|Equation||(# children) x (Q: Reduction in child abuse and neglect due to the intervention) x ($ benefit from reduced foster care placement)|
|Explanation||This metric estimates the impact of reduced child abuse and neglect on lifetime health, estimated in terms of quality-adjusted life years (QALY). It is based on a meta-analysis of the impact of the Parents as Teachers (PAT) home visiting model.
Note: Constellation treats child abuse/neglect and out of home placements as equivalent outcomes. In the case of this metric, we link the home visiting intervention to a reduction of child abuse and then monetize this outcome using the value of out of home placement. We don’t know the monetary cost of child abuse, this cost could be larger or smaller than the cost of out of home placement, our estimation would underestimate the effect of the program if the former is true or overestimated otherwise.
Number of children: The number of participants reported by program.
Q: Reduced child abuse and neglect due to the intervention: [2×10-5]. This is estimated by Constellation’s staff using the following formula:
In this formula, ES is the effect size from a meta-analysis of Parents as Teachers on child abuse and neglect is [0.061] (WSIPP, 2019). The base percentage [0.0003] is the standard deviation of the counterfactual rate of child abuse. We assume a rate of child abuse of [9%], based on an incidence rate of 3% reported by the MN Department of Human Services and adjusted for population of color by a factor of 3. (Minnesota Department of Human Services, 2018).
Benefit from reduced child abuse and neglect: [$350,000]. This is an estimate of the value of preventing child abuse in terms of lost quality-adjusted life years, based on the findings of Peterson, et al (2015). These benefits are already discounted to present value.
|References||Gray JD, Cutler CA, Dean JG, Kempe CH. Prediction and prevention of child abuse and neglect. J Social Issues 1979;35:127–39.
Honig AS, Morin C. When should programs for teen parents and babies begin? Longitudinal evaluation of a teen parents and babies program. J Primary Prev 2001;21:447–54.
Huxley P, Warner R. Primary prevention of parenting dysfunction in high risk cases. Am J Orthopsychiatry 1993;63:582–8.
Minnesota Compass (2018) “Wilder Research analysis of data from the Minnesota Department of Human Services, and Bridged-Race Population Estimates, U.S. Centers for Disease Control and Prevention. https://www.mncompass.org/early-childhood/risk-and-reach/maltreatment-reports-filed
Minnesota Department of Human Services (2018). Child protection in Minnesota: Keeping children safe. DHS-4735-ENG. Retrieved from https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4735-ENG.
Olds, D. L., Eckenrode, J., Henderson, C. R., Kitzman, H., Powers, J., Cole, R., Sidora, K., Morris, P., Pettitt, L. M., Luckey, D., York, N., Eckenrode, N., & Kitzman, N. (n.d.). Long-term Effects of Home Visitation on Maternal Life Course and Child Abuse and Neglect Fifteen-Year Follow-up of a Randomized Trial.
Peterson, C., Florence, C., & Klevens, J. (2018). The economic burden of child maltreatment in the United States, 2015. Child Abuse and Neglect, 86, 178–183. https://doi.org/10.1016/j.chiabu.2018.09.018
Velasquez J, Christensen M, Schommer B. Intensive services help prevent child abuse. Am J Maternal Child Nurs 1984;9:113–7.
Wagner MM, Clayton SL. The Parents as Teachers program: results from two demonstrations. Future Child 1999;9:91–115.
Washington State Institute for Public Policy. (2017). Benefit-cost technical documentation. Olympia, WA: Author. Retrieved from: http://www.wsipp.wa.gov/TechnicalDocumentation/WsippBenefitCostTechnicalDocumentation.pdf
Washington State Institute for Public Policy. (2019). Retrieved from: http://www.wsipp.wa.gov/BenefitCost/Program/118