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Return on Investment in NREPP Youth Substance Abuse Prevention Programs. Ted R Miller, PhD, PIRE. COST EFFECTIVENESS. Walk thru BCA of a typical program BCAs for NREPP programs BCAs for DWI & Crime Prevention Programs. Cost-Benefit Analysis of School-based SA Prevention Programs.

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Return on Investment in NREPP Youth Substance Abuse Prevention Programs


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return on investment in nrepp youth substance abuse prevention programs

Return on Investment in NREPP Youth Substance Abuse Prevention Programs

Ted R Miller, PhD, PIRE

slide3
Walk thru BCA of a typical program
  • BCAs for NREPP programs
  • BCAs for DWI & Crime Prevention Programs
cost benefit analysis of school based sa prevention programs
Cost-Benefit Analysis of School-based SA Prevention Programs
  • Looked at a typical school-based program
  • % of youth 12-14 who delay start-up due to the program
  • Prevention delays start of substance use by 2 years on average
  • # youth delaying use
  • % reduction in substance use
slide5
Total cost savings =

Cost of use x % reduced

  • Divide the cost saving benefits by program cost
  • State & local government savings
what costs result from using
What Costs Result from Using?
  • Illness/Poisoning
  • Violent Crime
  • Property Crime
  • Public Order/Supply Crimes *
  • Impaired Driving
  • Other Injury *

* Not costed for tobacco

what costs result from using12
What Costs Result from Using?

MONETARY COSTS

  • Medical
  • Work Loss
  • Other Resources (Property Damage/Police)
  • Quality of Life – Controversial to Put a $ Value On
program cost pupil
Program Cost/Pupil
  • $220 average across 11 programs
  • Includes training of teachers
  • Teacher salaries, fringe, & overhead
  • Program materials
effectiveness vs cost effectiveness
Effectiveness vs Cost-Effectiveness
  • % reduction in DWI deaths measures effectiveness
  • BCR also considers cost
  • The most effective interventions sometimes have lower returns on investment (measured by BCRs)
lower return on investment
Lower Return on Investment
  • Project TND (Toward No Drugs) 0%, D
  • STARS for families 8% binge
  • Original DARE (not on NREPP) did not work
slide21
CASAstart costs more than it saves
  • Across Ages – razor-thin savings
  • Project PATHE (not on NREPP) does not work
lack costs for indicated programs
Lack Costs for Indicated Programs
  • Use community referrals extensively
  • How much use of those services results
  • What does it cost
21 minimum drinking age
21 Minimum Drinking Age
  • Reduces youth DWI deaths
  • Reduces youth suicides
  • Raises age of initiation which lowers the risk of alcoholism in adulthood
  • Reduces % of youth who drink
  • Reduces % of youth who binge
  • Reduces sales & profits
other interventions
Other Interventions ?
  • Community mobilization & capacity building: advocacy to change laws, enforcement & norms
  • Adults work with youth to improve outcomes
  • Peer-to-peer
  • Media: social norms
  • Billboard campaign
  • Web education/social networking
underage drinking prevention
Underage Drinking Prevention
  • Aggressively enforce underage sales laws
  • Improve age-checking technology
  • Reduce outlet density
  • Social host policies that hold adults liable when kids drink at home parties
college drinking prevention
College Drinking Prevention
  • Restrict pitchers & schooners
  • Discourage happy hours
  • Ban all-you-can-drink hours
slide30
Do not create the wrong story: 3 Soundbites, 2 dozen variants, work your way back – or the 10 seconds they use may not be on your story
  • A press conference is not live; if you mis-speak, say it over
  • Beware silence
  • Rule of 3s
  • Rhyme, alliteration
  • Passion
  • Paint pictures
  • T-shirts
slide31
Plan how/when to release
  • People do not understand big numbers
  • You cannot spend some savings
  • Select costs to suit the audience
  • White on blue slides; large type size
  • Minimize words on slides
  • Do not read every #
  • Put a face with the $
free pire technical assistance
Free PIRE Technical Assistance

Monique Sheppard & Ted Miller

Children's Safety Network Economics &

Data Resource Center

Enforcement of Underage Drinking Laws TA & Training Center

CSAP State Epidemiological Workgroup TA

301-755-2728

sheppard@pire.org

prevention approaches can impact broadly or narrowly
Prevention Approaches Can Impact Broadly or Narrowly
  • Thinning Alcohol Outlet Density or Raising Alcohol Taxes changes alcohol consumption & thus reduces all alcohol-related problems
  • Creating Defensible Space (thru lighting, gating, etc.) only reduces violence
  • Evaluations often do not assess some impacts, notably for midnight driving curfew, 0-tolerance, .08
impaired driving measures
Impaired Driving Measures
  • No one intervention will reduce impaired driving deaths by more than 17%
  • We need to select a package of complementary measures
what happens if we implement multiple measures
What Happens If We Implement Multiple Measures
  • Implementing one broad measure can have a large effect on the BCR for another because each reduces a % of the remaining problem
when combine targeted broad measures
When combine targeted & broad measures
  • Large impact on a narrowly targeted segment of the problem
  • Minimal effectiveness reduction in the BCR for the broad-based intervention
rules for a sensible dwi package
Rules for a Sensible DWI Package
  • Broader measures like regional trauma systems, 20% ETOH tax, occupant restraint, & graduated licensing lose little effectiveness as targeted DWI measures are implemented
  • Measures tightly targeting subgroups only modestly reduce the pool of injuries/effectiveness of all-driver DWI measures
multi problem behaviour is the norm
Multi-Problem Behaviour Is the Norm
  • Some Interventions Should Affect Multiple Problems
  • Spillover Benefits Of
    • DWI on Other Harm
    • Non-DWI on DWI
    • Non-ETOH Measures on ETOH
which general dwi measures impact consumption or harm
Which General DWI Measures Impact Consumption or Harm?
  • .08 maximum driver BAC
  • Server training
  • Enforcing Laws vs Serving Intoxicated Patrons (SIP Laws)
  • Intensive Breath Testing
    • Could force drinking to the home, adding domestic violence, etc.
which youth dwi measures impact consumption or harm
Which "Youth" DWI Measures Impact Consumption or Harm?
  • 21 Minimum Legal Drinking Age
  • 0 ETOH Tolerance f/Drivers < 21
  • ETOH Tax Increase
  • Enforcing Underage Sales Laws
  • Graduated Licensing w/Curfew
which hardcore dwi measures impact consumption or harm
Which Hardcore DWI Measures Impact Consumption or Harm?
  • Jail
  • Mandatory offender treatment
  • House arrest

(positive or negative effect: domestic violence ??)

conclusions
Conclusions
  • Some NREPP programs are better than others
  • Some NREPP programs should only be used in special circumstances
  • Often one must trade off the largest impact vs the largest return per $ spent