Peer-reviewed article
Family-Centered Care and Outcomes of Child Flourishing and Family Resilience and Connection
Anna E. Austin, Christine Katie Thang, Sasha S. Svendsen ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This cross-sectional study used 2021 to 2024 National Survey of Children's Health data on 110,984 US children aged 6 to 17 who had a health care visit in the past year. It compared children whose caregivers reported family-centered care with those whose caregivers did not. After adjusting for confounders, family-centered care was linked to a higher share of children flourishing and of families reporting resilience and connection. The links were stronger for children with adverse childhood experiences (ACEs) than for children without them. The authors suggest that family-centered care is a practical way for health professionals to support child and family well-being.
Key points
- The sample was 110,984 US children aged 6 to 17 with a health care visit in the past 12 months.
- Child flourishing was 8.6 percentage points higher among those who received family-centered care (95% CI 0.072-0.101).
- Family resilience and connection was 8.2 percentage points higher among those who received it (95% CI 0.069-0.096).
- For child flourishing, the difference was 11.2 points for children with ACEs and 6.8 points for children without ACEs.
- For family resilience and connection, the difference was larger for children with ACEs (10.5 points) than for those without (the abstract reports 0.0563).
Limitations
The cross-sectional design, with caregiver-reported measures, shows association only and cannot show that family-centered care caused better outcomes or in which direction the link runs. The findings apply to US children who had a health care visit, so they may not carry over to other settings or to children without access to care.
Abstract
Importance Family-centered care is an approach to pediatric health care that recognizes the essential role of the family in ensuring child health and well-being, seeks to establish collaborative partnerships among the child, family, and health care team, and provides a framework for implementing trauma-informed care. However, the association between receiving family-centered care and key measures of child and family well-being, including among families with a history of trauma and adversity, is unknown. Objectives To examine associations between family-centered care and child flourishing and family resilience and connection among US children and to assess whether associations differ by the child’s history of adverse childhood experiences (ACEs). Design, Setting, and Participants This cross-sectional study used 2021 to 2024 National Survey of Children’s Health data from children aged 6 to 17 years. Analyses were conducted in September to December 2025. Exposure Caregiver report of receipt of family-centered care by the child’s physician or other health care practitioners in the past 12 months. Main Outcomes and Measures Child flourishing and family resilience and connection based on caregiver response to established measures. Results This study assessed 110 984 children (mean [SD] age, 11.5 [0.02], years; 57 302 [51.0%] male and 53 682 [49.0%] female) who had a health care visit in the past 12 months. Adjusted for potential confounders, the prevalence of child flourishing was 8.6 percentage points higher (prevalence difference [PD], 0.086; 95% CI, 0.072-0.101), and the prevalence of family resilience and connection was 8.2 percentage points higher (PD, 0.082; 95% CI, 0.069-0.096) for those who received family-centered care compared with those who did not. Among children with and without ACEs, the prevalence of child flourishing (with ACES: PD, 0.112; 95% CI, 0.089-0.132; without ACEs: PD, 0.068; 95% CI, 0.049-0.087) and family resilience and connection (with ACEs: PD, 0.105; 95% CI, 0.085-0.125; without ACEs: PD, 0.0563; 95% CI, 0.043-0.081) was higher for those who received family-centered care compared with those who did not, with larger estimates among children with ACEs than children without ACEs. Conclusions and Relevance Results from this cross-sectional study found that family-centered care was associated with a higher prevalence of child flourishing and family resilience and connection, particularly among those with a history of adversity. These results suggest that family-centered care offers a practical and measurable way for health care professionals to promote well-being for all children and families but particularly for children with a history of ACEs.