1
|
Rice KL, Ottley P, Bing M, McMonigle M, Miller GF. Costs of Implementing Teen Dating Violence and Youth Violence Prevention Strategies: Evidence From 5 CDC-Funded Local Health Departments. Public Health Rep 2024; 139:351-359. [PMID: 37846099 PMCID: PMC11037232 DOI: 10.1177/00333549231201615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVES In 2016, the Centers for Disease Control and Prevention supported 5 local health departments (LHDs) to implement teen dating violence and youth violence primary prevention strategies across multiple levels of the social-ecological model and build capacity for the expansion of such prevention efforts at the local level. The objective of this study was to estimate the total cost of implementing primary prevention strategies for all LHDs across 3 years of program implementation. METHODS We used a microcosting analytic approach to identify resources and compute costs for all prevention strategies implemented by LHDs. We computed the total program cost, total and average cost per strategy by social-ecological model level, and average cost of implementation per participant served by the program. All costs were inflated via the monthly Consumer Price Index and reported in August 2020 dollars. RESULTS For 3 years of program implementation, the total estimated cost of implementing teen dating violence and youth violence primary prevention strategies was >$7.1 million across all 5 LHDs. The largest shares of program-related costs were program staff (55.9%-57.0%) and contracts (22.4%-25.5%). Among prevention strategies, the largest share of total costs was for strategies implemented at the community level of the social-ecological model (42.8%). CONCLUSIONS The findings from this analysis provide a first look at the total costs of implementing comprehensive teen dating violence and youth violence primary prevention strategies and serve as a foundation for investments in local violence prevention funding for young people.
Collapse
Affiliation(s)
- Ketra L. Rice
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Phyllis Ottley
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Melissa Bing
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Megan McMonigle
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gabrielle F. Miller
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
2
|
Melendez-Torres GJ, Orr N, Farmer C, Shaw N, Chollet A, Rizzo AJ, Kiff F, Rigby E, Hagell A, Priolo Filho SR, Taylor B, Young H, Bonell C, Berry V. School-based interventions TO Prevent Dating and Relationship Violence and Gender-Based Violence: STOP-DRV-GBV systematic review. PUBLIC HEALTH RESEARCH 2024; 12:1-192. [PMID: 38421001 DOI: 10.3310/ktwr6997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Background Schools have a duty of care to prevent violence between students but a significant amount of dating and relationship violence and gender-based violence occurs in schools. These are important public health issues with important longitudinal consequences for young people. Objectives To understand functioning and effectiveness of school-based interventions for the prevention of dating and relationship violence and gender-based violence. Review methods We undertook a mixed-methods systematic review to synthesise different types of evidence relating to school-based interventions for the prevention of dating and relationship violence and gender-based violence to understand if, how and in what ways these interventions are effective. We searched 21 databases and 2 trial registers and undertook forwards and backwards citation chasing, author contact and other supplementary search methods. Searches identified all literature published to June 2021. All screening was undertaken in duplicate and independently, and we quality appraised all included studies. Results We included 247 reports (68 outcome evaluations, 137 process evaluations). Synthesis of intervention components produced an intervention typology: single-component, curricular, multicomponent, and multilevel programmes. Synthesis of intervention theories suggested that interventions aiming to increase students' sense of school belonging and sense of safety in the school building could encourage increased learning of prosocial skills and increased prosocial peer norms, and so potentially reducing dating and relationship violence and gender-based violence. Synthesis of factors affecting delivery highlighted school organisation and leaders who believed in the importance of addressing dating and relationship violence/gender-based violence, along with time and resources to deliver the interventions. The ease with which the intervention could be delivered and modified was also important. Meta-analysis found stronger evidence for intervention effectiveness in reducing dating and relationship violence than for gender-based violence, with significant long-term impacts on dating and relationship violence victimisation and perpetration, and some evidence that interventions in high-income countries could be effective for reducing victimisation and perpetration of gender-based violence in the long-term. Impacts on knowledge and attitudes were primarily short-term. Network meta-analysis did not suggest superiority of any intervention type. Moderation evidence suggested interventions reduced dating and relationship violence perpetration in boys more than girls, but reduced gender-based violence perpetration more in girls. Metaregression by intervention component did not explain heterogeneity in effectiveness, but qualitative comparative analysis suggested that reducing perpetration was important to reducing victimisation, and that perpetration could be reduced via focus on interpersonal skills, guided practice and (for gender-based violence) implementation of social structural components. Limitations Despite an exhaustive search, trials may have been missed and risk of publication bias was high for several analyses. Conclusions This is the most comprehensive systematic review of school-based interventions for dating and relationship violence and gender-based violence to date. It is clear that the prevention of dating and relationship violence and gender-based violence in schools will require longer-term investment to show benefit. Future work Future research is needed to understand why intervention effectiveness appears stronger for dating and relationship violence than gender-based violence. Study registration The study is registered as PROSPERO CRD42020190463. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR130144) and is published in full in Public Health Research; Vol. 12, No. 3. See the NIHR Funding and Awards website for further award information.
