Characteristics and Behavioral Outcomes for Youth in Group Care and Family-Based Care : Propensity Score Matching Approach Using National Data

Objective: This study aimed to answer two questions: (1) Given expected differences in children who are placed in group care compared to those in family-based settings, is it possible to match children on baseline characteristics? (2) Are there differences in behavioral outcomes for youth with episodes in group care versus those in family-based care?

Methods: Using data from the National Study on Child and Adolescent Well-Being, the study sample included 1,191 children with episodes in out-of-home care (n=254 youth with group care episodes; n=937 youth with episodes in family-based care and no group care). Conditioning variables were identified, which distinguished between youth with episodes in group care and those without. Using propensity score matching, all youth placed into group care were matched on the propensity score with family-based care youth. Nearest-neighbor matching was used with a caliper of 0.3. Based on the matched sample, behavioral outcomes at 36 months, as measured by the Child Behavior Checklist (total, externalizing, and internalizing) were compared for the two groups.

Results: Of the total 254 youth with group care episodes, 157 could be matched to youth with episodes in family-based care. No significant differences remained on identified variables between the two groups in the matched sample. Findings showed no significant differences with regard to the three behavioral outcomes.

Conclusions: There is considerable overlap in characteristics between youth in group care and those in family-based care. This raises questions about the placement decision-making process, the role of group care settings and the ability of service systems to provide optimal levels of care for youth. The no-difference finding with regard to behavioral outcomes does not support the contention that group care produces worse outcomes than family-based care. However, given the cost and restrictive nature of group care, youth with behavior problems no more severe than found in lower level care, should be placed in family- based care.

Practice Implications: Service systems need to clarify criteria for entry into group care and develop protocols that would provide clear and objective guidance about who gets placed into group care with the aim of eliminating unnecessary group care utilization.