Objective

To determine whether the Communities That Care (CTC) prevention system is a cost-beneficial intervention.

Methods

Data were from a longitudinal panel of 4,407 youth participating in a randomized controlled trial including 24 towns in seven states, matched in pairs within state, and randomly assigned to condition. Significant differences favoring intervention youth in sustained abstinence from delinquency, alcohol use, and tobacco use through grade 12 were monetized and compared to economic investment in CTC.

Results

CTC was estimated to produce $4,477 in benefits per youth (discounted 2011 dollars). It costs $556 per youth to implement CTC for 5 years. The net present benefit was $3,920. The benefit–cost ratio was $8.22 per dollar invested. The internal rate of return was 21 %. Risk that investment would exceed benefits was minimal. Investment was expected to be recouped within 9 years. Sensitivity analyses in which effects were halved yielded positive cost-beneficial results.

Conclusions

CTC is a cost-beneficial, community-based approach to preventing initiation of delinquency, alcohol use, and tobacco use. CTC is estimated to generate economic benefits that exceed implementation costs when disseminated with fidelity in communities.