Systematic review of economic evaluations of interventions for high risk young people

Abstract

BackgroundThe aim of this systematic literature review is to identify and critique full economic evaluations of interventions for high risk young people with the purpose of informing the design of future rigorous economic evaluations of such intervention programs.MethodsA PRISMA compliant search of the literature between 2000 and April 2018 was conducted to identify full economic evaluations of youth focussed interventions for at risk young people. Duplicates were removed and two researchers independently screened the article titles and abstracts according to PICOS criteria for exclusion and inclusion. The remaining full text articles were assessed for eligibility and a quality assessment of the included articles was conducted using the Drummond checklist.ResultsThe database, grey literature and hand searches located 488 studies of interventions for at risk young people. After preliminary screening of titles and abstracts, 104 studies remained for full text examination and 29 empirical studies containing 32 separate economic evaluations were judged eligible for inclusion in the review. These comprised 13 cost-benefit analyses (41%), 17 cost-effectiveness analyses (53%), one cost-utility analysis (3%) and a social return on investment (3%). Three main methodological challenges were identified: 1. attribution of effects; 2. measuring and valuing outcomes; and 3. identifying relevant costs and consequences.ConclusionsA cost-benefit analysis would best capture the dynamic nature of a multi-component intervention for high risk young people, incorporating broader intersectoral outcomes and enabling measurement of more domains of risk. Prospective long-term data collection and a strong study design that incorporates a control group contribute to the quality of economic evaluation. Extrapolation of impact into the future is important for this population, in order to account for the time lag in effect of many impacts and benefits arising from youth interventions.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3450-x) contains supplementary material, which is available to authorized users.

Exploring Community-Based Options for Reducing Youth Crime

“…This simple design helps to ensure adequate power to detect differences between the key variables of interest, program efficacy and cost. An additional literature search informed the identification of realistic values for these variables [ 1 , 2 ].…”

“…The DCE model excluded intervention-specific co-efficients for cost and benefit and excluded an alternative specific constant. The former specification was selected to facilitate ease of data collection and model interpretation, which was judged to be a higher priority than optimising the precision of the estimate, given this is the first economic modelling that has ever been applied to community-based programs for high-risk young people internationally [ 1 , 2 ]. The latter specification is appropriate given the aim of the study is to estimate preferences for existing approaches to reducing youth crime, rather than predicting the likely adoption of new strategies [ 23 ].…”

“…The BackTrack program was established in Armidale in northern New South Wales (NSW), Australia, in 2006, for 14–17-year-old high risk young people ( , accessed on 15 April 2021). It is underpinned by six key principles derived from previous reviews of the literature [ 1 , 2 ] together with feedback from staff [ 3 ]: (i) in recognition that its participants are more likely to engage in multiple risk behaviour, the program is comprised of multiple components that target different areas of need simultaneously (e.g., personal development, skills training and legal issues); (ii) flexibility in the delivery of the program components, which reflects that the focus of young people’s needs shifts over time; (iii) flexibility in program attendance, so that participants are able to start, leave, and re-enter the program as they wish, or as their life circumstances permit; (iv) a requirement that young people in the program eventually actively participate in all components of the program; (v) active engagement of local businesses, local media, key stakeholders (e.g., police, and magistrates), and community members in delivering program elements, resolving bureaucratic problems, providing infrastructure and funds, and facilitating communication about the benefits of the program; and (vi) recognition that achieving sustained change among high-risk young people will take a number of years.…”

“…Such views have the potential to impact on program uptake, funding, sustainability and estimates of its benefits. Despite the importance of economic evaluation, a systematic review of community-based programs for high-risk young people found that no published evaluations to date have conducted an economic analysis or systematically quantified the costs or economic benefit derived from such programs [ 2 ]. The aim of the current study is to address this lack of data and seeks to explore community value and preferences for reducing youth crime and improving community safety using BackTrack in a rural setting in Armidale, New South Wales, Australia.…”

The Network Constellation of Personality and Substance Use: Evolution from Early to Late Adolescence

“…Adolescent substance use and risk behaviours impose significant economic costs in terms of lost productivity, reductions in health‐related quality of life, and rehabilitation (Edmunds, Ling, Shakeshaft, Doran, & Searles, 2018). Youth substance use precipitates negative consequences on the brain and behavioural health of the individual (Chassin & Hussong, 2009).…”