Honeycutt Amanda A, Khavjou Olga A, Jones Deborah J, Cuellar Jessica, Forehand Rex L
RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.
University of North Carolina at Chapel Hill, Campus Box 3270, Chapel Hill, NC 27599, USA.
J Child Fam Stud. 2015 Feb;24(2):499-504. doi: 10.1007/s10826-013-9862-7.
Disruptive behavior disorders (DBD) in children can lead to delinquency in adolescence and antisocial behavior in adulthood. Several evidence-based behavioral parent training (BPT) programs have been created to treat early onset DBD. This paper focuses on one such program, Helping the Noncompliant Child (HNC), and provides detailed cost estimates from a recently completed pilot study for the HNC program. The study also assesses the average cost-effectiveness of the HNC program by combining program cost estimates with data on improvements in child participants' disruptive behavior. The cost and effectiveness estimates are based on implementation of HNC with low-income families. Investigators developed a Microsoft Excel-based costing instrument to collect data from therapists on their time spent delivering the HNC program. The instrument was designed using an activity-based costing approach, where each therapist reported program time by family, by date, and for each skill that the family was working to master. Combining labor and non-labor costs, it is estimated that delivering the HNC program costs an average of $501 per family from a payer perspective. It also costs an average of $13 to improve the Eyberg Child Behavior Inventory intensity score by 1 point for children whose families participated in the HNC pilot program. The cost of delivering the HNC program appears to compare favorably with the costs of similar BPT programs. These cost estimates are the first to be collected systematically and prospectively for HNC. Program managers may use these estimates to plan for the resources needed to fully implement HNC.
儿童破坏性行为障碍（DBD）可能会导致青少年犯罪以及成年后的反社会行为。目前已经创建了几种基于证据的行为家长培训（BPT）项目来治疗早期发作的DBD。本文聚焦于其中一个项目——帮助不听话儿童（HNC），并提供了最近完成的HNC项目试点研究的详细成本估算。该研究还通过将项目成本估算与儿童参与者破坏性行为改善的数据相结合，评估了HNC项目的平均成本效益。成本和效益估算是基于对低收入家庭实施HNC的情况。研究人员开发了一种基于Microsoft Excel的成本核算工具，以收集治疗师在提供HNC项目上所花费时间的数据。该工具采用作业成本法设计，每位治疗师按家庭、日期以及家庭正在努力掌握的每项技能来报告项目时间。从付款方的角度来看，综合劳动力和非劳动力成本，估计为每个家庭提供HNC项目平均花费501美元。对于参与HNC试点项目的儿童家庭，将艾伯格儿童行为量表强度得分提高1分平均还需花费13美元。提供HNC项目的成本似乎与类似BPT项目的成本相比具有优势。这些成本估算是首次针对HNC进行系统且前瞻性的收集。项目经理可以使用这些估算来规划全面实施HNC所需的资源。