Collapse
Affiliation(s)
| | - Noreen Orr
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Caroline Farmer
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Naomi Shaw
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Annah Chollet
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Andrew J Rizzo
- College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Fraizer Kiff
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Emma Rigby
- Association for Young People's Health, London, UK
| | - Ann Hagell
- Association for Young People's Health, London, UK
| | | | - Bruce Taylor
- National Opinion Research Center, University of Chicago, Chicago, IL, USA
| | - Honor Young
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Chris Bonell
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Vashti Berry
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| |
Collapse
|
3
|
Weber E, Peskin MF, Markham CM, Shegog R, Baumler ER, Addy RC, Temple JR, Hernandez B, Cuccaro P, Thiel MA, Gabay EK, Emery ST. Economic Evaluation of an Intervention to Prevent Adolescent Dating Violence (Me & You). JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2983-3010. [PMID: 35617674 PMCID: PMC11010237 DOI: 10.1177/08862605221104534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Me & You: Building Healthy Relationships (Me & You) is a multilevel, technology-enhanced adolescent dating violence (DV) prevention program that aimed to reduce DV among ethnic-minority, early adolescent, urban youth. A group-randomized control trial of Me & You, conducted with 10 middle schools from a large urban school district in Southeast Texas in 2014-2015, found it to be effective in reducing DV perpetration and decreasing some forms of DV victimization. Economic evaluations of DV interventions are extremely limited, despite calls for more economic analyses to be incorporated in research. We help fill this gap by evaluating the cost-effectiveness from the payer and societal perspectives of implementing the Me & You program. Using cost data collected alongside the Me & You group-randomized trial, we computed incremental cost-effectiveness ratios. Our primary outcome was "any DV perpetrated" within 12 months of the intervention. We conducted a cost-benefit analysis beyond the intervention endpoint by using literature estimates of per-victim lifetime costs of DV. We performed sensitivity analyses to assess effects of uncertain parameters. Under the base-case scenario, the cost of the Me & You curriculum compared to the standard curriculum was $103.70 per-student from the societal perspective, and the effectiveness was 34.84 perpetrations averted, implying an incremental cost per perpetration averted of $2.98, which ranged from $0.48 to $73.24 in sensitivity analysis. Thus, we find the Me & You curriculum is cost-effective and cost-saving in most scenarios. Policymakers should carefully consider school-based DV prevention programs, and cost data should be regularly collected in adolescent prevention program evaluations.
Collapse
Affiliation(s)
- Ellerie Weber
- UTHealth, Deptartment of Management, Policy & Community Health, Houston, TX, USA
- Icahn School of Medicine at Mount Sinai, NY, USA
| | - Melissa F. Peskin
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | | | - Ross Shegog
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | - Elizabeth R. Baumler
- UTHealth, Deptartment of Management, Policy & Community Health, Houston, TX, USA
- UTMB, Center for Violence Prevention, Galveston, TX, USA
| | - Robert C. Addy
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | - Jeff R. Temple
- UTMB, Center for Violence Prevention, Galveston, TX, USA
| | - Belinda Hernandez
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | - Paula Cuccaro
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | - Melanie A. Thiel
- UTHealth, Deptartment of Management, Policy & Community Health, Houston, TX, USA
- UTMB, Center for Violence Prevention, Galveston, TX, USA
| | - Efrat K. Gabay
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | | |
Collapse
|
4
|
Tang S, Paglisotti TE, Ports KA, Abebe KZ, Jones KA, Levtov R, Kato-Wallace J, Miller E. Cost Analysis of Community-Based Violence Prevention Programs: Manhood 2.0 and Job Skills Programs. JOURNAL OF FAMILY VIOLENCE 2022; 39:449-456. [PMID: 38617027 PMCID: PMC11010587 DOI: 10.1007/s10896-022-00481-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 11/27/2022] [Accepted: 11/30/2022] [Indexed: 04/16/2024]
Abstract
Purpose Sexual violence (SV) and adolescent relationship abuse (ARA) are common in the U. S. and have strong associations with negative health and wellbeing outcomes. Manhood 2.0 is the first U.S. program designed for community settings to build bystander skills while also challenging harmful gender norms. A cluster-randomized trial comparing Manhood 2.0 to Job Skills, a job readiness training control condition, demonstrated that it is a promising strategy to prevent sexual violence and adolescent relationship abuse. Such community-based interventions may be particularly relevant in lower resource urban settings, and the costs of such prevention programs have not been considered previously. Methods The aim of the present study is to perform systematic and standardized cost calculations associated with implementing Manhood 2.0 among adolescent males. In addition, this study provides detailed cost information of the community-based intervention program, as well as costs associated with implementing the Job Skills control program. Program implementation data were recorded throughout the study period (2015-2019) by the Manhood 2.0 study team. Results The cost of implementing Manhood 2.0 is $4,771 per complete round of program delivery and $451 per participant, which is approximately the same cost as the control Job Skills program ($4,432 and $453 per participant). The marginal cost per additional round of Manhood 2.0 program is $3,682. Conclusion Implementation of a community-based program requires substantial resources and collaborations with community partners especially in economically disadvantaged neighborhoods. This study provides a snapshot of the cost information of a community-based intervention program from the implementing agency's perspective, which is essential in helping decision-makers understand the costs they will incur by implementing prevention programs and ensuring program feasibility and sustainability.
Collapse
Affiliation(s)
- Shichao Tang
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, US
- Present address: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop S107-3, 4770 Buford Highway NE, GA - Georgia 30341 Atlanta, United States
| | - T. Even Paglisotti
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, US
| | - Katie A. Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, US
| | - Kaleab Z. Abebe
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, US
| | - Kelley A. Jones
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, US
| | | | | | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, US
| |
Collapse
|
5
|
Kiff F, Shaw N, Orr N, Rizzo AJ, Chollet A, Young H, Rigby E, Hagell A, Berry V, Bonell C, Melendez-Torres GJ, Farmer C. Systematic Review of the Economics of School-Based Interventions for Dating Violence and Gender-Based Violence. HEALTH EDUCATION & BEHAVIOR 2022; 50:339-346. [PMID: 36503294 PMCID: PMC10164611 DOI: 10.1177/10901981221138064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Dating and relationship violence (DRV) and gender-based violence (GBV) among children and young people incur a high cost to individuals and society. School-based interventions present an opportunity to prevent DRV and GBV early in individuals’ lives. However, with school resources under pressure, policymakers require guidance on the economics of implementing interventions. As part of a large systematic review funded by the National Institute for Health and Care Research (NIHR), we searched for economic evaluations and costing studies of school-based interventions for DRV and GBV. No formal economic evaluations were identified. Seven studies reporting costs, cost savings, or resource use for eight interventions were identified. The largest costs of implementing interventions were related to staff training and salaries but savings could be made by implementing interventions on a large scale. The potential cost savings of avoided DRV and GBV far outweighed the costs of implementation.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Emma Rigby
- Association for Young People’s Health, London, UK
| | - Ann Hagell
- Association for Young People’s Health, London, UK
| | | | - Chris Bonell
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | |
Collapse
|
6
|
Matjasko JL, Herbst JH, Estefan LF. Preventing Adverse Childhood Experiences: The Role of Etiological, Evaluation, and Implementation Research. Am J Prev Med 2022; 62:S6-S15. [PMID: 35597583 PMCID: PMC9215220 DOI: 10.1016/j.amepre.2021.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/24/2021] [Accepted: 10/06/2021] [Indexed: 11/11/2022]
Abstract
Research on adverse childhood experiences is a vital part of the data-to-action link and the development of evidence-based public health and violence prevention practice. Etiological research helps to elucidate the key risk and protective factors for adverse childhood experiences and outcome research examines the consequences of exposure to them. Evaluation research is critical to building the evidence base for strategies that are likely to have a significant impact on preventing and reducing adverse experiences during childhood. Implementation research efforts inform the movement and scale-up of evidence-based findings to public health practice. The Centers for Disease Control and Prevention's Division of Violence Prevention located in the National Center for Injury Prevention and Control is investing in a number of research initiatives that are designed to advance what is known about the causes and consequences of adverse childhood experiences (i.e., etiological research), the strategies that are effective at reducing and preventing them (i.e., evaluation research), and how to best adapt and scale effective strategies (i.e., implementation research). This article complements the other articles in this Special Supplement by briefly providing a review of reviews for each of these areas and highlighting recent research investments and strategic directions by the Centers for Disease Control and Prevention in the area of child abuse and neglect and adverse childhood experience prevention. Research investments are critical to advancing the evidence base on the prevention of adverse childhood experiences and to ensure safe, stable, and nurturing relationships and environments so that all children can live to their fullest potential.
