Purpose: The potential benefits of preventing adolescent alcohol use are enormous; however, rigorous economic evaluations of prevention programs are scarce, especially among minority populations. This research examines the cost-effectiveness of the Strong African-American Families -Teen Version (SAAF-T), an adolescent substance abuse prevention program focused on rural African-Americans, in prevention of alcohol-related outcomes.
Method: Our research team prospectively collected the programmatic costs, at the societal perspective, of SAAF-T and its attention-control intervention. Multiple imputation was used to estimate missing costs and a generalized linear model to assess the incremental costs. Participants (N=473) completed baseline and 1-year follow-up assessments, indicating the number of times he or she consumed alcohol (alcohol use) and the number of times he or she consumed four or more drinks at one time (binge drinking) through a categorical variable. To calculate incremental effects, we used interval regression, and an analytic horizon of 1 year post-intervention. No imputation was necessary for outcomes. We controlled for socio-economic status (SES) and participant gender in all regressions. Stratified analyses were conducted to compare the results of females (N=270) to males (N=203) and of participants with a lower SES (N=266) to participants with a higher SES (N=207).
Result: For the full sample, SAAF-T has an ICER of $50 for the reduction of 1 episode of alcohol use over 12 months and an ICER of $199 for a 50% reduction in these episodes. Furthermore, SAAF-T has an ICER of $127 for a reduction of 1 binge drinking episode over 12 months and an ICER of $136 for a 50% reduction in these episodes. In the stratified analysis, participants with a lower SES have an ICER of $144 and $95 for a 50% reduction in alcohol use and binge drinking, respectively, while higher SES participants have ICERs of $245 and $225, respectively. Similarly, males have an ICER of $138 for a 50% reduction in alcohol use, while females have an ICER of $239; binge drinking was not significantly different by gender.
Conclusion: SAAF-T is a cost-effective intervention in reducing both total alcohol use and episodes of heavy alcohol use one-year post-intervention. Our research indicates that SAAF-T is more cost-effective for participants with a lower SES for both outcomes and more cost-effective for males in reducing alcohol use.
See more of: The 34th Annual Meeting of the Society for Medical Decision Making