A Cost Analysis of the Legacy for Childrentm Program in Two Diverse Communities

Introduction: Although research gives strong indication that early childhood education is an important mechanism for promoting development among children in poverty, the cost of these interventions is less clear. Our research describes the process for collecting and analyzing the programmatic costs associated with one promising prevention program targeting children in poverty – the Legacy for Children^TM (Legacy) program developed by the Centers for Disease Control and Prevention, and implemented and evaluated in Los Angeles and Miami.

 Methods: Prospective collection of the programmatic inputs and outputs required to implement and run the Legacy intervention took place from October 2000 to March 2007 for the Los Angeles site and from April 2001 to October 2008 for the Miami site. Programmatic costs were assessed from the provider perspective, meaning those costs that accrued to the provider delivering the intervention only, exclusive of participant costs or other non-provider costs, and included only the value of budgeted resources required to deliver the intervention. Program costs occurred at the intervention group level and intervention administrative level. For family-level estimates, administrative costs were not evenly distributed, as groups that met more frequently were likely to require more resources. Program outputs were broadly categorized into pre-implementation and implementation, and program inputs included labor, space, supplies, and equipment. Data sources for the cost analysis included site invoices, time and activity diaries, and information collected from site study coordinators.

 Results: The total implementation costs, in 2008 US dollars, were $2,187,718 for the 5-year program implemented in Miami and $1,412,066 for the 3-year implementation in Los Angeles. When assessing costs based on the number of families participating in the intervention and assuming natural attrition, Miami cost $18,000 per family served compared to $13,000 per family served in Los Angeles. For Miami, roughly half of all the implementation costs were for labor (54.2%), compared to a much larger proportion (81.6%) in Los Angeles.

 Conclusions: The methods for collecting and analyzing the costs for the Legacy intervention provide a template for others in the field of early childhood education who are considering future economic evaluations. Estimates of Legacy total intervention costs, costs by group, and costs by activity level should be useful for both interested stakeholders in the intervention and for future analyses that compare the intervention costs to relevant program outcomes and impacts.