Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .
Costs and effectiveness of the fast track intervention for antisocial behavior.
BACKGROUND Antisocial behavior is enormously costly to the youth involved , their families , victims , taxpayers and other members of society . These costs are generated by school failure , delinquency and involvement in the juvenile justice system , drug use , health services and other services . For prevention programs to be cost effective , they must reduce these costly behaviors and outcomes . AIM The Fast Track intervention is a 10-year , multi-component prevention program targeting antisocial behavior . The intervention identified children at school entry and provided intervention services over a 10-year period . This study examined the intervention 's impact on outcomes affecting societal costs using data through late adolescence . METHODOLOGY The intervention is being evaluated through a multi-cohort , multi-site , multi-year r and omized control trial of program participants and comparable children and youth in similar schools , and that study provides the data for these analyses . Schools within four sites ( Durham , NC ; Nashville , TN ; Seattle , WA ; and rural central Pennsylvania ) were selected as high-risk based on crime and poverty statistics of the neighborhoods they served . Within each site , schools were divided into multiple sets matched for demographics ( size , percentage free/reduced lunch , ethnic composition ) ; one set within each pair was r and omly assigned to the intervention and one to the control condition . Within participating schools , high-risk children were identified using a multiple-gating procedure . For each of three annual cohorts , all kindergarteners ( 9,594 total ) in 54 schools were screened for classroom conduct problems by teachers . Those children scoring in the top 40 % within cohort and site were then solicited for the next stage of screening for home behavior problems by the parents , and 91 % agreed ( n = 3,274 ) . The teacher and parent screening scores were then st and ardized within site and combined into a sum score . These summed scores represented a total severity-of-risk screen score .  Children were selected for inclusion into the study based on this screen score , moving from the highest score downward until desired sample sizes were reached within sites , cohorts , and conditions . RESULTS AND DISCUSSION The intervention lacked both the breadth and depth of effects on costly outcomes to demonstrate cost-effectiveness or even effectiveness . LIMITATIONS The outcomes examined here reflect effects observed during measurement windows that are not complete for every outcome . Data are lacking on some potential outcomes , such as the use of mental health services before year 7 . CONCLUSION AND IMPLICATION S The most intensive psychosocial intervention ever fielded did not produce meaningful and consistent effects on costly outcomes . The lack of effects through high school suggests that the intervention will not become cost-effective as participants progress through adulthood . FUTURE RESEARCH Future research should consider alternative approaches to prevention  youth violence
Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .