TY - JOUR
T1 - Economic value of community-based services for problematic sexual behaviors in youth
T2 - A mixed-method cost-effectiveness analysis
AU - Dopp, Alex R.
AU - Mundey, Peter
AU - Silovsky, Jane F.
AU - Hunter, Michael
AU - Slemaker, Alexandra
N1 - Funding Information:
This report was prepared by the National Center on the Sexual Behavior of Youth within the Center on Child Abuse and Neglect of the University of Oklahoma Health Sciences Center. The project was supported by Grants 2010-WP-BX-K062 and 2013-MU-MU-K102 (PI: Silovsky) awarded by the Office of Juvenile Justice and Delinquency Prevention , Office of Justice Programs , U.S. Department of Justice . The opinions, findings, and conclusions or recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect those of the Department of Justice.
Funding Information:
This report was prepared by the National Center on the Sexual Behavior of Youth within the Center on Child Abuse and Neglect of the University of Oklahoma Health Sciences Center. The project was supported by Grants2010-WP-BX-K062 and 2013-MU-MU-K102 (PI: Silovsky) awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect those of the Department of Justice. The authors wish to thank the community agencies and families who participated. We are also grateful to Lana O. Beasley for her contributions to qualitative data collection and analyses, as well as her comments on this manuscript. Further, we appreciate the individuals and agencies involved in our collaborative partnership among professionals in university-based research and training and technical assistance teams, federal and local agencies, expert consultants, and community based service agencies. They are too numerous to mention by name, but we note their dedication to efforts to systematically develop, implement, evaluate, and expand effective intervention programs for families impacted by youth with problematic sexual behaviors.
Publisher Copyright:
© 2019 The Authors
PY - 2020/7
Y1 - 2020/7
N2 - Background: Problematic sexual behavior in youth represents a significant public health problem in need of evidence-based treatments. Unfortunately, such treatments are not available in most communities. Objective: This study used a mixed quantitative-qualitative approach to investigate the economics of the implementation of Problematic Sexual Behavior – Cognitive-Behavioral Therapy (PSB-CBT), an evidence-based treatment for problem sexual behaviors in youth. Participants and setting: Youth (N = 413) participated in PSB-CBT at six program sites in youth service agencies across the United States. Method: We used cost-effectiveness ratios (CERs) to compare the direct and indirect costs of PSB-CBT to self- and caregiver-reported youth clinical outcomes (i.e., problem sexual behavior as well as secondary behavioral health problems). CERs represented the cost of achieving one standard unit of change on a measure (i.e., d = 1.0). The design and interpretation of those quantitative analyses were informed by qualitative themes about program costs and benefits that were derived from interviews with 59 therapists, administrators, and stakeholders. Results: CERs (i.e., $ per SD) were $1,772 per youth for problem sexual behavior and ranged from $2,867 to $4,899 per youth for secondary outcomes. These quantitative results, considered alongside the qualitative perspectives of interviewees, suggested that the implementation of PSB-CBT was cost-effective. The results were robust to uncertainty in key parameters under most, but not all, conditions. Conclusions: The results have important implications for decisions made by administrators, policymakers, and therapists regarding use of community-based approaches to address problematic sexual behavior of youth.
AB - Background: Problematic sexual behavior in youth represents a significant public health problem in need of evidence-based treatments. Unfortunately, such treatments are not available in most communities. Objective: This study used a mixed quantitative-qualitative approach to investigate the economics of the implementation of Problematic Sexual Behavior – Cognitive-Behavioral Therapy (PSB-CBT), an evidence-based treatment for problem sexual behaviors in youth. Participants and setting: Youth (N = 413) participated in PSB-CBT at six program sites in youth service agencies across the United States. Method: We used cost-effectiveness ratios (CERs) to compare the direct and indirect costs of PSB-CBT to self- and caregiver-reported youth clinical outcomes (i.e., problem sexual behavior as well as secondary behavioral health problems). CERs represented the cost of achieving one standard unit of change on a measure (i.e., d = 1.0). The design and interpretation of those quantitative analyses were informed by qualitative themes about program costs and benefits that were derived from interviews with 59 therapists, administrators, and stakeholders. Results: CERs (i.e., $ per SD) were $1,772 per youth for problem sexual behavior and ranged from $2,867 to $4,899 per youth for secondary outcomes. These quantitative results, considered alongside the qualitative perspectives of interviewees, suggested that the implementation of PSB-CBT was cost-effective. The results were robust to uncertainty in key parameters under most, but not all, conditions. Conclusions: The results have important implications for decisions made by administrators, policymakers, and therapists regarding use of community-based approaches to address problematic sexual behavior of youth.
UR - http://www.scopus.com/inward/record.url?scp=85067563688&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067563688&partnerID=8YFLogxK
U2 - 10.1016/j.chiabu.2019.104043
DO - 10.1016/j.chiabu.2019.104043
M3 - Article
C2 - 31239075
AN - SCOPUS:85067563688
SN - 0145-2134
VL - 105
JO - Child Abuse and Neglect
JF - Child Abuse and Neglect
M1 - 104043
ER -