Washington State Institute for Public Policy
Strengthening Families for Parents and Youth 10-14
Public Health & Prevention: Home- or Family-based
Benefit-cost estimates updated December 2016.  Literature review updated April 2012.
Strengthening Families for Parents and Youth 10-14 (also known as the Iowa Strengthening Families Program) is a family-based program that attempts to reduce behavior problems and substance use by enhancing parenting skills, parent-child relationships, and family communication. The seven-week intervention is designed for 6th grade students and their families.
The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2015). The chance the benefits exceed the costs are derived from a Monte Carlo risk analysis. The details on this, as well as the economic discount rates and other relevant parameters are described in our Technical Documentation.
Benefit-Cost Summary Statistics Per Participant
Benefits to:
Taxpayers $1,076 Benefits minus costs $3,301
Participants $2,106 Benefit to cost ratio $5.00
Others $1,336 Chance the program will produce
Indirect ($392) benefits greater than the costs 71 %
Total benefits $4,126
Net program cost ($825)
Benefits minus cost $3,301
1In addition to the outcomes measured in the meta-analysis table, WSIPP measures benefits and costs estimated from other outcomes associated with those reported in the evaluation literature. For example, empirical research demonstrates that high school graduation leads to reduced crime. These associated measures provide a more complete picture of the detailed costs and benefits of the program.

2“Others” includes benefits to people other than taxpayers and participants. Depending on the program, it could include reductions in crime victimization, the economic benefits from a more educated workforce, and the benefits from employer-paid health insurance.

3“Indirect benefits” includes estimates of the net changes in the value of a statistical life and net changes in the deadweight costs of taxation.
Detailed Monetary Benefit Estimates Per Participant
Benefits from changes to:1 Benefits to:
Taxpayers Participants Others2 Indirect3 Total
Crime $148 $0 $344 $74 $566
Labor market earnings associated with high school graduation $1,029 $2,265 $1,037 $0 $4,331
K-12 grade repetition $5 $0 $0 $2 $7
K-12 special education $1 $0 $0 $0 $1
Property loss associated with alcohol abuse or dependence $0 $2 $3 $0 $5
Health care associated with disruptive behavior disorder $1 $0 $1 $1 $3
Costs of higher education ($107) ($161) ($50) ($54) ($372)
Adjustment for deadweight cost of program $0 $0 $0 ($415) ($415)
Totals $1,076 $2,106 $1,336 ($392) $4,126
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $754 2009 Present value of net program costs (in 2015 dollars) ($825)
Comparison costs $0 2009 Cost range (+ or -) 10 %
Costs are based on unit costs provided in Suter, C. (2010). Economic Evaluation of a Community-Based, Family-Skills Prevention Program (Master’s Thesis). Washington State University. Our estimate includes Suter's total cost per program, divided by average number of families per program in the study.
The figures shown are estimates of the costs to implement programs in Washington. The comparison group costs reflect either no treatment or treatment as usual, depending on how effect sizes were calculated in the meta-analysis. The cost range reported above reflects potential variation or uncertainty in the cost estimate; more detail can be found in our Technical Documentation.
Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)
The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic in order to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the types of program impacts that were measured in the research literature (for example, crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases.

Adjusted effect sizes are used to calculate the benefits from our benefit cost model. WSIPP may adjust effect sizes based on methodological characteristics of the study. For example, we may adjust effect sizes when a study has a weak research design or when the program developer is involved in the research. The magnitude of these adjustments varies depending on the topic area.

WSIPP may also adjust the second ES measurement. Research shows the magnitude of some effect sizes decrease over time. For those effect sizes, we estimate outcome-based adjustments which we apply between the first time ES is estimated and the second time ES is estimated. We also report the unadjusted effect size to show the effect sizes before any adjustments have been made. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured Primary or secondary participant No. of effect sizes Treatment N Adjusted effect sizes (ES) and standard errors (SE) used in the benefit-cost analysis Unadjusted effect size (random effects model)
First time ES is estimated Second time ES is estimated
ES SE Age ES SE Age ES p-value
Alcohol use before end of middle school 1 153 -0.128 0.184 13 -0.128 0.184 18 -0.387 0.036
Disruptive behavior disorder symptoms 2 284 -0.007 0.103 13 -0.003 0.053 16 -0.055 0.741
Alcohol use in high school 1 152 -0.069 0.235 15 -0.069 0.235 18 -0.210 0.359
Smoking in high school 1 152 -0.172 0.219 15 -0.172 0.219 18 -0.523 0.019
Cannabis use in high school 1 152 -0.288 0.323 15 -0.288 0.323 18 -0.874 0.011
Illicit drug use in high school 1 151 -0.105 0.152 15 -0.105 0.152 18 -0.317 0.038
Internalizing symptoms 2 192 -0.112 0.102 13 -0.082 0.086 15 -0.339 0.001
Citations Used in the Meta-Analysis

Gottfredson, D., Kumpfer, K., Polizzi-Fox, D., Wilson, D., Puryear, V., Beatty, P., & Vilmenay, M. (2006). The Strengthening Washington D.C. Families Project: A randomized effectiveness trial of family-based prevention. Prevention Science, 7(1), 57-74.

Spoth, R., Redmond, C., & Lepper, H. (1999). Alcohol initiation outcomes of universal family-focused preventive interventions: One- and two-year follow-ups of a controlled study. Journal of Studies on Alcohol, 13, 103-111.

Spoth, R., Reyes, M.L., Redmond, C., & Shin, C. (1999). Assessing a public health approach to delay onset and progression of adolescent substance use: Latent transition and loglinear analyses of longitudinal family preventive intervention outcomes. Journal of Consulting and Clinical Psychology, 67(5), 619-630.

Spoth, R.L., Redmond, C., & Shin, C. (2000). Reducing adolescents' aggressive and hostile behaviors: Randomized trial effects of a brief family intervention 4 years past baseline. Archives of Pediatrics & Adolescent Medicine, 154(12), 1248-1258.

Spoth, R.L., Redmond, C., & Shin, C. (2001). Randomized trial of brief family interventions for general populations: Adolescent substance use outcomes 4 years following baseline. Journal of Consulting and Clinical Psychology, 69(4), 627-642.

Spoth, R.L., Clair, S., Shin, C., & Redmond, C. (2006). Long-term effects of universal preventive interventions on methamphetamine use among adolescents. Archives of Pediatrics & Adolescent Medicine, 160(9), 876-882.

Trudeau, L., Spoth, R., Randall, G., & Azevedo, K. (2007). Longitudinal effects of a universal family-focused intervention on growth patterns of adolescent internalizing symptoms and polysubstance use: Gender comparisons. Journal of Youth and Adolescence, 36(6), 725-740.

For more information on the methods
used please see our Technical Documentation.