Comprehensive Cost Analysis of First Step Next for Preschoolers with Disruptive Behavior Disorder: Using Real-World...

Area of Science:

• Child Psychology
• Behavioral Science
• Educational Interventions

Background:

• Disruptive behavior disorders in youth have significant societal costs, yet comprehensive data on early intervention program implementation and scaling costs are lacking.
• Effective early intervention programs are vital, but their financial implications for broad application remain poorly understood.
• Existing research highlights the need for detailed cost analyses of evidence-based interventions in real-world settings.

Purpose of the Study:

• To estimate the costs associated with delivering and disseminating the First Step Next (FSN) early intervention program in preschool and kindergarten.
• To determine the per-student implementation costs, incremental costs for additional students, and overall dissemination costs for FSN.
• To conduct a sensitivity analysis to identify key factors influencing cost variations.

Main Methods:

• The Ingredients Method was employed to meticulously estimate all resources and associated costs for FSN implementation and dissemination.
• Cost data were collected from two cohorts involving 29 triads implementing the FSN intervention.
• A sensitivity analysis was performed to assess the impact of variables like personnel wages on total costs.

Main Results:

• The per-child cost to implement FSN for 29 triads across two cohorts was $4330.
• The incremental cost for serving an additional student decreased to $2970, indicating economies of scale.
• Disseminating FSN to a cohort of 40 students cost $170,106 ($4253 per student), with sensitivity analysis revealing a range of $3141-$7829 per student.

Conclusions:

• This study provides a comprehensive cost analysis of an evidence-based early intervention for disruptive behavior disorders, utilizing real-world implementation data.
• The findings highlight the cost-effectiveness of scaling interventions once initial infrastructure is established.
• Personnel wages were identified as a primary driver of cost variability in FSN dissemination, emphasizing the need for strategic resource allocation.