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. 2025 Jul;69(1):107639.
doi: 10.1016/j.amepre.2025.04.009. Epub 2025 Apr 18.

Family-Based Interventions to Prevent Substance Use Among Youth: Community Guide Systematic Economic Review

Verughese Jacob  1 , Jeffrey A Reynolds  2 , Sajal K Chattopadhyay  2 , David P Hopkins  2 , Cora Peterson  3 , Bianca Tenney  2 , Nelia Nadal  4 , Alison E Cuellar  5 , Lisa A Prosser  6 , John M Clymer  7 , Sarah A Stoddard  8 ; Community Preventive Services Task Force
Affiliations

Family-Based Interventions to Prevent Substance Use Among Youth: Community Guide Systematic Economic Review

Verughese Jacob et al. Am J Prev Med. 2025 Jul.

Abstract

Introduction: This paper presents a systematic review of evidence from economic evaluations of family-based interventions that was recommended by the Community Preventive Services Task Force to prevent substance use among youth.

Methods: The search covered studies published from inception of databases through October 2023 and was limited to those based in the U.S. and other high-income countries. This review reports results from peer-reviewed studies and government reports as separate sources of evidence. Analyses were conducted in June 2023 through September 2024. Monetary values are in 2023 U.S. dollars.

Results: The search yielded 11 peer-reviewed studies and 2 government reports: 1 from the Washington State Institute for Public Policy that evaluated 14 programs and 1 from the Substance Abuse and Mental Health Administration that evaluated 8 programs. The median intervention cost ranged from $655 to $1,672 per family and $677 to $753 per youth or participant across the 3 sources of evidence. The median benefit to cost ratio were 5.8, 3.9, and 8.9 from peer-reviewed studies, Washington State Institute for Public Policy, and Substance Abuse and Mental Health Administration, respectively, with all 3 estimates indicating that benefits exceed cost. Substance Abuse and Mental Health Administration's report found some interventions to be cost saving and the others to have a median cost per quality-adjusted life years gained of $21,426.

Discussion: The Community Preventive Services Task Force determined that cost-benefit evidence across the 3 sources showed that societal benefits exceeded cost of family-based interventions to prevent substance use among youth. The Task Force determined that there were not enough studies to reach a conclusion about cost-effectiveness.

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Figures

Figure 1.
Figure 1.
Analytic Framework: Family-based Interventions to Prevent Substance Use Among Youth *Cost or benefit driver; QALY, quality-adjusted life year; DALY, disability-adjusted life year
Figure 2.
Figure 2.
Search Yield and Included Studies a https://www.wsipp.wa.gov/BenefitCost b https://www.samhsa.gov/sites/default/files/cost-benefits-prevention.pdf
See this image and copyright information in PMC

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