title: Economic evaluation of a comprehensive teenage pregnancy prevention program: pilot program.
abstract: BACKGROUND
  Previous research has suggested that comprehensive teenage pregnancy prevention programs that address sexual education and life skills development and provide academic support are effective in reducing births among enrolled teenagers. However, there have been limited data on the costs and cost effectiveness of such programs.
  
  
  OBJECTIVE
  The study used a community-based participatory research approach to develop estimates of the cost-benefit of the Pathways/Senderos Center, a comprehensive neighborhood-based program to prevent unintended pregnancies and promote positive development for adolescents.
  
  
  METHODS
  Using data from 1997-2003, an in-time intervention analysis was conducted to determine program cost-benefit while teenagers were enrolled; an extrapolation analysis was then used to estimate accrued economic benefits and cost-benefit up to age 30 years.
  
  
  RESULTS
  The program operating costs totaled $3,228,152.59 and reduced the teenage childbearing rate from 94.10 to 40.00 per 1000 teenage girls, averting $52,297.84 in total societal costs, with an economic benefit to society from program participation of $2,673,153.11. Therefore, total costs to society exceeded economic benefits by $559,677.05, or $1599.08 per adolescent per year. In an extrapolation analysis, benefits to society exceed costs by $10,474.77 per adolescent per year by age 30 years on average, with social benefits outweighing total social costs by age 20.1 years.
  
  
  CONCLUSIONS
  This comprehensive teenage pregnancy prevention program is estimated to provide societal economic benefits once participants are young adults, suggesting the need to expand beyond pilot demonstrations and evaluate the long-range cost effectiveness of similarly comprehensive programs when they are implemented more widely in high-risk neighborhoods.
authors.affiliation: Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT 06520-8088, USA. marjorie.rosenthal@yale.edu
authors.forename: Marjorie S
authors.initials: MS
authors.lastname: Rosenthal
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Ross
authors.forename: Roseanne
authors.initials: R
authors.lastname: Bilodeau
authors.forename: Rosemary S
authors.initials: RS
authors.lastname: Richter
authors.forename: Jane E
authors.initials: JE
authors.lastname: Palley
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Bradley
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D055812:Community-Based Participatory Research / Q000379:methods*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000706:statistics & numerical data; D011275:Pregnancy, Unwanted; D015397:Program Evaluation; D012736:Sex Education / Q000191:economics*; D014481:United States; D055815:Young Adult