber, J. A., & Thompson, S. G. (2000). Analysis of cost data in randomized trials: An application of the non-parametric bootstrap. Statistics in Medicine, 19, 3219–3236.CrossRefPubMed Barber, J. A., & Thompson, S. G. (2000). Analysis of cost data in randomized trials: An application of the non-parametric bootstrap. Statistics in Medicine, 19, 3219–3236.CrossRefPubMed
Zurück zum Zitat Belfield, C. R., Nores, M., Barnett, S., & Schweinhart, L. (2006). The high/scope perry preschool program cost–benefit analysis using data from the age-40 follow up. Journal of Human Resources, 41(1), 162–190.CrossRef Belfield, C. R., Nores, M., Barnett, S., & Schweinhart, L. (2006). The high/scope perry preschool program cost–benefit analysis using data from the age-40 follow up. Journal of Human Resources, 41(1), 162–190.CrossRef
Zurück zum Zitat Biblarz, T. J., & Raftery, A. E. (1999). Family structure, educational attainment, and socioeconomic success: Rethinking the “pathology of matriarchy” 1. American Journal of Sociology, 105(2), 321–365. doi:10.1086/210314.CrossRef Biblarz, T. J., & Raftery, A. E. (1999). Family structure, educational attainment, and socioeconomic success: Rethinking the “pathology of matriarchy” 1. American Journal of Sociology, 105(2), 321–365. doi:10.​1086/​210314.CrossRef
Zurück zum Zitat Drug Topics Red Book: pharmacy’s fundamental resource (2007). Montvale, NJ: Thomson Medical Economics Drug Topics Red Book: pharmacy’s fundamental resource (2007). Montvale, NJ: Thomson Medical Economics
Zurück zum Zitat Efron, B., & Tibshirani, R. J. (1994). An introduction to the bootstrap. Boca Raton: Champman & Hall/CRC. Efron, B., & Tibshirani, R. J. (1994). An introduction to the bootstrap. Boca Raton: Champman & Hall/CRC.
Zurück zum Zitat Fergusson, D. M., Horwood, L. J., & Lynskey, M. T. (1994). Parental separation, adolescent psychopathology, and problem behaviors. Journal of the American Academy of Child & Adolescent Psychiatry, 33, 1122–1131. doi:10.1097/00004583-199410000-00008.CrossRef Fergusson, D. M., Horwood, L. J., & Lynskey, M. T. (1994). Parental separation, adolescent psychopathology, and problem behaviors. Journal of the American Academy of Child & Adolescent Psychiatry, 33, 1122–1131. doi:10.​1097/​00004583-199410000-00008.CrossRef
Zurück zum Zitat Flay, B. R., Biglan, A., Boruch, R. F., Castro, F. G., Gottfredson, D., Kellam, S., & Ji, P. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6, 151–175. doi:10.1007/s11121-005-5553-y.CrossRefPubMed Flay, B. R., Biglan, A., Boruch, R. F., Castro, F. G., Gottfredson, D., Kellam, S., & Ji, P. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6, 151–175. doi:10.​1007/​s11121-005-5553-y.CrossRefPubMed
Zurück zum Zitat Gold, M. R., Siegel, J. E., Russell, L. B., & Weinstein, M. C. (Eds.). (1996). Cost-effectiveness in health and medicine. USA: Oxford University Press. Gold, M. R., Siegel, J. E., Russell, L. B., & Weinstein, M. C. (Eds.). (1996). Cost-effectiveness in health and medicine. USA: Oxford University Press.
Zurück zum Zitat Greenberg, P. E., Kessler, R. C., Birnbaum, H. G., Leong, S. A., Lowe, S. W., Berglund, P. A., & Corey-Lisle, P. K. (2003). The economic burden of depression in the United States: How did it change between 1990 and 2000? Journal of Clinical Psychiatry, 64(12), 1465–1475. doi:10.4088/JCP.v64n1211.CrossRefPubMed Greenberg, P. E., Kessler, R. C., Birnbaum, H. G., Leong, S. A., Lowe, S. W., Berglund, P. A., & Corey-Lisle, P. K. (2003). The economic burden of depression in the United States: How did it change between 1990 and 2000? Journal of Clinical Psychiatry, 64(12), 1465–1475. doi:10.​4088/​JCP.​v64n1211.CrossRefPubMed
Zurück zum Zitat Heckman, J., Grunewald, R., & Reynolds, A. (2006). The dollars and cents of investing early: Cost-benefit analysis in early care and education. Zero to Three, 26(6), 10–17. Heckman, J., Grunewald, R., & Reynolds, A. (2006). The dollars and cents of investing early: Cost-benefit analysis in early care and education. Zero to Three, 26(6), 10–17.
