title: A decision support tool to determine cost-to-benefit of a family-centered in-home program for at-risk adolescents.
abstract: Family-centered program research has demonstrated its effectiveness in improving adolescent outcomes. However, given current fiscal constraints faced by governmental agencies, a recent report from the Institute of Medicine and National Research Council highlighted the need for cost-benefit analyses to inform decision making by policymakers. Furthermore, performance management tools such as balanced scorecards and dashboards do not generally include cost-benefit analyses. In this paper, we describe the development of an Excel-based decision support tool that can be used to evaluate a selected family-based program for at-risk children and adolescents relative to a comparison program or the status quo. This tool incorporates the use of an efficient, user-friendly interface with results provided in concise tabular and graphical formats that may be interpreted without need for substantial training in economic evaluation. To illustrate, we present an application of this tool to evaluate use of Boys Town's In-Home Family Services (IHFS) relative to detention and out-of-home placement in New York City. Use of the decision support tool can help mitigate the need for programs to contract experts in economic evaluation, especially when there are financial or time constraints.
authors.affiliation: University of Nebraska Medical Center, College of Public Health, 984350 Nebraska Medical Center, Omaha, NE 68198-4350, United States. Electronic address: fernando.wilson@unmc.edu.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Wilson
authors.affiliation: University of Nebraska-Lincoln, College of Business Administration, 1240 R Street, Lincoln, NE 68588-0491, United States.
authors.forename: Ozgur M
authors.initials: OM
authors.lastname: Araz
authors.affiliation: Boys Town National Research Institute, 14100 Crawford St., Boys Town, NE 68010, United States.
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Thompson
authors.affiliation: Boys Town National Research Institute, 14100 Crawford St., Boys Town, NE 68010, United States.
authors.forename: Jay L
authors.initials: JL
authors.lastname: Ringle
authors.affiliation: Boys Town National Research Institute, 14100 Crawford St., Boys Town, NE 68010, United States.
authors.forename: W Alex
authors.initials: WA
authors.lastname: Mason
authors.affiliation: City University of New York, CUNY Graduate School of Public Health and Health Policy, 55 W. 125th St., New York, NY 10027, United States.
authors.forename: Jim P
authors.initials: JP
authors.lastname: Stimpson
mesh_terms: D000293:Adolescent; D003362:Cost-Benefit Analysis / Q000379:methods*; D003661:Decision Support Techniques; D005196:Family Therapy / Q000191:economics / Q000379:methods*; D006801:Humans; D007604:Juvenile Delinquency / Q000191:economics / Q000517:prevention & control*; D008297:Male; D015397:Program Evaluation / Q000379:methods
keywords: Cost benefit analysis; Decision making; Family-based intervention research; Juvenile delinquency; Youth