Abstract
Early childhood interventions can improve self-regulation, but there are few economic evaluations of such interventions. This study analyzed the cost-effectiveness of an early childhood self-regulation intervention (Red Light Purple Light!; RLPL), comparing three different models of implementation across stages of intervention development: (Model 1) trained research assistants (RAs; graduate students) directly delivered the RLPL intervention to children; (Model 2) RAs trained trainers (e.g., program coaches), who then trained teachers to implement RLPL with children (e.g., train-the-trainer); and (Model 3) program faculty trained teachers to deliver the RLPL intervention to children. We implemented a cost-effectiveness analysis by calculating the incremental cost-effectiveness ratio. We also conducted a series of sensitivity analyses to adjust for parameter uncertainty. Our base-case analysis suggests that Model 2 was the most cost-effective strategy, in that a cost of $23 per child was associated with a one-unit increase of effect size on self-regulation scores. The “train-the-trainer” model remained the optimal strategy across scenarios in our sensitivity analysis. This study fills an important gap in cost-effectiveness analyses on early childhood self-regulation interventions. Our process and results can serve as a model for future cost-effectiveness analyses of early childhood intervention programs and may ultimately inform decisions related to intervention adoption that optimize resource allocation and improve program design.
Highlights
Many children, especially those experiencing socio-demographic risks such as poverty, enter formal schooling without key skills needed to thrive in a classroom environment (Blair and Raver, 2015)
The present study focuses on a cost-effectiveness analysis of the Red Light, Purple Light (RLPL) self-regulation intervention, which has been shown to have significant positive effects on self-regulation (e.g., Tominey and McClelland, 2011; Schmitt et al, 2015; Duncan et al, 2018; McClelland et al, 2019)
The program effectiveness was similar across the RLPL models, the cost varied from $7.72 per child in Model 2 to $11.15 per child in Model 1
Summary
Especially those experiencing socio-demographic risks such as poverty, enter formal schooling without key skills needed to thrive in a classroom environment (Blair and Raver, 2015). These skills are included in a construct called school readiness and include self-regulation and early academic skills (Snow, 2006). Children facing sociodemographic risk who struggle with self-regulation and early academic skills are likely to. Cost-Effectiveness Analyses for Self-Regulation Intervention face achievement gaps that persist and widen over time (Zelazo et al, 2016). Self-regulation is a significant predictor of shortand long-term academic, social, and life outcomes (Moffitt et al, 2011; McClelland et al, 2013; Zelazo et al, 2016; Robson et al, 2020). Large-scale classroom curricula that combine self-regulation and academic skills have shown mixed effects (Farran et al, 2013; Blair and Raver, 2014; Morris et al, 2014), but targeted self-regulation interventions that can be implemented in the classroom have shown positive effects across both self-regulation and academic domains (Tominey and McClelland, 2011; Schmitt et al, 2015; McClelland et al, 2019)
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