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We evaluated a program of payments for ecosystem services in Uganda that offered forest-owning households annual payments of 70,000 Ugandan shillings per hectare if they conserved their forest. The program was implemented as a randomized controlled trial in 121 villages, 60 of which received the program for 2 years. The primary outcome was the change in land area covered by trees, measured by classifying high-resolution satellite imagery. We found that tree cover declined by 4.2% during the study period in treatment villages, compared to 9.1% in control villages. We found no evidence that enrollees shifted their deforestation to nearby land. We valued the delayed carbon dioxide emissions and found that this program benefit is 2.4 times as large as the program costs.

We meta-analyze for impact and cost-effectiveness 94 studies from 47 conditional cash transfer programs in low- and middle-income countries worldwide, focusing on educational outcomes that include enrollment, attendance, dropout, and school completion. To conceptually guide and interpret the empirical findings of our meta-analysis, we present a simple economic framework on household decision making that generates predictions, all else constant, for the association between certain program context and design characteristics and impact estimates. We also present a simple modelfor the analysis of program costs, using it to compute cost-effectiveness estimatesfor a subsample of programs. For all schooling outcomes, we find strong support for heterogeneity in impact, transfer-effectiveness, and cost-effectiveness estimates. Our meta-analytic results of impact and transfer-effectiveness estimates provide support to some—but not all—of the predictions from the household decision-making model.

Studies have shown that community health workers (CHWs) can improve the effectiveness of health care systems; however, little has been reported about CHW program costs. We examined the costs of a program staffed by three CHWs associated with a small, rural hospital in Vermont. We used a standardized data collection tool to compile cost information from administrative data and personal interviews. We analyzed personnel and operational costs from October 2010 to September 2011. The estimated total program cost was $420,348, a figure comprised of $281,063 (67 %) for personnel and $139,285 (33 %) for operations. CHW salaries and office space were the major cost components. Our cost analysis approach may be adapted by others to conduct cost analyses of their CHW program. Our cost estimates can help inform future economic studies of CHW programs and resource allocation decisions.

Implementing social emotional learning (SEL) programs in school settings is a promising approach to promote critical social and emotional competencies for all students. However, there are several challenges to implementing manualized SEL programs in schools, including program cost, competing demands, and content that is predetermined and cannot be tailored to individual classroom needs. Identifying core components of evidence-based SEL programs may make it possible to develop more feasible approaches to implementing SEL in schools. The purpose of this study was to systematically identify the core components in evidence-based elementary school SEL programs, using the five interrelated sets of competencies identified by the Collaborative for Academic, Social, and Emotional Learning (CASEL) as an organizing framework. We present the components that were identified, and the rates at which each component was included in the sample of evidence-based SEL programs. The core components that occurred most frequently across programs were Social Skills (100% of programs), Identifying Others’ Feelings (100% of programs), Identifying One’s Own Feelings (92.3% of programs), and Behavioral Coping Skills/Relaxation (91.7% of programs). These findings illustrate the feasibility of systematically identifying core components from evidence-based SEL programs and suggest potential utility of developing and evaluating modularized SEL programs.

A persistent concern about wellintentioned efforts to improve living standards for the 1.2 billion people who survive (if it can be called that) on less than $1.25 US per day is figuring out what works. A second concern is figuring out whether what works in one setting can be made to work in another. Banerjee et al. describe encouraging results from a set of pilot projects in Ethiopia, Ghana, Honduras, India, Pakistan, and Peru encompassing 11,000 households. Each project provided short-term aid and longer-term support to help participants graduate to a sustainable level of existence. Science , this issue 10.1126/science.1260799 Helping people in Ethiopia, Ghana, Honduras, India, Pakistan, and Peru to become self-employed enables the very poor to become less poor. We present results from six randomized control trials of an integrated approach to improve livelihoods among the very poor. The approach combines the transfer of a productive asset with consumption support, training, and coaching plus savings encouragement and health education and/or services. Results from the implementation of the same basic program, adapted to a wide variety of geographic and institutional contexts and with multiple implementing partners, show statistically significant cost-effective impacts on consumption (fueled mostly by increases in self-employment income) and psychosocial status of the targeted households. The impact on the poor households lasted at least a year after all implementation ended. It is possible to make sustainable improvements in the economic status of the poor with a relatively short-term intervention.

