Cost-effectiveness of Consultation for a Daily Report Card Intervention: Comparing In-Person and Online Implementation Strategies

ABSTRACT

Teachers can implement a high quality Daily Report Card (DRC) intervention when they receive face-to-face consultation or interactive online supports. Yet, it is unclear which method is most cost-effective. Using an ingredients-based approach and societal perspective, we examined costs and cost-effectiveness (compared to typical practice) of three implementation strategies (face-to-face standard consultation, face-to-face enhanced consultation, interactive online supports) with 112 elementary school teachers. Teachers received consultation for DRC implementation with one student with or at risk for ADHD. Over 2 months, we collected data on teachers’ implementation and changes in student behaviors. Regarding cost per student, enhanced consultation was the most costly ($864), followed by standard consultation ($634) and interactive online supports ($307). Regarding cost-effectiveness (costs required to achieve the desired effect beyond typical practice), interactive online supports were the most cost-effective followed by enhanced consultation and standard consultation. We discuss implications for research and maximizing outcomes given dollars spent.

Compliance with Ethical Standards

Procedures in both studies were approved by the Institutional Review Boards at all universities and within all school districts. All procedures were performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Disclosure statement

The first and fourth author received no financial benefit from the DRC.O program, but are the primary developer of the websites. Other authors have no conflicts of interest to disclose.

Additional information

Funding

The research reported here was supported by the Institute of Education Sciences, U.S. Department of Education, through Grant (R324A120272) and PolicyWise for Children & Families, Alberta Canada. The opinions expressed are those of the authors and do not represent views of the Institute or the U.S. Department of Education or PolicyWise for Children & Families.

Notes on contributors

Julie Sarno Owens

Julie Sarno Owens, PhD, is a professor of psychology at Ohio University and codirector of the Center for Intervention Research in Schools. Her program of research is focused on evaluating the effectiveness and feasibility of evidence-based interventions in the school setting and developing strategies to address barriers to intervention implementation.

Samantha M. Margherio

Samantha M. Margherio is a clinical psychology doctoral student at Ohio University. Her research focuses on the development and evaluation of interventions for youth with externalizing disorders and substance use disorders, including a special interest in the cost-effectiveness of these interventions.

Mary Lee

Mary Lee is a clinical psychology graduate student at Ohio University. Her research focuses on implementation of interventions in schools for youth with emotional and behavioral concerns.

Steven W. Evans

Steven W. Evans, PhD, is a distinguished professor of psychology at Ohio University and codirector of the Center for Intervention Research in Schools. His research focuses on the development and evaluation of school-based interventions for adolescents with ADHD and related disorders.

D. Max Crowley

D. Max Crowley, Ph.D. is an assistant professor of human development and family studies a the Pennsylvania State University.  Dr. Crowley is a prevention scientist investigating how to optimize investments in healthy development—with a focus on preventive strategies to reduce substance misuse and delinquent behavior.

Erika K. Coles

Erika K. Coles, Ph.D.  is an assistant professor and clinic director in the  Center for Children and Families at Florida International University. Her interests include increasing the effectiveness of behavioral interventions for the treatment of ADHD.

Clifton S. Mixon

Clifton S. Mixon, Ph.D. is a clinical psychologist at Ochsner Hospital for Children in New Orleans, Louisiana. He treats children and adolescents with mental and behavioral health difficulties.