D. Max Crowley

Research Priorities for Economic Analyses of Prevention: Current Issues and Future Directions

In response to growing interest in economic analyses of prevention efforts, a diverse group of prevention researchers, economists, and policy analysts convened a scientific panel, on “Research Priorities in Economic Analysis of Prevention” at the 19th annual conference of the Society for Prevention Research. The panel articulated four priorities that, if followed in future research, would make economic analyses of prevention efforts easier to compare and more relevant to policymakers and community stakeholders. These priorities are: (1) increased standardization of evaluation methods, (2) improved economic valuation of common prevention outcomes, (3) expanded efforts to maximize evaluation generalizability and impact as well as (4) enhanced transparency and communicability of economic evaluations. In this paper, we define three types of economic analyses in prevention, provide context and rationale for these four priorities as well as related sub-priorities, and discuss the challenges inherent in meeting them.

Can we build an efficient response to the prescription drug abuse epidemic? Assessing the cost effectiveness of universal prevention in the PROSPER trial

PURPOSE Prescription drug abuse has reached epidemic proportions. Nonmedical prescription opioid use carries increasingly high costs. Despite the need to cultivate efforts that are both effective and fiscally responsible, the cost-effectiveness of universal evidence-based-preventive-interventions (EBPIs) is rarely evaluated. This study explores the performance of these programs to reduce nonmedical prescription opioid use. METHODS Sixth graders from twenty-eight rural public school districts in Iowa and Pennsylvania were blocked by size and geographic location and then randomly assigned to experimental or control conditions (2002-2010). Within the intervention communities, prevention teams selected a universal family and school program from a menu of EBPIs. All families were offered a family-based program in the 6th grade and received one of three school-based programs in 7th-grade. The effectiveness and cost-effectiveness of each school program by itself and with an additional family-based program were assessed using propensity and marginal structural models. RESULTS This work demonstrates that universal school-based EBPIs can efficiently reduce nonmedical prescription opioid use. Further, findings illustrate that family-based programs may be used to enhance the cost-effectiveness of school-based programs. CONCLUSIONS Universal EBPIs can effectively and efficiently reduce nonmedical prescription opioid use. These programs should be further considered when developing comprehensive responses to this growing national crisis.

The Role of Social Impact Bonds in Pediatric Health Care

* Abbreviation: SIB — : social impact bond In 2010, the United Kingdom’s Ministry of Justice entered into an agreement with a nonprofit known as Social Finance to prevent reoffending by juvenile offenders released from prison in Peterborough, England. What made this contract unique is that the government payments to Social Finance were not based on delivery of services but instead on the level of government cost aversion from reduced recidivism. To cover the upfront cost of funding this prevention effort, Social Finance raised

Building Efficient Crime Prevention Strategies: Considering the Economics of Investing in Human Development.

5 million from private investors. If the effort successfully reduces recidivism 7.5% by 2016, then they will receive back their initial investment plus a performance bonus—totaling up to

Financing prevention: opportunities for economic analysis across the translational research cycle.

8 million. This contract, now commonly known as a social impact bond (SIB), represents an innovative financing strategy that leverages private investment to move public services upstream to prevent greater costs in the future. Interim results from the Peterborough SIB indicated that recidivism has dropped 6% compared with the rest of England.1 Since its implementation, new SIBs are being developed to target a wide array of public problems (eg, reducing recidivism, preterm births, and special education). These bonds are attracting substantial interest and support from the private sector. For instance, Goldman Sachs is supporting a

The power of a collaborative relationship between technical assistance providers and community prevention teams: A correlational and longitudinal study.

9.6 million SIB to reduce recidivism on Rikers Island in New York City. In addition, they are supporting, along with the J.B. and M.K. Pritzker Family Foundation, a

Standards of evidence for conducting and reporting economic evaluations in prevention science

7 million bond in Salt Lake City, Utah, to reduce special education needs. Goldman Sachs has also recently announced the development of a

Can Genetics Predict Response to Complex Behavioral Interventions? Evidence from a Genetic Analysis of the Fast Track Randomized Control Trial

250 million social impact … Address correspondence to D. Max Crowley, PhD, Center for Child and Family Policy, Box 90545, Durham, NC 27705. E-mail: max.crowley{at}duke.edu

Evaluating the Impact of Implementation Factors on Family-Based Prevention Programming: Methods for Strengthening Causal Inference

The aftermath of the global recession has encouraged policy makers to confront the staggering public burden of crime (Cohen, 1988, 2005; Ludwig, 2010; McCollister, French, and Fang, 2010; Miller, Cohen, and Rossman, 1993). In this context, there is growing acceptance that many “tough-on-crime” policies have become primary drivers of crime’s increasing societal cost (Andrews and Bonta, 2010; Artello, 2013; Becker, 1968; Braga and Weisburd, 2011; Cameron, 1988; Cohen, 2005; Paternoster, 2010; Rikard and Rosenberg, 2007; Vitiello, 2013). Policy makers have responded with growing interest in making strategic investments in youth that prevent the development of lifetime offenders, instead of continuing to institute harsher punishments that lead to costly mass incarceration (Dodge, 2001; Farrington, 1994; Heckman, 2006; Homel, 2013; O’Connell, Boat, and Warner, 2009). In response, innovative strategies for preventing crime and controlling costs are being engaged (Barnett and Masse, 2007; Guyll, Spoth, and Crowley, 2011; Welsh and Farrington, 2010). At the forefront are developmental prevention programs that intervene early in life to reduce risk factors for delinquent and criminal behaviors (Durlak, 1998; Eckenrode et al., 2010; Hawkins, Catalano, and Miller, 1992; Hawkins and Weis, 1985; Reynolds, Temple, White, Ou, and Robertson, 2011). As a growing body of evidence illustrates, when implemented appropriately, these developmental prevention efforts not only effectively prevent crime but also are cost-effective solutions that save public resources (Crowley, Hill, Kuklinski, and Jones, 2013; Crowley, Jones, Greenberg, Feinberg, and Spoth, 2012; Heckman, Moon, Pinto, Savelyev, and Yavitz, 2010; Klietz, Borduin, and Schaeffer, 2010; Kuklinski, Briney, Hawkins, and Catalano, 2012; Reynolds et al., 2011). Manning, Smith, and Homel (2013, this issue) outline an innovative approach for valuing these programs to guide policy making. Their work draws on Saaty’s analytical hierarchy process (AHP), often used in the private sector, but less frequently in policy settings (Saaty, 1988). This method ultimately provides an important framework for discussing how to build effective and efficient crime prevention efforts informed by developmental science (Gifford-Smith, Dodge, Dishion, and McCord, 2005; Lerner et al., 2005; Osgood, 2005). In this essay, I expand on Manning et al.’s (2013) discussion by highlighting how this new approach can complement current efforts to value developmental crime prevention programs for evidence-based policy making. I then discuss the importance of considering local programming capacity when investing in prevention and the economic value of prevention approaches that invest in both youth and their families (i.e., dual-generation approaches). Next, I provide a forward look at two approaches policy makers can engage when seeking to fund developmental prevention. I then conclude with four action steps for research and policy that can facilitate the dissemination of effective and efficient developmental crime prevention efforts.

Economic analysis of methamphetamine prevention effects and employer costs.

Prevention advocates often make the case that preventive intervention not only improves public health and welfare but also can save public resources. Increasingly, evidence-based policy efforts considering prevention are focusing on how programs can save taxpayer resources from reduced burden on health, criminal justice, and social service systems. Evidence of prevention’s return has begun to draw substantial investments from the public and private sector. Yet, translating prevention effectiveness into economic impact requires specific economic analyses to be employed across the stages of translational research. This work discusses the role of economic analysis in prevention science and presents key translational research opportunities to meet growing demand for estimates of prevention’s economic and fiscal impact.