Youth violence is a national public health concern in USA, especially in resource-constrained urban communities. Between 2018 and 2021, the Healthy Communities for Youth (HCFY) program addressed youth violence prevention in select economically marginalized urban communities, with the HCFY program reducing the likelihood of youth-involved violent crime. Leveraging costs from program expense reports, this study analyzes the costs of the HCFY program in order to inform policymaking and the program’s future ongoing implementation. Total HCFY program costs were $821,000 ($290,100 annually including program start-up costs) over the 34-month project period. Operationalization costs contributed the largest share (64.8%), with 45% attributable to intervention coordinators. In the intervention community, the program costs $100 per capita, $1100 per youth-involved crime case, and $8100 per youth-involved violent crime case. Findings were sensitive to the number of youth-involved crime or violent crime cases and costs of high-level program leadership and self-evaluation analysts, with the per youth-involved violent crime case cost ranging between $700 and $1600 over the program period. Analysis of HCFY program costs is an important step in determining the affordability of a community-level program to prevent youth violence in resource-limited urban communities.

This study surveys active labor market programs (ALMPs) in selected countries of the Middle East and North Africa (MENA) region, identifies key challenges to their effective and efficient delivery, and proposes a policy framework for reforming public service provision. This study draws on data collected through surveys administered to public social, employment, and education agencies in selected MENA countries to identify key constraints and options for reforming publicly provided employment programs. Recent political transitions arising from the Arab Spring have contributed to the deterioration of labor market outcomes in the MENA region. In this context, ALMPs could become an important policy lever to address some of the challenges facing labor markets. These include: joblessness, skills mismatches, lack of labor market mobility, large and expanding informal sector, and lack of formal employment networks. The study also provides specific details on the beneficiaries, targeting, and expenditures of ALMPs during this same period.

Abstract Cost analyses are used to determine overall costs of implementing evidence-based programming and may help decision makers determine how best to allocate finite resources. Child sexual abuse (CSA), regularly viewed as a human rights violation, is also a public health concern estimated to impact 27% of females and 5% of males by age 18. Universal, school-based CSA programs are one prevailing prevention strategy. However, there are no known cost analyses of school-based CSA prevention programming, thereby limiting potential scalability. Using the ingredients method, this cost analysis presents the findings of implementing Safe Touches, an evidence-based universal prevention program, across four sites (i.e., counties) in one mid-Atlantic state. Reaching a total of 14,235 s grade students, results indicate an average cost of $43 per student, an average classroom cost of $859, an average district cost of $10,637, and an average site cost of $154,243. There was a noted decrease in costs when more students were reached, suggesting a need to focus efforts on bolstering the reach of implementation efforts. Sensitivity analyses explored variations in implementation constraints such as personnel and facilities suggesting a range of per-student costs (lower-bound per-student cost = $34; upper-bound per-student cost = $64). Findings presented herein may be used to inform future universal CSA prevention efforts by providing detailed information about the costs of large-scale implementation of an evidence-based program among elementary-aged children.

