Document Detail

Economic analysis of a multi-site prevention program: assessment of program costs and characterizing site-level variability.
MedLine Citation:
PMID:  23299559     Owner:  NLM     Status:  MEDLINE    
Programmatic cost analyses of preventive interventions commonly have a number of methodological difficulties. To determine the mean total costs and properly characterize variability, one often has to deal with small sample sizes, skewed distributions, and especially missing data. Standard approaches for dealing with missing data such as multiple imputation may suffer from a small sample size, a lack of appropriate covariates, or too few details around the method used to handle the missing data. In this study, we estimate total programmatic costs for a prevention trial evaluating the Strong African American Families-Teen program. This intervention focuses on the prevention of substance abuse and risky sexual behavior. To account for missing data in the assessment of programmatic costs we compare multiple imputation to probabilistic sensitivity analysis. The latter approach uses collected cost data to create a distribution around each input parameter. We found that with the multiple imputation approach, the mean (95 % confidence interval) incremental difference was $2,149 ($397, $3,901). With the probabilistic sensitivity analysis approach, the incremental difference was $2,583 ($778, $4,346). Although the true cost of the program is unknown, probabilistic sensitivity analysis may be a more viable alternative for capturing variability in estimates of programmatic costs when dealing with missing data, particularly with small sample sizes and the lack of strong predictor variables. Further, the larger standard errors produced by the probabilistic sensitivity analysis method may signal its ability to capture more of the variability in the data, thus better informing policymakers on the potentially true cost of the intervention.
Phaedra S Corso; Justin B Ingels; Steven M Kogan; E Michael Foster; Yi-Fu Chen; Gene H Brody
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Prevention science : the official journal of the Society for Prevention Research     Volume:  14     ISSN:  1573-6695     ISO Abbreviation:  Prev Sci     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-09-03     Completed Date:  2014-03-17     Revised Date:  2014-10-14    
Medline Journal Info:
Nlm Unique ID:  100894724     Medline TA:  Prev Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  447-56     Citation Subset:  IM    
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MeSH Terms
African Continental Ancestry Group
Costs and Cost Analysis*
Preventive Health Services / economics*,  organization & administration
Grant Support

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