title: Helping the Noncompliant Child: An Assessment of Program Costs and Cost-Effectiveness.
abstract: Disruptive behavior disorders (DBD) in children can lead to delinquency in adolescence and antisocial behavior in adulthood. Several evidence-based behavioral parent training (BPT) programs have been created to treat early onset DBD. This paper focuses on one such program, Helping the Noncompliant Child (HNC), and provides detailed cost estimates from a recently completed pilot study for the HNC program. The study also assesses the average cost-effectiveness of the HNC program by combining program cost estimates with data on improvements in child participants' disruptive behavior. The cost and effectiveness estimates are based on implementation of HNC with low-income families. Investigators developed a Microsoft Excel-based costing instrument to collect data from therapists on their time spent delivering the HNC program. The instrument was designed using an activity-based costing approach, where each therapist reported program time by family, by date, and for each skill that the family was working to master. Combining labor and non-labor costs, it is estimated that delivering the HNC program costs an average of $501 per family from a payer perspective. It also costs an average of $13 to improve the Eyberg Child Behavior Inventory intensity score by 1 point for children whose families participated in the HNC pilot program. The cost of delivering the HNC program appears to compare favorably with the costs of similar BPT programs. These cost estimates are the first to be collected systematically and prospectively for HNC. Program managers may use these estimates to plan for the resources needed to fully implement HNC.
authors: RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.
authors: Amanda A
authors: AA
authors: Honeycutt
authors: RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.
authors: Olga A
authors: OA
authors: Khavjou
authors: University of North Carolina at Chapel Hill, Campus Box 3270, Chapel Hill, NC 27599, USA.
authors: Deborah J
authors: DJ
authors: Jones
authors: University of North Carolina at Chapel Hill, Campus Box 3270, Chapel Hill, NC 27599, USA.
authors: Jessica
authors: J
authors: Cuellar
authors: University of Vermont, Burlington, VT 05405, USA.
authors: Rex L
authors: RL
authors: Forehand
keywords: behavioral parent training program; cost analysis; cost-effectiveness; disruptive behavior disorders
references: BMJ. 2007 Mar 31;334(7595):682
references: 17350965
references: Am J Public Health. 2005 Oct;95(10):1767-72
references: 16131639
references: Behav Res Ther. 1994 Jan;32(1):101-7
references: 8135705
references: J Child Fam Stud. 2010 Oct 1;19(5):629-645
references: 20823946
references: J Consult Clin Psychol. 2000 Aug;68(4):624-40
references: 10965638
references: Eur J Health Econ. 2013 Feb;14(1):85-94
references: 21853340
references: Am Psychol. 2010 Feb-Mar;65(2):85-97
references: 20141264
references: Br J Psychiatry. 2005 Aug;187:106-8
references: 16055820
references: Clin Psychol Rev. 2013 Mar;33(2):241-52
references: 23313761
references: Psychopharmacol Bull. 1995;31(1):83-91
references: 7675994
references: Child Care Health Dev. 2008 May;34(3):380-90
references: 18410644
references: J Fam Psychol. 2008 Aug;22(4):506-17
references: 18729665
references: J Clin Child Adolesc Psychol. 2008 Jan;37(1):215-37
references: 18444059
references: J Am Acad Child Adolesc Psychiatry. 2007 Nov;46(11):1414-24
references: 18049291
references: BMJ. 2001 Jul 28;323(7306):191
references: 11473907
references: BMJ. 2007 Mar 31;334(7595):678
references: 17350966