P1: GCR/GCR/GCX P2: GCV/GCQ
Prevention Science [PREV] PP050-294344 January 23, 2001 18:17 Style ﬁle version Nov. 04, 2000
Prevention Science, Vol. 2, No. 1, 2001
Applying Cost Analysis Methods to School-Based
Christine M. Caffray,
Alison Snow Jones,
and Lisa Werthamer
In order to efﬁciently allocate scarce prevention resources, policymakers need information
about the economic costs of school-based substance use prevention programs. The objective
of this paper is to outline economic cost analysis methods and demonstrate their applicability
to school-based prevention programs. As an example, the paper focuses on estimating the
economic cost of ALPHA, an intensive school-based substance use prevention program. The
cost of ALPHA is compared to the costs of 3 elementary school programs that were alternatives
to ALPHA. We collected cost information for 3 years, using a cost questionnaire that was
completed by program and school budget ofﬁcers and school principals. The program costs
obtained from these sources were modiﬁed to conform to well-established economic cost
KEY WORDS: drug prevention; school-based; economic evaluation; cost-analysis.
School-based substance use prevention pro-
grams have become a popular method of educating
and empowering children so that they can resist the
use of alcohol, tobacco, and other drugs during youth
and, eventually, avoid substance abuse and its well-
documented costs and consequences during adult-
hood (Harwood et al., 1998). A 1996 survey of mid-
dle and high schools in 35 states revealed that in
every state surveyed, at least 98% of schools reported
Department of Epidemiology and Social Medicine, Monteﬁore
Medical Center, Bronx, New York.
Department of Psychology, Cognitive and Neural Science Divi-
sion, University of South Florida, Tampa, Florida.
Department of Health Policy and Management, Johns Hopkins
University School of Public Health, Baltimore, Maryland.
Henry J. Kaiser Family Foundation, Washington, District of
Children’s Mental Health Services Research Center, University
of Tennessee at Knoxville, Tennessee.
Correspondence should be directed to Pinka Chatterji, Depart-
ment of Epidemiology and Social Medicine, Monteﬁore Medical
Centre, 111 East 210th Street, Bronx, New York 10467; e-mail:
including substance use prevention in required health
education courses (Grunbaum et al., 1998). Find-
ings from another recent, national study of school-
based drug prevention efforts indicated that all of the
19 school districts surveyed were implementing drug
prevention curricula (Tashjian et al., 1996).
The spread of school-based substance use pre-
vention programs is consistent with the federal gov-
ernment’s commitment to school-based alcohol and
illicit drug education, as stated in Healthy People
2000 (U.S. Department of Health & Human Services,
1991). The Department of Education’s Safe and Drug
Free Schools and Communities Program (SDFSP)
funds substance use and violence prevention pro-
grams in almost every school district in the United
States (U.S. Ofﬁce of National Drug Control Policy,
1999). In 1999, the federal government appropriated
$566 million for SDFSP, including $35 million to re-
cruit, hire, and train substance use and violence pre-
vention program coordinators in middle schools (U.S.
Department of Education, 1999).
Despite the popularity of school-based sub-
stance use prevention interventions, some have ques-
tioned the effectiveness and worth of these programs.
2001 Society for Prevention Research