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Group care programs are often criticized for producing poor outcomes, especially in light of community-based alternatives like treatment foster care that have a stronger evidence base. In this study, data from Girls and Boys Town were used to compare outcomes of youth in treatment foster care (n=112) and group care (n=716) using propensity score matching, a method that can minimize selection bias in nonrandomized designs. Eighteen background covariates were used to develop propensity scores for the likelihood of receiving treatment foster care rather than group care. Several matching methods generated balanced samples on which the outcomes were compared. Results found that group care youth were more likely to be favorably discharged, more likely to return home, and less likely to experience subsequent placement in the first six months after discharge. Legal involvement and residing in a home-like environment at follow-up did not differ. Positive outcomes for group care youth suggest that family-style group care programs may promote effectiveness. Keywordstreatment foster care; family-style group care; propensity score matching Prevailing wisdom in systems of care for youth promotes a philosophy of least restrictive and community-based care (Stroul & Friedman, 1986). A growing body of evidence suggests that specialized foster care settings like treatment foster care (Chamberlain & Reid, 1991;Fisher & Chamberlain, 2000) are more effective and cost-efficient than group care (Chamberlain & Reid, 1998;Eddy & Chamberlain, 2000; U.S. Department of Health and Human Services [USDHHS], 1999). In a continuum of care, group care often serves youth whose needs surpass the capacity of traditional family foster care, but are not acute enough to warrant inpatient hospitalization (CWLA, 2004). With the emergence of treatment foster care as a possible alternative to group placements, questions about the continued broad use of group care are increasing (Barth, 2005).Despite widespread questions about youth safety during care (Barth, 2002) and equivocal outcomes following care (Hair, 2005;Wells, 1991), group care programs are prevalent. In this article, the term group care will be used interchangeably with residential care to label programs Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptChild Youth Serv Rev. Author manuscript; available in PMC 2009 January 1. Published in final edited form as:Child Youth Serv Rev. 2008 ; 30(7): 746-757. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript that provide services 24-hours a day to...

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This is a review article examining the relationship between involvement in athletics and disordered eating. According to research on risk factors in the general population, gender, race, and activities that encourage dieting or weight loss by emphasizing a thin shape play an important role in the prevalence of eating disturbance. Factors in the athletic environment that increase the athlete's risk are addressed, such as the belief among athletes and coaches that a reduction in weight or body fat can enhance athletic performance. The authors propose a shift in emphasis from athletic performance to the health of the athlete. Practical educational recommendations to reduce the athlete's risk of disordered eating are offered for athletes and sport management personnel. Additionally preventative suggestions are offered for modifying aspects of the athletic environment.We tend to think of athletes, especially those at collegiate or elite levels of competition, as being "healthy." This assumption of health may in part be engendered by their athletic performance or by what they are able and willing to endure through training and conditioning. This level of physical rigor gets interpreted as healthy. Yet in the name of commitment and competition, athletes engage in behaviors that are far from healthy. This has become of increasing concern as a growing subpopulation of athletes is suffering from anorexia nervosa, bulimia nervosa, and other disordered eating patterns.