Child Abuse & Neglect 32 (2008) 335–351 Assessing the cost-effectiveness of Family Connections , Diane DePanfilis a,* , Howard Dubowitz b , James Kunz c a University of Maryland School of Social Work, Baltimore, MD, USA b University of Maryland School of Medicine, Department of Pediatrics, Baltimore, MD, USA c McDaniel College, Department of Social Work, Westminster, MD, USA Received 22 August 2005; received in revised form 27 September 2006; accepted 7 June 2007 Abstract Objective: To assess the cost-effectiveness of two alternate forms of Family Connections (FC), a child neglect prevention program, in relation to changes in risk and protective factors and improvements in child safety and behavioral outcomes. Methods: In the original FC study, a sample of 154 families (473 children) in a poor, urban neighborhood, who met risk criteria for child neglect, were randomly assigned to receive either a 3- or 9-month intervention. CPS reports and self-report and observational data on risk and protective factors, safety, and behavioral outcomes were collected prior to, at the end of, and 6-months post intervention. The current study compared the costs of delivering the 3- or 9-month intervention in relation to reported improvements in risk and protective factors, safety, and behavioral outcomes for each group. Results: The 3-month intervention was more cost effective than the 9-month intervention in relation to positive changes in risk and protective factors and child safety. However, cost-effectiveness analysis indicated that the 9- month intervention was more cost effective (CE ratio = $276) than the 3-month intervention (CE ratio = $337) in relation to improved unit changes in the child’s behavior between baseline and 6 months after service closure. Conclusions: This study successfully explored the cost-effectiveness of the FC intervention in relation to its intended outcomes. More extensive cost analyses are currently being conducted in the replication of this program in multiple jurisdictions across the United States.  Development of this paper was partially supported by Grant Number 90CA1580 from the Children’s Bureau, U.S. Department of Heath and Human Services, Diane DePanfilis (Principal Investigator); Howard Dubowitz and Esta Glazer-Semmel (Co-Principal Investigators).  Portions of this paper were presented at the Eighth Annual Conference of the Society for Social Work and Research, New Orleans, January 16–19, 2004 in New Orleans. * Corresponding author address: Ruth H. Young Center for Families, University of Maryland School of Social Work, 525 W. Redwood Street, Baltimore, MD 21201, USA. 0145-2134/$ – see front matter © 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.chiabu.2007.06.005