Strengthening Benefit-Cost Analyses of Substance Abuse Prevention

描述(由申请人提供)：据估计，药物滥用每年给国家造成的损失超过1800亿美元(France等人，2008；Harwood，2004；Mark等人，2007；Schori，2011)，然而，关于当前的循证预防干预措施(EBPI)是否能有效地降低这些成本(即，计划的好处是否大于计划的运营成本；Aos等人，2004,2011；Heckman等人，2010)，人们知之甚少。这在很大程度上是因为研究人员缺乏对进行高质量效益-成本分析(BCA)至关重要的三个组成部分，以可靠地估计药物滥用(SA)预防工作的效率(Bukoski等人，1998年；Crowley等人，2011年e；Karoly，2011年；O‘Connell等人，2009年)。这些问题包括缺乏 (1)成本估算，说明采用、实施和维持SA预防计划所需的资源；(2)从货币角度估计从减少SA风险因素中获得的社会效益；以及(3)关于评估SA预防成本和收益的最佳实践和研究优先事项的指导。为了加强BCA实践，本建议中描述的研究战略将估计和模拟由NIDA资助的大规模SA预防工作的系统成本，估计针对特定SA风险因素的社会价值，并确定SA预防的BCA的最佳做法和研究优先事项。此外，这项工作将为我过渡到一名独立调查员后进行富有成效的研究计划奠定基础。 公共卫生相关性：该提案旨在加强当前的生物多样性评估实践，以评估药物滥用预防工作的效率。通过改进这一领域的BCA，研究人员可以获得更稳健和可靠的估计，从而促进更知情的社会资源分配和有效的SA预防工作。反过来，更有效的药物滥用预防工作将允许以更低的成本提供更多的服务，并有可能极大地减少这一重大公共卫生问题。

DESCRIPTION (provided by applicant): Substance abuse is estimated to cost the nation over $180 billion annually (French et al., 2008; Harwood, 2004; Mark et al., 2007; Schori, 2011), yet little is known about whether current evidence-based preventive interventions (EBPI) can efficiently reduce these costs (i.e., whether program benefits are greater than the cost of operating the program; Aos et al., 2004, 2011; Heckman et al., 2010). This is largely because researchers lack three components vital to conducting high-quality benefit-costs analyses (BCAs) that reliably estimate the efficiency of substance abuse (SA) prevention efforts (Bukoski et al., 1998; Crowley et al., 2011e; Karoly, 2011; O'Connell et al., 2009). These include a lack of (1) cost estimates that account for the resources needed to adopt, implement and sustain SA prevention programs, (2) estimates of the social benefits gained from reducing SA risk factors in monetary terms, and (3) guidance around best practices and research priorities for evaluating SA prevention costs and benefits. To strengthen BCA practice, the research strategy described in this proposal will estimate and model the systemic costs of a large-scale NIDA-funded SA prevention effort, estimate the societal value of targeting specific SA risk factors, and identify best practices and research priorities for BCAs of SA prevention. Further, this work will provide the foundation for a productive research program as I transition to an independent investigator. PUBLIC HEALTH RELEVANCE: The proposal is designed to strengthen current BCA practice for evaluating the efficiency of substance abuse prevention efforts. By improving BCAs in this area, researchers can obtain more robust and reliable estimates that can facilitate more informed allocation of social resources and efficient SA prevention efforts. In turn, more efficien substance abuse prevention efforts would allow for the provision of additional services at a lower cost and have the potential to dramatically reduce this major public health problem.