Taking a School-Based Child Sexual Abuse Prevention Program to Scale: a Cost Analysis

Area of Science:

• Public Health
• Health Economics
• Child Welfare

Background:

• Child sexual abuse (CSA) is a significant public health issue affecting 27% of females and 5% of males by age 18.
• School-based programs are a common strategy for CSA prevention, but cost analyses are lacking, hindering scalability.
• Resource allocation decisions require accurate cost data for effective public health interventions.

Purpose of the Study:

• To conduct the first known cost analysis of a universal, school-based child sexual abuse prevention program.
• To provide detailed cost data for the "Safe Touches" program implemented across four sites in a mid-Atlantic state.
• To inform future large-scale implementation efforts and resource allocation for CSA prevention programs.

Main Methods:

• Utilized the ingredients method for cost analysis.
• Collected data on the implementation of the "Safe Touches" program across four counties.
• Analyzed costs per student, classroom, district, and site, including sensitivity analyses for personnel and facilities.

Main Results:

• The average cost was $43 per student, $859 per classroom, $10,637 per district, and $154,243 per site for 14,235 students.
• Costs per student decreased with increased student reach, indicating economies of scale.
• Sensitivity analyses revealed a per-student cost range of $34 to $64.

Conclusions:

• Large-scale implementation of evidence-based child sexual abuse prevention programs is feasible.
• Optimizing program reach is crucial for reducing per-student costs and enhancing scalability.
• The findings provide essential economic data for decision-makers planning universal CSA prevention initiatives.