Zurück zum Zitat Horowitz, S. M., Hoagwood, K., Stiffman, A. R., Summerfeld, T., Weisz, J. R., Costello, E. J., et al. (2001). Reliability of the services assessment for children and adolescents. Psychiatric Services, 52, 1088–1094. doi:10.1176/appi.ps.52.8.1088.CrossRef Horowitz, S. M., Hoagwood, K., Stiffman, A. R., Summerfeld, T., Weisz, J. R., Costello, E. J., et al. (2001). Reliability of the services assessment for children and adolescents. Psychiatric Services, 52, 1088–1094. doi:10.​1176/​appi.​ps.​52.​8.​1088.CrossRef
Zurück zum Zitat Jurs, D. G., & Glass, G. V. (1971). The effect of experimental mortality on the internal and external validity of the randomized comparative experiment. Journal of Experimental Education, 40, 62–66.CrossRef Jurs, D. G., & Glass, G. V. (1971). The effect of experimental mortality on the internal and external validity of the randomized comparative experiment. Journal of Experimental Education, 40, 62–66.CrossRef
Zurück zum Zitat Miller, T. R. (2004). The social costs of adolescent problem behavior. In A. Biglan, P. A. Brennan, S. L. Foster, & H. D. Holder (Eds.), Helping adolescents at risk: Prevention of multiple problem behaviors (pp. 31–56). New York: The Guilford Press. Miller, T. R. (2004). The social costs of adolescent problem behavior. In A. Biglan, P. A. Brennan, S. L. Foster, & H. D. Holder (Eds.), Helping adolescents at risk: Prevention of multiple problem behaviors (pp. 31–56). New York: The Guilford Press.
Zurück zum Zitat National Center for Health Statistics. (2008). Marriage and divorce: Retrieved from http://www.cdc.gov/nchs/fastats/divorce.htm. National Center for Health Statistics. (2008). Marriage and divorce: Retrieved from http://​www.​cdc.​gov/​nchs/​fastats/​divorce.​htm.​
Zurück zum Zitat O’Neill, D., McGilloway, S., Donnelly, M., Bywater, T., & Kelly, P. (2010). A cost-benefit analysis of early childhood intervention: Evidence from an experimental evaluation of the incredible years parenting program. Department of Economics, Finance and Accounting, National University of Ireland-Maynooth O’Neill, D., McGilloway, S., Donnelly, M., Bywater, T., & Kelly, P. (2010). A cost-benefit analysis of early childhood intervention: Evidence from an experimental evaluation of the incredible years parenting program. Department of Economics, Finance and Accounting, National University of Ireland-Maynooth
Zurück zum Zitat Paxton, R., Valois, R., & Drane, J. (2007). Is there a relationship between family structure and substance use among public middle school students? Journal of Child and Family Studies, 16, 593–605. doi:10.1007/s10826-006-9109-y.CrossRef Paxton, R., Valois, R., & Drane, J. (2007). Is there a relationship between family structure and substance use among public middle school students? Journal of Child and Family Studies, 16, 593–605. doi:10.​1007/​s10826-006-9109-y.CrossRef
Zurück zum Zitat Reynolds, A. J., Temple, J. A., Robertson, D. L., & Mann, E. A. (2002). Age 21 cost-benefit analysis of the Title I Chicago child-parent centers. Educational Evaluation and Policy Analysis, 24(4), 267–303. doi:10.3102/01623737024004267.CrossRef Reynolds, A. J., Temple, J. A., Robertson, D. L., & Mann, E. A. (2002). Age 21 cost-benefit analysis of the Title I Chicago child-parent centers. Educational Evaluation and Policy Analysis, 24(4), 267–303. doi:10.​3102/​0162373702400426​7.CrossRef
Zurück zum Zitat 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.CrossRef 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.CrossRef
Zurück zum Zitat Stewart, W. F., Ricci, J. A., Chee, E., & Morganstein, D. (2003). Lost productive work time costs from health conditions in the United States: Results from the American Productivity Audit. Journal of Occupational and Environmental Medicine, 45(12), 1234–1246. doi:10.1097/01.jom.0000099999.27348.78.CrossRefPubMed Stewart, W. F., Ricci, J. A., Chee, E., & Morganstein, D. (2003). Lost productive work time costs from health conditions in the United States: Results from the American Productivity Audit. Journal of Occupational and Environmental Medicine, 45(12), 1234–1246. doi:10.​1097/​01.​jom.​0000099999.​27348.​78.CrossRefPubMed
