2021 · Study · English

Long-term Impacts and Benefit–Cost Analysis of the Communities That Care Prevention System at Age 23, 12 Years After Baseline

Kuklinski, M. R., Oesterle, S., Briney, J. S., & Hawkins, J. D.

Kuklinski, M. R., Oesterle, S., Briney, J. S., & Hawkins, J. D. (2021). Long-term Impacts and Benefit–Cost Analysis of the Communities That Care Prevention System at Age 23, 12 Years After Baseline. Prevention Science, 22(4), 452–463. doi.org/10.1007/s11121-021-01218-7

Summary

Longest follow-up of the CTC trial, in Prevention Science: the panel of 4,407 young people from 24 communities was surveyed at age 23, twelve years after baseline in grade 5. Primary outcomes were lifetime abstinence from substance use and antisocial behaviour; secondary outcomes were four-year college completion, major depression and generalised anxiety. CTC showed a statistically significant global effect on the primary outcomes and on primary and secondary outcomes combined. Point estimates put the absolute gain in lifetime abstinence at 3.5–6.1 percentage points (13–55% relative), though confidence intervals were wide; college completion was 1.9 points higher (20% relative) and mental health did not differ. The authors call these sustained effects small. Benefit–cost analysis nonetheless found CTC reliably cost-beneficial: net present value $7,152 per participant (95% credible interval $1,253–$15,268) from primary impacts and $17,919 ($306–$39,186) with secondary ones, still positive after discounting for the developer’s involvement in the trial. The central reference for the economic case for CTC.