Taking a School-Based Child Sexual Abuse Prevention Program to Scale: a Cost Analysis

Stacey L. Shipe, Kate Guastaferro, Jennie G. Noll, Christian M. Connell, Paul L. Morgan, D. Max Crowley

Research output: Contribution to journalArticlepeer-review


Cost analyses are used to determine overall costs of implementing evidence-based programming and may help decision makers determine how best to allocate finite resources. Child sexual abuse (CSA), regularly viewed as a human rights violation, is also a public health concern estimated to impact 27% of females and 5% of males by age 18. Universal, school-based CSA programs are one prevailing prevention strategy. However, there are no known cost analyses of school-based CSA prevention programming, thereby limiting potential scalability. Using the ingredients method, this cost analysis presents the findings of implementing Safe Touches, an evidence-based universal prevention program, across four sites (i.e., counties) in one mid-Atlantic state. Reaching a total of 14,235 s grade students, results indicate an average cost of $43 per student, an average classroom cost of $859, an average district cost of $10,637, and an average site cost of $154,243. There was a noted decrease in costs when more students were reached, suggesting a need to focus efforts on bolstering the reach of implementation efforts. Sensitivity analyses explored variations in implementation constraints such as personnel and facilities suggesting a range of per-student costs (lower-bound per-student cost = $34; upper-bound per-student cost = $64). Findings presented herein may be used to inform future universal CSA prevention efforts by providing detailed information about the costs of large-scale implementation of an evidence-based program among elementary-aged children.

Original languageEnglish (US)
Pages (from-to)1394-1403
Number of pages10
JournalPrevention Science
Issue number8
StatePublished - Nov 2022


  • Child sexual abuse
  • Cost analysis
  • Economic evaluation
  • Implementation
  • Prevention

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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