Investing in Prevention Infrastructure: Economic Evaluation of the PROSPER System

National Institute on Drug Abuse (NIDA)
Award Number: R01DA0579967
Administered in: College of Health and Human Development

Abstract:

This study evaluates the economic impact of a major NIDA-funded prevention delivery and support system for evidence-based preventive interventions (EBPIs) known as PROSPER (PROmoting School/community-university Partnerships to Enhance Resilience). This research builds on the existing randomized trial of PROSPER that delivered EBPIs to over 12,000 youth in rural communities 18 to 20 years ago and cultivated sustained high-quality local prevention efforts. These community prevention teams selected and implemented family-focused and school-based EBIs for middle school students in 6th and 7th grade. Initial assessments followed students from pretest (6th grade) through 12th grade (five years post-intervention). Prior funded research pointed to consistent findings for reduced substance misuse among intervention participants. These earlier findings warrant further investigation of the economic implications. Consequently, this study allows us to assess how long-term effects of the intervention translate into economic benefits through adulthood. Beyond estimating the full economic impact of the PROSPER system, we also assess how local program implementation and supportive systemic factors may influence the efficiency of universal prevention efforts, providing needed information around how to build efficient substance abuse prevention efforts. The specific aims of this study are to: (1) Evaluate the economic impact of the PROSPER model for preventing substance misuse; (2) Model how variation in local prevention infrastructure influences economic impact; and (3) Assess how individual risk factors impact prevention efficiency. Prior work demonstrated how the resources necessary for program delivery can be managed more efficiently within a prevention delivery system that cultivates sustainable funding streams to support long-term dissemination. This research follows this investigation by evaluating how these increased efficiencies can improve the likelihood for positive economic benefit resulting from intervention effectiveness. Importantly, this inquiry examines the range of expected economic outcomes given variation in implementation factors for program delivery, leveraging unique detailed data assessing this. Further, investigations of how economic impact may vary due to participant characteristics will further inform policy makers of the range of outcomes that could be expected. Thus, this research provides a unique opportunity to determine the long-term economic benefit from an efficient prevention delivery system’s impact on reduced substance misuse and risky behavior among adolescents.