Evaluating Youth Needs and Response to Services in a Residential Program Based on Neighborhood Factors

Communities have different neighborhood factors, such as economic, educational, and healthcare resources that can influence child development. This study evaluated the relationship between neighborhood factors and the clinical needs and treatment response of youth in a residential program. The Child Opportunity Index was used to gain a better understanding of the relationship between neighborhood factors and youth presenting problems, behavioral incidents, changes in total difficulties from intake to discharge, residential placement safety and stability, and discharge placement. The sample included 1773 youth from 34 states in the U.S. who resided in the Boys Town Family Home Program from 2013 to 2023. Including neighborhood factors in the clinical assessment provided new insights into youth treatment needs and response to services. Youth who came from neighborhoods with better community resources had more severe clinical needs, with mixed internalizing and externalizing problems, while greater proportion of youth from communities with poorer quality of resources presented with truancy and legal problems. Youth from different communities with varying neighborhood resources made progress in the program, but youth from neighborhoods with better resources made greater gains because they started with more significant clinical needs. Limitations and recommendations for further research are also discussed.