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Assessing the cost-effectiveness of Family Connections
Diane DePanfilis1, Howard Dubowitz, James Kunz
1University of Maryland School of Social Work, Baltimore, MD, USA.
Insights
The 3-month Family Connections (FC) program is more cost-effective for improving child safety and reducing neglect risk. However, the 9-month FC intervention is more cost-effective for improving child behavior. These findings aid decisions on optimal program length.
Area of Science:
- Child Welfare Research
- Public Health Interventions
- Health Economics
Background:
- Child neglect prevention programs aim to improve child safety and family well-being.
- Family Connections (FC) is a program designed to mitigate risks associated with child neglect.
- Determining the optimal duration of intervention is crucial for resource allocation and program effectiveness.
Purpose of the Study:
- To evaluate the cost-effectiveness of 3-month versus 9-month Family Connections (FC) interventions.
- To compare the impact of different intervention lengths on risk and protective factors.
- To assess the influence of intervention duration on child safety and behavioral outcomes.
Main Methods:
- A randomized controlled trial comparing 3-month and 9-month FC interventions.
- Data collection included child protective services reports, self-reports, and observational measures.
- Cost-effectiveness analysis was conducted based on intervention duration and reported outcomes.
Main Results:
- The 3-month FC intervention demonstrated greater cost-effectiveness in enhancing protective factors and child safety.
- The 9-month FC intervention was more cost-effective in improving child behavior outcomes.
- Cost-effectiveness ratios indicated differential benefits based on intervention length and outcome measure.
Conclusions:
- Both 3-month and 9-month FC interventions show varying cost-effectiveness depending on the targeted outcomes.
- Findings suggest that intervention duration should be tailored to specific goals, such as risk reduction or behavioral improvement.
- Further cost analyses in diverse settings are needed to inform practice regarding service delivery timing.
Objective:
To assess the cost-effectiveness of two alternate forms of Family Connections (FC), a child neglect prevention program, in relation to changes in risk and protective factors and improvements in child safety and behavioral outcomes.
Methods:
In the original FC study, a sample of 154 families (473 children) in a poor, urban neighborhood, who met risk criteria for child neglect, were randomly assigned to receive either a 3- or 9-month intervention. CPS reports and self-report and observational data on risk and protective factors, safety, and behavioral outcomes were collected prior to, at the end of, and 6-months post intervention. The current study compared the costs of delivering the 3- or 9-month intervention in relation to reported improvements in risk and protective factors, safety, and behavioral outcomes for each group.
Results:
The 3-month intervention was more cost effective than the 9-month intervention in relation to positive changes in risk and protective factors and child safety. However, cost-effectiveness analysis indicated that the 9-month intervention was more cost effective (CE ratio=$276) than the 3-month intervention (CE ratio=$337) in relation to improved unit changes in the child's behavior between baseline and 6 months after service closure.
Conclusions:
This study successfully explored the cost-effectiveness of the FC intervention in relation to its intended outcomes. More extensive cost analyses are currently being conducted in the replication of this program in multiple jurisdictions across the United States.
Practice Implications:
Practitioners in community-based programs must make difficult decisions about the optimal length of time to serve children and families. Prevention programs may be more competitive for funding when they have demonstrated cost-effectiveness. Study results indicated that a 3-month intervention was more cost effective than a 9-month intervention in enhancing protective factors and reducing the risk of child neglect; 9-month intervention was more cost effective than 3-month intervention in reducing problematic child behavior. Further research is needed before practitioners should consider these findings in relation to their own decisions about the timing of service closures.
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