Cost Effectiveness of Strategies for Recruiting Low-Income Families for Behavioral Parent Training
- 169 Downloads
The goal of this study was to assess cost, effectiveness, and cost-effectiveness of recruitment strategies used to engage low-income families of young children with disruptive behavior disorder to participate in a Behavioral Parent Training (BPT) program. For this analysis, we used data on labor and non-labor resources associated with 13 recruitment strategies implemented in February 2014 through February 2016. We assessed the effectiveness of each strategy as the number of families that enrolled into the study. Cost-effectiveness of each recruitment strategy was expressed as cost per family enrolled; analysis was conducted in 2016. We calculated the cost of total recruitment effort for 13 strategies during the 2-year period to be $11,496 with an average cost of $885 per recruitment strategy or $255 per enrolled family. Across strategies, total costs ranged from $25 to $2540. “University mass e-mail” and “school flyers” resulted in the most phone screens (34 each); however, only 10% of these families enrolled in the study (three and four families, respectively). “Craigslist” was the most effective strategy with 30 families screened and 11 of them enrolling. Three strategies did not yield any participants. The four strategies with the lowest cost per family enrolled were “Facebook page,” “Craigslist,” “university mass e-mail,” and “organization/agency” (<$90). In conclusion, we found that some recruitment strategies were more successful at engaging low-income families to participate in a BPT program than others. Our results indicate that using a combination of recruitment strategies may be the optimal approach for recruiting low-income families.
KeywordsBehavioral parent training Disruptive behavior disorder Recruitment strategies Cost-effectiveness
All co-authors contributed substantively to the research questions, hypotheses, and writing of the manuscript. In addition, OAK developed and implemented the cost data collection approach and assisted with the data analyses and interpretation; PT completed data management and analyses; and DJJ is principal investigator of the parent study upon which this study is based.
This report was prepared with support from the National Institute of Mental Health (grant 1-R01-MH100377).
Compliance with ethical standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. University of North Carolina at Chapel Hill provided IRB approval for the study.
Informed consent was obtained from all individual participants included in the study.
- Addy, S., Anglehart, W., & Skinner, C. (2013). Fact sheet: Basic facts about low income children: children under 18 years—2011. National Center for Children in Poverty. http://www.nccp.org/publications/pdf/text_1074.pdf.
- American Psychological Association (2016). About the office on socioeconomic status. http://www.apa.org/pi/ses/about/index.aspx.Google Scholar
- August, G. J., Realmuto, G. M., MacDonald, A. W., Nugent, S. M., & Crosby, R. (1996). Prevalence of ADHD and comorbid disorders among elementary school children screened for disruptive behavior. Journal of Abnormal Child Psychology, 24(5), 571–595. https://doi.org/10.1007/BF01670101.CrossRefPubMedGoogle Scholar
- Bureau of Labor Statistics, US Department of Labor (2015). Occupational outlook handbook, 2016–17 Edition, Mental health counselors and marriage and family therapists. http://www.bls.gov/ooh/community-and-social-service/mental-health-counselors-and-marriage-and-family-therapists.htm.Google Scholar
- Chorpita, B. F., Daleiden, E. L., Ebesutani, C., Young, J., Becker, K. D., Nakamura, B. J., & Starace, N. (2011). Evidence-based treatmentsfor children and adolescents: an updated review of indicators of efficacy and effectiveness. Clinical Psychology: Science and Practice, 18(2), 154–172. https://doi.org/10.1111/j.1468-2850.2011.01247.x.Google Scholar
- Conger, R. D., & Donnellan, M. B. (2007). An interactionist perspective on the socioeconomic context of human development. Annual Review of Psychology, 58, 175–199. https://doi.org/10.1146/annurev.psych.58.110405.085551.CrossRefPubMedGoogle Scholar
- Costello, E. J., Egger, H., SpringerAmpamp; Angold, A. (2005). 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. Journal of the American Academy of Child and Adolescent Psychiatry, 44(10), 972–986. https://doi.org/10.1097/01.chi.0000172552.41596.6f.CrossRefPubMedGoogle Scholar