Rising child welfare costs and a desire to keep kids out of the system have encouraged the use of kinship care—of which custodial grandparents make up the majority of caregivers. Unfortunately, custodial grandparents report greater needs for social and emotional support to successfully care for their grandchildren. Yet, the resources required to provide preventive social-emotional support to these families are unknown. In the wake of the Family First Act and other policy actions to expand preventive services, we undertake a cost analysis of the social intelligence training (SIT) within a randomized controlled trial spanning 48 states of the United States of America. Estimated implementation costs were $90,638 (CI $45,254–186,998) which equated to $255 (CI $127–526) per participant. This dual-generation online approach offers key lessons into not only how to resource social-emotional learning (SEL) prevention for custodial grandparents—but also sheds light on how we might provide universal supports to this population. Child welfare system costs have risen to over $33 billion dollars a year—with nearly half of all spending being the result of out-of-home placement (Rosinsky et al., 2021 ) Child Welfare Financing SFY 2018: A survey of federal, state, and local expenditures. https://www.childtrends.org/wp-content/uploads/2021/05/ChildWelfareFinancing_ChildTrends_March2021.pdf ). Practitioners, policymakers, and child advocates are seeking solutions for how to both better protect children and manage these growing public costs (Ringel et al., 2018 ). Improving child welfare outcomes: Balancing investments in prevention and treatment. Rand health quarterly, 7(4)). Further, many extended families seek ways to keep children out of the “system” when parents are unable to care for their offspring (Lin, Children and Youth Services Review 93:203–216, 2018 ). A strategy used by all of these groups is the use of kinship care arrangements where extended family provides formal or informal care of children. Several important benefits are recognized from kinship care, including providing connections to family members, communities, and culture. Yet, little is known about how social-emotional supports could enhance kinship arrangements, and to date, no studies have systematically evaluated the costs of such supports. In this context, we conduct a cost analysis of such a program—known as social intelligence training.

COVID-19 disproportionally impacted the health and well-being of older adults—many of whom live with chronic conditions—due to their higher risk of dying and being hospitalized. It also created several secondary pandemics, including increased falls risk, sedentary behavior, social isolation, and physical inactivity due to limitations in mobility from lock-down policies. With falls as the leading cause of preventable death and hospitalizations, it became vital for in-person evidence-based falls prevention programs (EBFPPs) to pivot to remote delivery. In Spring 2020, many EBFPP administrators began re-designing programs for remote delivery to accommodate physical distancing guidelines necessitated by the pandemic. Transition to remote delivery was essential for older adults and persons with disabilities to access EBFPPs for staying healthy, falls and injury free, out of hospitals, and also keeping them socially engaged. We collaborated with the Administration on Community Living (ACL), the National Council on Aging (NCOA), and the National Falls Prevention Resource Center (NFPRC), for an in-depth implementation evaluation of remotely delivered EBFPPs. We examined the process of adapting and implementing four EBFPPs for remote delivery, best practices for implementing the programs remotely within the RE-AIM evaluation framework. This enhances NFPRC’s ongoing work supporting dissemination, implementation, and sustainability of EBFPPs. We purposively sampled organizations for maximum variation in organization and provider type, geographic location, and reach of underserved older populations (Black, Indigenous, or other People of Color (BIPOC), rural, disabilities). This qualitative evaluation includes provider-level data from semi-structured interviews ( N  = 22) with program administrators, staff, and leaders. The interview guide included what, why, and how adaptations were made to EBFPP interventions and implementation strategies using Wiltsey-Stirman ( 2019 ) adaptations framework (FRAME), reach, and implementation outcomes (acceptability, feasibility, fidelity, and costs; Proctor et al., 2011 ), focusing on equity to learn for whom these programs were working and opportunities to address inequities. Findings demonstrate remote EBFPPs made planned and fidelity-consistent adaptations to remote delivery in partnership with researchers and community organizations, focusing on participant safety both in program content and delivery. Supports using and accessing technology were needed for delivery sites and leaders to facilitate engagement, and improved over time. While remote EBFPP delivery has increased access to EBFPPs for some populations from the perspective of program administrator, leaders, and staff (e.g., caregivers, rural-dwellers, persons with physical disabilities), the digital divide remains a barrier in access to and comfort using technology. Remote-delivered EBFPPs were acceptable and feasible to delivery organizations and leaders, were able to be delivered with fidelity using adaptations from program developers, but were more resource intensive and costly to implement compared to in-person. This work has important implications beyond the pandemic. Remote delivery has expanded access to groups traditionally underserved by in-person programming, particularly disability communities. This work will help answer important questions about reach, accessibility, feasibility, and cost of program delivery for older adults and people with disabilities at risk for falls, those living with chronic conditions, and communities most vulnerable to disparities in access to health care, health promotion programming, and health outcomes. It will also provide critical information to funders about elements required to adapt EBFPPs proven effective in in-person settings for remote delivery with fidelity to achieve comparable outcomes.