Interventions

Investing in Children provides information on over 100 interventions. To find the intervention that best matches your criteria you can search by:

Outcomes affected – covering health, education, behaviour, emotional well-being and relationships

Age group targeted – ranging from birth to 22 years

Level of intervention – extent to which the intervention is targeted (see here for definitions)

Focus of intervention – the aspect(s) of children’s lives the intervention focuses on to achieve desired outcomes.

The list of interventions below the search criteria automatically updates as you search, so that only those that meet the selected criteria are displayed. The list of search criteria also updates automatically, so that only criteria that could still apply are shown.

Once you find interventions that meet your criteria you can click on the intervention name for more information. Here we walk briefly through the Incredible Years parent training programme as an example.

Intervention information

‘Blueprints approved’ means that the intervention meets high  standards of evidence.

Target group indicates whom the intervention is for, in this case parents of children aged 2-12 with conduct problems.

Focus of intervention shows that Incredible Years addresses factors relating to the individual/peer, their family and school/work (reflected in the table on risk and protective factors targeted).

Level of intervention summarises whether the intervention is universal or targeted, and if targeted then in what respect it is targeted. Definitions of the six levels are provided  here. Incredible Years is ‘indicated prevention’, meaning that it is for high-risk individuals who are identified as having signs or symptoms of an mental, emotional or behavioural disorder.

Outcomes affected lists the key developmental outcomes that the intervention affects. Incredible Years affects children’s behaviour, mental health and relations with parents.

Impact of intervention provides more detailed information about outcomes affected in the shape of the average effect sizes derived from relevant studies. For example, the effect of Incredible Years on ADHD symptoms is -0.57* (the asterisk means that it is statistically significant). Effects can vary greatly within a study and across studies, and therefore the effects might not be seen in every case (this variation is taken into account in the cost-benefit analysis). A minus sign before the effect size indicates a reduction in that outcome, as in this case (a reduction in ADHD symptoms).

Risk and protective factors targeted concern the factors targeted by an intervention that are known to increase the likelihood of specified poor outcomes (risk factors) or buffer children from poor outcomes in the context of specified risks (protective factors). For example, Incredible Years seeks to reduce aggressive or violent parenting (a risk factor) but also boost parent social support (a protective factor).

Information on focus of intervention, level of intervention, outcomes affected and risk and protective factors targeted all comes from set lists, allowing direct comparison between interventions.

Cost-benefit analysis

Cost is an estimate of the total cost of delivery per child, which for Incredible Years parent training is £1,211. The actual cost will vary by site, depending on the local delivery strategy and structure.

The results of the cost-benefit analysis are first presented in terms of benefits to taxpayers, participants and others. These benefits come from several outcomes, but are grouped to indicate the three major beneficiaries. In the case of Incredible Years:

Benefits to taxpayers (£1,064) include money from reduced crime (savings to the justice system), increased taxes paid due to increased earnings as adults, reduced need for additional educational support, reduced need for CAMHS services, and reduced use of health care.

Benefits to participants (£554) come from increased earnings due to improved educational outcomes and a small reduction in health care costs.

Benefits to others (£36) consist of benefits to potential victims of crime from crime prevention as well as reduced cost of health care to third parties such as insurance companies or private health care providers.

Total benefits is the sum of benefits to taxpayer, participants and others (£1,654).

It is important to note that a minus sign before a benefit indicates a loss.

Benefits minus costs captures net benefits after subtracting costs to deliver Incredible Years (£443).

Benefit-cost ratio refers to pounds saved for each pound invested (1.37).

The next results show the attractiveness of the investment option:

Rate of return on investment (6%) is the internal rate of return (IRR), which is a figure that is used frequently in the world of finance, and can help you to compare interventions side-by-side on purely economic terms. Specifically, the IRR is the interest rate (also known as the discount rate) that will bring the benefits that accrue from each intervention over the child's life to equal the current value of cash invested in that intervention.

Risk of loss (33%) refers to the risk that if an investor made this investment 100 times, they would lose money from the investment 33 times out of 100, based on a Monte Carlo simulation, which takes uncertainty in the estimates into account.

Source of benefits

The next table provides a breakdown of the source of benefits, or where the benefits come from. This refers to the outcomes affected by the intervention. In the case of Incredible Years, the programme has an effect on several outcomes, including crime, education, mental health and behaviour. These all lead to monetary benefits and this is broken down in this table according to the groupings of beneficiaries.

In addition to outcomes for children, Incredible Years has also been found to reduce depression in mothers, who are considered to be the secondary participant in our analyses. The benefits coming from the mothers’ outcomes are indicated with a *.

Interpreting the cost-benefit information

Incredible Years yields a net benefit (£443) and a relatively low risk of loss (33%). It is an attractive investment in that it yields benefits that are short-term (e.g. reduced educational and CAMHS costs) and long-term (e.g. increased earnings and reduced crime) benefits. As this intervention affects maternal mental health as well as that of children, the benefits include those resulting from the increased earnings and reduced health care usage of mothers. The net benefit is strongly affected by delivery costs, which could vary considerably depending on how the service is set up, so local commissioners should estimate these in collaboration with the developers before deciding whether this - or indeed any other interventions listed on Investing in Children - is worthwhile investment.

Other information

Contact information provides details of the person or organisation responsible for overseeing the dissemination of the intervention (in some cases this is the intervention designer). Further information about interventions can be found at their designated websites (where available) or, for those that are 'Blueprints approved', at  Blueprints for Healthy Youth Development.

Local authorities running the intervention in the UK refers to those sites in the UK where we understand the intervention in question is currently operational. There is an option for website users to contact us about other sites using the intervention.

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