Department of Psychology, Iowa State University, Ames, 50011-3180, USA.
J Stud Alcohol Drugs. 2011 Jul;72(4):577-85. doi: 10.15288/jsad.2011.72.577.
The goal of this research was to evaluate economically three interventions designed to prevent substance use in general populations of adolescents, specifically focusing on the prevention of methamphetamine use and its subsequent benefits to employers.
In a randomized, controlled trial, three preventive interventions were delivered to 6th- or 7th-grade youth in 58 Iowa school districts, with 905 of these youth (449 girls) providing follow-up assessments as 12th graders. Intervention conditions included the family-focused Iowa Strengthening Families Program (ISFP), the school-based Life Skills Training (LST) program, and a combined condition of both the Strengthening Families Program: For Parents and Youth 10-14 (SFP10- 14; an ISFP revision) plus LST (LST + SFP10-14). Analyses based on intervention costs, 12th-grade methamphetamine use rates, and methamphetamine- related employer costs yielded estimates of intervention cost, cost-effectiveness, benefit-cost ratio, and net benefit.
The ISFP lowered methamphetamine use by 3.9%, cost $25,385 to prevent each case, and had a benefit-cost ratio of 3.84, yielding a net benefit of $2,813 per youth. The LST program reduced methamphetamine use by 2.5%, required $5,122 per prevented case, and had a benefit-cost ratio of 19.04, netting $2,273 per youth. The combined LST + SFP10-14 prevention condition lowered methamphetamine use rates by 1.8%, cost $62,697 to prevent each case, had a benefit-cost ratio of 1.56, and netted $620 per youth. Findings were robust after varying a number of key parameters across a range of plausible values.
Substance use prevention programming is economically feasible, particularly for effective interventions that have lower per person treatment delivery costs.
本研究旨在评估三项旨在预防一般青少年群体药物使用的干预措施的经济性,特别是预防甲基苯丙胺使用及其对雇主的后续效益。
在一项随机对照试验中,向 58 个爱荷华州学区的 6 或 7 年级青少年提供三种预防干预措施,其中 905 名青少年(449 名女孩)作为 12 年级学生提供后续评估。干预条件包括以家庭为中心的爱荷华州家庭强化计划(ISFP)、基于学校的生活技能培训(LST)计划以及家庭强化计划:父母与青少年 10-14 岁(SFP10-14;ISFP 修订版)加 LST(LST+SFP10-14)的联合条件。基于干预成本、12 年级甲基苯丙胺使用率和甲基苯丙胺相关雇主成本的分析得出了干预成本、成本效益比、效益成本比和净效益的估计值。
ISFP 将甲基苯丙胺使用率降低了 3.9%,预防每个病例的成本为 25385 美元,效益成本比为 3.84,每个青少年的净效益为 2813 美元。LST 计划将甲基苯丙胺使用率降低了 2.5%,预防每个病例的成本为 5122 美元,效益成本比为 19.04,每个青少年的净效益为 2273 美元。LST+SFP10-14 联合预防条件将甲基苯丙胺使用率降低了 1.8%,预防每个病例的成本为 62697 美元,效益成本比为 1.56,每个青少年的净效益为 620 美元。在一系列合理值范围内改变了多个关键参数后,结果仍然稳健。
药物使用预防计划在经济上是可行的,特别是对于那些具有较低人均治疗成本的有效干预措施。