Zurück zum Zitat Stiffman, A. R., Horwitz, S. M., Hoagwood, K., Compton, W., Cotter, L., Bean, D., Narrow, W., & Weisz, J. R. (2000). The service assessment for children and adolescents (SACA). Adult and child reports. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1032–1039. doi:10.1097/00004583-200008000-00019.CrossRefPubMed Stiffman, A. R., Horwitz, S. M., Hoagwood, K., Compton, W., Cotter, L., Bean, D., Narrow, W., & Weisz, J. R. (2000). The service assessment for children and adolescents (SACA). Adult and child reports. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1032–1039. doi:10.​1097/​00004583-200008000-00019.CrossRefPubMed
Zurück zum Zitat Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., & Haine, R. A. (2002). Six-year follow-up of preventive interventions for children of divorce. JAMA, the Journal of the American Medical Association, 288(15), 1874–1881. doi:10.1001/jama.288.15.1874.CrossRefPubMed Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., & Haine, R. A. (2002). Six-year follow-up of preventive interventions for children of divorce. JAMA, the Journal of the American Medical Association, 288(15), 1874–1881. doi:10.​1001/​jama.​288.​15.​1874.CrossRefPubMed
Zurück zum Zitat Wolchik, S. A., Sandler, I. N., Tein, J.-Y., Mahrer, N. E., Millsap, R. E., Winslow, E., & Reed, A. (2013). Fifteen-year follow-up of a randomized trial of a preventive intervention for divorced families: Effects on mental health and substance use outcomes in young adulthood. Journal of Clinical and Consulting Psychology, 81, 600–673. doi:10.1037/a0033235.CrossRef Wolchik, S. A., Sandler, I. N., Tein, J.-Y., Mahrer, N. E., Millsap, R. E., Winslow, E., & Reed, A. (2013). Fifteen-year follow-up of a randomized trial of a preventive intervention for divorced families: Effects on mental health and substance use outcomes in young adulthood. Journal of Clinical and Consulting Psychology, 81, 600–673. doi:10.​1037/​a0033235.CrossRef
Zurück zum Zitat Wolchik, S. A., Sandler, I., Weiss, L., & Winslow, E. B. (2007). New Beginnings: An empirically-based program to help divorced mothers promote resilience in their children. In J. M. Briesmeister & C. E. Schaefer (Eds.), Handbook of parent training: Helping parents prevent and solve problem behaviors (pp. 25–62). John Wiley & Sons: New York. Wolchik, S. A., Sandler, I., Weiss, L., & Winslow, E. B. (2007). New Beginnings: An empirically-based program to help divorced mothers promote resilience in their children. In J. M. Briesmeister & C. E. Schaefer (Eds.), Handbook of parent training: Helping parents prevent and solve problem behaviors (pp. 25–62). John Wiley & Sons: New York.
Zurück zum Zitat Wolchik, S. A., West, S. G., Sandler, I., Tein, J., Coatsworth, D., Lengua, L., & Griffin, W. A. (2000). An experimental evaluation of theory-based mother and mother-child programs for children of divorce. Journal of Consulting and Clinical Psychology, 68, 843–856. doi:10.1037/0022-006X.68.5.843.CrossRefPubMed Wolchik, S. A., West, S. G., Sandler, I., Tein, J., Coatsworth, D., Lengua, L., & Griffin, W. A. (2000). An experimental evaluation of theory-based mother and mother-child programs for children of divorce. Journal of Consulting and Clinical Psychology, 68, 843–856. doi:10.​1037/​0022-006X.​68.​5.​843.CrossRefPubMed
Zurück zum Zitat Wolchik, S. A., West, S. G., Westover, S., Sandler, I. N., Martin, A., Lustig, J., & Fisher, J. (1993). The children of divorce parenting intervention: Outcome evaluation of an empirically based program. American Journal of Community Psychology, 21(3), 293–331. doi:10.1007/BF00941505.CrossRefPubMed Wolchik, S. A., West, S. G., Westover, S., Sandler, I. N., Martin, A., Lustig, J., & Fisher, J. (1993). The children of divorce parenting intervention: Outcome evaluation of an empirically based program. American Journal of Community Psychology, 21(3), 293–331. doi:10.​1007/​BF00941505.CrossRefPubMed
Metadaten
Titel
Cost-Benefit Analysis of a Preventive Intervention for Divorced Families: Reduction in Mental Health and Justice System Service Use Costs 15 Years Later
verfasst von
Patricia M. Herman
Nicole E. Mahrer
Sharlene A. Wolchik
Michele M. Porter
Sarah Jones
Irwin N. Sandler
Publikationsdatum
01.05.2015
Verlag
Springer US
Erschienen in
Prevention Science / Ausgabe 4/2015
Print ISSN: 1389-4986
Elektronische ISSN: 1573-6695
DOI
https://doi.org/10.1007/s11121-014-0527-6

Weitere Artikel der Ausgabe 4/2015

Prevention Science 4/2015 Zur Ausgabe