Highlights
- •Young children are able to flourish despite exposure to adversity.
- •Parent, family, and neighborhood support promote child flourishing.
- •When parents are emotionally supported, children are more likely to flourish.
- •Innovative pediatric primary care models may promote resilience and flourishing.
Abstract
Purpose
Explore factors associated with flourishing and family resilience among children aged
6 months to 5 years old in the 2016 National Survey of Children's Health (NSCH).
Design and methods
Cross-sectional analysis of the 2016 NSCH was conducted using Kleinman and Norton's
Regression Risk Analysis method to derive adjusted risk measures for logistic regression
models to assess factors contributing to (1) child flourishing and (2) child flourishing
stratified between resilient and non-resilient families.
Results
In multivariable models, resilient families less often reported a child with two or
more lifetime ACE exposures (ARD −0.11, 95% CI −0.15, −0.08), more likely to live
in a supportive neighborhood (ARD 0.08, 95% CI 0.05,0.11), and more likely to report
emotional support in raising children (ARD 0.07, 95% CI 0.12, 0.40). Accounting for
ACE exposures, within resilient families, child flourishing was more likely when the
child lived in a supportive neighborhood (ARD 0.09, 95% CI 0.03, 0.15), received care
in a patient centered medical home (ARD 0.09, 95% CI 0.02,0.15), and when parents
reported having emotional support in raising children (ARD 0.10, 95% CI 0.05, 0.17)
Within non-resilient families, child flourishing was more likely when parents had
emotional support in raising children (ARD 0.15, 95% CI 0.04,0.27).
Conclusion
Promoting emotional support for parents may bolster family resilience and help young
children to flourish despite adversity.
Practice implications
Further research and innovative models of care are needed to optimize the role of
pediatric primary care in promoting safe, stable, nurturing relationships and environments
for children and families.
Keywords
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Article info
Publication history
Published online: May 28, 2022
Accepted:
May 16,
2022
Received in revised form:
April 19,
2022
Received:
January 11,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
