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Related Experiment Video

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Measuring the Subjective Value of Risky and Ambiguous Options using Experimental Economics and Functional MRI Methods

Measuring the Subjective Value of Risky and Ambiguous Options using Experimental Economics and Functional MRI Methods

Published on: September 19, 2012

An economic analysis of Native CHOICES.

Robert Rosenman¹, Carolyn Noonan², Richard F MacLehose³

¹School of Economic Sciences, Washington State University, Pullman, WA, 99163, USA.

Journal of Substance Use and Addiction Treatment

|December 22, 2025

Summary

Native CHOICES is a cost-effective program that reduces alcohol-exposed pregnancies (AEPs) and fetal alcohol spectrum disorders (FASDs) in American Indian communities. The intervention demonstrates significant economic benefits and improved quality of life.

Keywords:

Alcohol exposed pregnancies Cost benefit Cost efficiency Fetal alcohol spectrum disorders

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Area of Science:

Public Health
Health Economics
Preventive Medicine

Background:

Fetal alcohol spectrum disorders (FASDs) are a significant public health concern linked to alcohol-exposed pregnancies (AEPs).
The Native CHOICES program, a culturally adapted intervention, effectively reduces AEP risk in American Indian communities.
This study provides the first economic analysis of the Native CHOICES program.

Purpose of the Study:

To conduct an economic analysis of the Native CHOICES program.
To assess the cost-benefit, cost-effectiveness, and quality-adjusted life years (QALYs) gained from Native CHOICES.
To evaluate the program's impact on reducing AEPs and FASDs.

Main Methods:

Utilized pre-pandemic data from a randomized controlled trial of Native CHOICES.
Conducted economic assessments including cost-benefit, cost-effectiveness, and QALY analysis.
Focused on a Northern Plains American Indian community.

Main Results:

Native CHOICES reduced AEP risk by 18-20% and FASDs by 6.84-7.6% within 6 months post-participation.
The program yielded a net economic benefit of $308,295 to $376,951 over 6 months.
Cost efficiency for FASDs avoided ranged from $84,887 to $93,709, with $2330-$2572 per QALY gained.

Conclusions:

Native CHOICES is a cost-effective intervention for preventing AEPs and FASDs.
The program demonstrates positive economic returns and improved health outcomes for American Indian participants.
Culturally adapted public health programs can be both effective and economically viable.