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Washington State Institute for Public Policy
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LifeSkills Training

Public Health & Prevention: School-based
Benefit-cost methods last updated December 2023.  Literature review updated June 2014.
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LifeSkills Training (LST) is a school-based classroom intervention to reduce the risks of alcohol, tobacco, drug abuse, and violence by targeting social and psychological factors associated with initiation of risky behaviors. Teachers deliver the program to middle/junior high school students in 24 to 30 sessions over three years. Students in the program are taught general self-management and social skills and skills related to avoiding substance use.
 
ALL
BENEFIT-COST
META-ANALYSIS
CITATIONS
For an overview of WSIPP's Benefit-Cost Model, please see this guide. The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2022). 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 $563 Benefits minus costs $1,763
Participants $1,295 Benefit to cost ratio $15.97
Others $48 Chance the program will produce
Indirect ($25) benefits greater than the costs 63%
Total benefits $1,881
Net program cost ($118)
Benefits minus cost $1,763

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. See Estimating Program Effects Using Effect Sizes for additional information.

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 Treatment age 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
Smoking before end of middle school
Any smoking of tobacco by the end of middle school, typically by age 13.
 13 8 3617 -0.028 0.033 14 -0.028 0.033 14 -0.083 0.012
Cannabis use before end of middle school
Any use of cannabis by the end of middle school, typically by age 13.
13 4 3056 -0.014 0.033 14 -0.014 0.033 14 -0.041 0.217
Alcohol use before end of middle school
Any use of alcohol by the end of middle school, typically by age 13.
13 5 3150 -0.026 0.033 14 -0.026 0.033 14 -0.080 0.017
Internalizing symptoms
Symptoms of internalizing behavior (e.g., sadness, anxiety, or withdrawal) measured on a validated scale.
 13 4 3092 -0.018 0.091 14 -0.018 0.091 16 -0.054 0.549
Alcohol use before end of high school
Any use of alcohol by the end of high school, typically between ages 14 and 18.
13 3 280 0.034 0.074 18 0.034 0.074 18 0.028 0.702
Smoking before end of high school
Any smoking of tobacco by the end of high school, typically between ages 14 and 18.
 13 4 359 -0.076 0.073 18 -0.076 0.073 18 -0.128 0.129
Cannabis use before end of high school
Any use of cannabis by the end of high school, typically between ages 14 and 18.
13 3 280 0.000 0.077 18 0.000 0.077 18 -0.007 0.398
Problem alcohol use
Alcohol use reflecting problem behaviors (e.g., high frequency drinking, binge drinking, or drinking that has a high impact on daily life) for individuals who do not have an alcohol use disorder.
 13 2 1947 -0.059 0.116 15 -0.059 0.116 25 -0.241 0.421
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
Affected outcome: Resulting benefits:1 Benefits accrue to:
Taxpayers Participants Others2 Indirect3 Total
Problem alcohol use Labor market earnings associated with problem alcohol use $544 $1,282 $0 $0 $1,826
Property loss associated with problem alcohol use $0 $3 $6 $0 $9
Health care associated with problem alcohol use $33 $6 $36 $16 $92
Mortality associated with problem alcohol $2 $4 $0 $25 $31
Internalizing symptoms K-12 grade repetition $1 $0 $0 $0 $1
Alcohol use before end of high school Criminal justice system ($16) $0 ($39) ($8) ($63)
Program cost Adjustment for deadweight cost of program $0 $0 $0 ($59) ($14)
Totals $563 $1,295 $48 ($25) $1,881
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Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $34 2013 Present value of net program costs (in 2022 dollars) ($118)
Comparison costs $0 2013 Cost range (+ or -) 10%
The cost estimate assumes teachers deliver 7.5 hours of the intervention over ten sessions per year (the program is typically implemented for three years) to approximately 26 students per class. The estimate includes cost for training and student materials based on data from Blueprints for Healthy Youth Development and the developer’s website (http://www.blueprintsprograms.com/program-costs/lifeskills-training-lst; https://www.lifeskillstraining.com/2016-PHP-Price-List.pdf).
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.
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
Benefits Minus Costs Over Time (Cumulative 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 discounted dollars. 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.

