More Evidence That CTC Is a Good Investment: Benefit-Cost Analysis of CTC Effects on Substance Use, Crime, and College Completion at Age 23

Introduction: Economic evaluations that document long-term benefit and favorable returns on investment can help motivate support for evidence-based intervention. Communities That Care (CTC) is a community prevention system tested in the Community Youth Development Study, a longitudinal randomized controlled trial involving a panel of 4,407 youth from 24 communities in 7 states. Panel reports have consistently supported CTC’s efficacy from age 10 baseline through age 23. We previously conducted benefit-cost analyses of CTC based on impacts on substance use and delinquency that were found at two important developmental transitions: the end of middle school and the end of high school. Both analyses indicated that CTC was cost-beneficial. The panel passed another salient developmental transition when they entered legal adulthood at age 21. Now age 23, several have also completed higher education. This presentation reports our latest economic evaluation of CTC, based on effects sustained through age 23.

Methods: We used extensive project records (e.g., project invoices, personnel logs, receipts) to estimate the cost per youth of delivering CTC during the five-year trial. We estimated total costs and the cost of key intervention components: training, technical assistance, and monitoring; coalition costs; intervention delivery. We estimated the total lifetime economic benefit per youth expected from CTC’s (a) sustained delays in the initiation of alcohol use, cigarette smoking, and crime from grade 12 through age 23, and (b) positive effect on college completion observed at age 23. We examined benefits by source (e.g., improved earnings, avoided health care and criminal justice systems costs) and beneficiary (e.g., participants, taxpayers). We compared long-term benefits to costs (all values in discounted, 2014 dollars per youth) to see if CTC was a cost-beneficial investment.

Results: CTC cost $584 per youth for 5 years of intervention but preliminary estimates indicate $8,484 in benefits per youth, resulting in a net present value (benefits less costs per youth) of $7,900 and return of $14.53 per dollar invested over the long term. The primary source of benefit was increased earnings, and the major beneficiaries were participants and taxpayers.

Conclusions: This BCA provides further support that CTC is a cost-beneficial investment. New evidence that CTC led to higher rates of college completion substantially increased the return on investment compared to prior analyses. They underscore the importance of renewing BCAs at developmental transitions to incorporate possible cascading effects in benefits estimates.