Collapse
Affiliation(s)
- Jennifer L Matjasko
- Division of Violence Prevention, National Center for Injury Prevention and Control (NCIPC), U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Jeffrey H Herbst
- Division of Violence Prevention, National Center for Injury Prevention and Control (NCIPC), U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lianne Fuino Estefan
- Division of Violence Prevention, National Center for Injury Prevention and Control (NCIPC), U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
7
|
DeGue S, Niolon PH, Estefan LF, Tracy AJ, Le VD, Vivolo-Kantor AM, Little TD, Latzman NE, Tharp A, Lang KM, Taylor B. Effects of Dating Matters® on Sexual Violence and Sexual Harassment Outcomes among Middle School Youth: a Cluster-Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:175-185. [PMID: 32844328 PMCID: PMC7840649 DOI: 10.1007/s11121-020-01152-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sexual violence (SV), including sexual harassment (SH), is a significant public health problem affecting adolescent health and well-being. This study extends prior research by evaluating the effectiveness of a comprehensive teen dating violence prevention model, Dating Matters, on SV and SH perpetration and victimization, inclusive of any victim-perpetrator relationship, among middle school students. Dating Matters includes classroom-delivered programs for youth in 6th, 7th, and 8th grades; community-based programs for parents; a youth communications program; training for educators; and community-level activities. Middle schools in four urban areas in the USA were randomly assigned to receive Dating Matters (DM, N = 22) or a standard-of-care intervention (SC, N = 24) over four consecutive school years (2012-2016). The analytic sample included two cohorts who entered the study in 6th grade and completed 8th grade by the end of the study allowing for full exposure to Dating Matters (DM: N = 1662; SC: N = 1639; 53% female; 50% black, non-Hispanic; 6 waves of data collection for each cohort). Structural equation modeling was employed with multiple imputation to account for missing data. Dating Matters was associated with significant reductions in SV and SH perpetration and victimization scores in most-but not all-sex/cohort groups by the end of 8th grade relative to an evidence-based TDV prevention program. On average, students receiving Dating Matters scored 6% lower on SV perpetration, 3% lower on SV victimization, 4% lower on SH perpetration, and 8% lower on SH victimization by the end of middle school than students receiving an evidence-based violence prevention program. Overall, Dating Matters shows promise for reducing SV and SH, occurring both within and outside dating relationships, through middle school. Clinicaltrials.gov Identifier: NCT01672541.
Collapse
Affiliation(s)
- Sarah DeGue
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-F63, Atlanta, GA, 30341, USA.
| | - Phyllis Holditch Niolon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-F63, Atlanta, GA, 30341, USA
| | - Lianne Fuino Estefan
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-F63, Atlanta, GA, 30341, USA
| | | | - Vi D Le
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-F63, Atlanta, GA, 30341, USA
| | - Alana M Vivolo-Kantor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-F63, Atlanta, GA, 30341, USA
| | - Todd D Little
- Institute for Measurement, Methodology, Analysis and Policy, Texas Tech University, Lubbock, TX, USA
| | - Natasha E Latzman
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-F63, Atlanta, GA, 30341, USA
| | - Andra Tharp
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-F63, Atlanta, GA, 30341, USA
| | - Kyle M Lang
- Institute for Measurement, Methodology, Analysis and Policy, Texas Tech University, Lubbock, TX, USA
| | - Bruce Taylor
- NORC at the University of Chicago, Chicago, IL, USA
| |
Collapse
|