Fast Track prevention program

Public Health & Prevention: Community-based
Benefit-cost estimates updated December 2017. Literature review updated April 2012.

Fast Track is a comprehensive prevention program delivered over ten years. The program seeks to reduce multiple risk factors in children’s lives by providing classroom sessions in elementary school, along with parent training groups, home visits, child social skill training groups, tutoring in reading, and peer pairing in the classroom. In 6th to 10th grades, youth and their parents attend group meetings and individualized services such as home visiting, family problem-solving sessions, and referrals to school and community services.

BENEFIT-COST	META-ANALYSIS	CITATIONS

The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2016). 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.

Benefits to:

Taxpayers	$2,254	Benefits minus costs	($84,127)
Participants	$1,941	Benefit to cost ratio	($0.36)
Others	$3,919	Chance the program will produce
Indirect	($30,334)	benefits greater than the costs	0 %
Total benefits	($22,219)
Net program cost	($61,908)
Benefits minus cost	($84,127)

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.
Benefits from changes to:¹	Benefits to:
Detailed Monetary Benefit Estimates Per Participant
	Taxpayers	Participants	Others²	Indirect³	Total

Crime	$1,157	$0	$2,743	$578	$4,478
Labor market earnings associated with high school graduation	$907	$1,998	$914	$0	$3,820
K-12 special education	$59	$0	$0	$30	$89
Health care associated with emergency department visits	$256	$49	$297	$128	$729
Costs of higher education	($125)	($105)	($34)	($62)	($327)
Adjustment for deadweight cost of program	$0	$0	$0	($31,008)	($31,008)

Totals	$2,254	$1,941	$3,919	($30,334)	($22,219)

Annual cost		Year dollars	Summary
Detailed Annual Cost Estimates Per Participant
Program costs	$5,828	2004	Present value of net program costs (in 2016 dollars)	($61,908)
Comparison costs	$0	2004	Cost range (+ or -)	10 %

This intensive program is delivered over a ten-year period. We estimated costs from Foster, E.M., Jones, D.E., & the Conduct Problems Prevention Research Group (2006). Can a costly intervention be cost-effective? An analysis of violence prevention. Archives of General Psychiatry, 63(11), 1284-1291.

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.

^{^^}WSIPP does not include this outcome when conducting benefit-cost analysis for this program.

**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.
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)
Meta-Analysis of Program Effects
				First time ES is estimated			Second time ES is estimated			Unadjusted effect size (random effects model)
				ES	SE	Age	ES	SE	Age	ES	p-value
Attention-deficit/hyperactivity disorder symptoms	Primary	1	445	-0.151	0.117	15	-0.018	0.082	17	-0.151	0.199
Crime	Primary	1	445	-0.173	0.067	15	-0.099	0.089	18	-0.173	0.010
Disruptive behavior disorder symptoms	Primary	1	445	-0.198	0.151	15	-0.028	0.098	17	-0.198	0.191
Emergency department visits	Primary	1	445	-0.177	0.089	19	0.000	0.086	21	-0.177	0.048
Hospitalization (psychiatric)^{^^}	Primary	1	445	0.006	0.171	19	0.006	0.171	29	0.006	0.972

Citations Used in the Meta-Analysis

Conduct Problems Prevention Research Group. (2007). Fast track randomized controlled trial to prevent externalizing psychiatric disorders: Findings from grades 3 to 9. Journal of the American Academy of Child & Adolescent Psychiatry, 46(10), 1250-1262.

Conduct Problems Prevention Research Group. (2010). Fast Track intervention effects on youth arrests and delinquency. Journal of Experimental Criminology, 6(2), 131-157.

Conduct Problems Prevention Research Group. (2011). The effects of the Fast Track preventive intervention on the development of conduct disorder across childhood. Child Development, 82(1), 331-345.

Jones, D., Godwin, J., Dodge, K. A., Bierman, K. L., Coie, J. D., Greenberg, M. T., . . . Pinderhughes, E. E. (2010). Impact of the fast track prevention program on health services use by conduct-problem youth. Pediatrics, 125(1), e130-e136.