- Dodge, K. A., Malone, P. S., Lansford, J. E., Miller, S., Pettit, G. S., & Bates, J. E. (2009). A dynamic cascade model of the development of substance-use onset. Monographs of the Society for Research in Child Development, 74(3), 119. https://doi.org/10.1111/j.1540-5834.2009.00528.x. vii-.Google Scholar
- Eyberg, S. M., & Pincus, D. (1999). Eyberg child behavior inventory & Sutter-Eyberg student behavior inventory-revised: professional manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
- Gardner, F., Connell, A., Trentacosta, C. J., Shaw, D. S., Dishion, T. J., & Wilson, M. N. (2009). Moderators of outcome in a brief family-centered intervention for preventing early problem behavior. The Journal of Consulting and Clinical Psychology, 77(3), 543–553. https://doi.org/10.1037/a0015622.CrossRefPubMedGoogle Scholar
- Gopalan, G., Goldstein, L., Klingenstein, K., Sicher, C., Blake, C., & McKay, M. M. (2010). Engaging families into child mental health treatment: updates and special considerations. Journal of the American Academy of Child and Adolescent Psychiatry, 19(3), 182–196.Google Scholar
- Jiang, Y., Ekono, M., & Skinner, C. (2016). Basic facts about low-income children: children under 18 years, 2014. New York, NY: National Center for Children in Poverty, Mailman School of Public Health, Columbia University.Google Scholar
- Jones, D. J., Anton, M., Zachary, C., Pittman, S., Turner, P., Forehand, R., & Khavjou, O. (2016). A review of the key considerations in mental health services research: a focus on low-income children and families. Couple and Family Psychology: Research and Practice, 5(4), 240–257. https://doi.org/10.1037/cfp0000069.CrossRefPubMedPubMedCentralGoogle Scholar
- Jones, D. J., Forehand, R., Cuellar, J., Kincaid, C., Parent, J., Fenton, N., & Goodrum, N. (2013). Harnessing innovative technologies to advance children’s mental health: behavioral parent training as an example. Clinical Psychology Review, 33(2), 241–252. https://doi.org/10.1016/j.cpr.2012.11.003.CrossRefPubMedGoogle Scholar
- Jones, D. J., Forehand, R., Cuellar, J., Parent, J., Honeycutt, A., Khavjou, O., & Newey, G. A. (2014). Technology-enhanced program for child disruptive behavior disorders: development and pilot randomized control trial. Journal of Clinical Child & Adolescent Psychology, 43(1), 88–101. https://doi.org/10.1080/15374416.2013.822308.CrossRefGoogle Scholar
- Kaehler, L. A., Jacobs, M., & Jones, D. J. (2016). Distilling common history and practice elements to inform dissemination: Hanf-model BPT programs as an example. Clinical Child and Family Psychology Review, 19(3), 236–258. https://doi.org/10.1007/s10567-016-0210-5.CrossRefPubMedPubMedCentralGoogle Scholar
- Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., & Sheehan, K. H., et al. (1997). The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry, 12(5), 224–231. 10.1016/S0924-9338(97)83296-8.CrossRefGoogle Scholar
- Leijten, P., Raaijmakers, M. A., de Castro, B. O., & Matthys, W. (2013). Does socioeconomic status matter? A meta-analysis on parent training effectiveness for disruptive child behavior. Journal of Clinical Child & Adolescent Psychology, 42(3), 384–392. https://doi.org/10.1080/15374416.2013.769169.CrossRefGoogle Scholar
- McMahon, R. J., & Forehand, R. (2003). Helping the noncompliant child: family-based treatment for oppositional behavior (2nd ed.). New York, NY: Guilford Press.Google Scholar
- Mendez-Luck, C. A., Trejo, L., Miranda, J., Jimenez, E., Quiter, E. S., & Mangione, C. M. (2011). Recruitment strategies and costs associated with community-based research in a Mexican-origin population. The Gerontologist, 51(Suppl 1), S94–S105. https://doi.org/10.1093/geront/gnq076.CrossRefPubMedPubMedCentralGoogle Scholar
- Moffitt, T. E., Arseneault, L., Jaffee, S. R., Kim-Cohen, J., Koenen, K. C., & Odgers, C. L., et al. (2008). Research review: DSM-V conduct disorder: research needs for an evidence base. Journal of Child Psychology and Psychiatry, 49(1), 3–33. https://doi.org/10.1111/j.1469-7610.2007.01823.x.CrossRefPubMedPubMedCentralGoogle Scholar
- National Institute of Mental Health (2016). Transforming and understanding the treatment of mental illnesses: Division of Services and Intervention Research (DSIR). http://www.nimh.nih.gov/about/organization/dsir/index.shtml.
- Schnirer, L., & Stack-Cutler, H. (2012). Recruitment and engagement of low-income populations: Service provider and researcher perspectives. Community-University Partnership for the Study of Children, Youth, and Families.Google Scholar
- Southern Education Foundation (2015). Low income children now a majority in the nation’s public schools. www.southerneducation.org.Google Scholar