Citations Used in the Meta-Analysis

Botvin, G.J., Baker, E., Botvin, E.M., Filazzola, A.D., & Millman, R.B. (1984). Prevention of alcohol misuse through the development of personal and social competence: A pilot study. Journal Studies on Alcohol, 45(6), 550-552.

Botvin, G.J., Baker, E., Dusenbury, L., Botvin, E. M., & Diaz, T. (1995). Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. Journal of the American Medical Association, 273(14), 1106-1112.

Botvin, G.J., Baker, E., Dusenbury, L., Tortu, S., & Botvin, E.M. (1990). Preventing adolescent drug abuse through a multimodal cognitive-behavioral approach: Results of a 3-year study. Journal of Consulting and Clinical Psychology, 58(4), 437-446.

Botvin, G.J., Batson, H.W., Witts-Vitale, S., Bess, V., Baker, E., Dusenbury, L. (1989). A psychosocial approach to smoking prevention for urban Black youth. Public Health Reports, 104(6), 573-583.

Botvin, G.J., Baker, E., Filazzola, A.D., & Botvin, E.M. (1990). A cognitive-behavioral approach to substance abuse prevention: One-year follow-up. Addictive Behaviors, 15(1), 47-63

Botvin, G.J., Dusenbury, L., Baker, E., James-Ortiz, S., Botvin, E.M., & Kerner, J. (1992). Smoking prevention among urban minority youth: Assessing effects on outcomes and mediating variables. Health Psychology, 11(5), 290-299.

Botvin, G.J., Dusenbury, L., Baker, E., James-Ortiz, S., & Kerner, J. (1989). A skills training approach to smoking prevention among Hispanic youth. Journal of Behavioral Medicine, 12(3), 279-296.

Botvin, G.J., & Eng, A. (1982). The efficacy of a multicomponent approach to the prevention of cigarette smoking. Preventive Medicine, 11(2), 199-211.

Botvin, G.J., Eng, A., & Williams, C.L. (1980). Preventing the onset of cigarette smoking through life skills training. Preventive Medicine, 9(1), 135-143.

Botvin, G.J., Epstein, J.A., Baker, E., Diaz, T., Ifill-Williams, M. (1997). School-based drug abuse prevention with inner-city minority youth. Journal of Child and Adolescent Substance Abuse, 6(1), 5-19.

Botvin, G.J., Griffin, K W., Diaz, T., & Ifill-Williams, M. (2001). Drug abuse prevention among minority adolescents: Posttest and one- year follow-up of a school-based preventive intervention. Prevention Science, 2(1), 1-13.

Botvin, G.J., Griffin, K.W., Diaz, T., & Ifill-Williams, M. (2001). Preventing binge drinking during early adolescence: One- and two-year follow-up of a school-based preventive intervention. Psychology of Addictive Behaviors, 15, 360-365.

Botvin, G.J., Renick, N.L., & Baker, E. (1983). The effects of scheduling format and booster sessions on a broad spectrum psychosocial approach to smoking prevention. Journal of Behavioural Medicine, 6(4), 359-379.

Botvin, G.J., Schinke, S.P., Epstein, J.A., Diaz, T., & Botvin, E.M. (1995). Effectiveness of culturally focused and generic skills training approaches to alcohol and drug abuse prevention among minority adolescents: Two-year follow-up results. Psychology of Addictive Behaviors, 9(3), 183-194.

Spoth, R.L., Randall, G.K., Trudeau, L., Shin, C., & Redmond, C. (2008). Substance use outcomes 5 1/2 years past baseline for partnership-based, family-school preventive interventions. Drug and Alcohol Dependence, 96(1), 57-68.

Vicary, J., Smith, E., Swisher, J., Hopkins, A., Elek, E., Bechtel, L., & Henry, K. (2006). Results of a 3-year study of two methods of delivery of life skills training. Health Education & Behavior, 33(3), 325-339.