{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:51:33Z","timestamp":1791215493038,"version":"4.1.0"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n 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\u2019s history of adverse childhood experiences (ACEs).<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional study used 2021 to 2024 National Survey of Children\u2019s Health data from children aged 6 to 17 years. Analyses were conducted in September to December 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Caregiver report of receipt of family-centered care by the child\u2019s physician or other health care practitioners in the past 12 months.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Child flourishing and family resilience and connection based on caregiver response to established measures.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n This study assessed 110\u202f984 children (mean [SD] age, 11.5 [0.02], years; 57\u202f302 [51.0%] male and 53\u202f682 [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.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.31265","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:00:25Z","timestamp":1791212425000},"page":"e2631265","source":"Crossref","is-referenced-by-count":0,"title":["Family-Centered Care and Outcomes of Child Flourishing and Family Resilience and Connection"],"prefix":"10.1001","volume":"9","author":[{"given":"Anna E.","family":"Austin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill"},{"name":"Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine K.","family":"Thang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha S.","family":"Svendsen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, UMass Chan Medical School, Worcester, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"2","key":"zoi260857r1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1542\/peds.2011-3084","article-title":"Patient-and family-centered care and the pediatrician\u2019s role.","volume":"129","author":"Committee on Hospital Care and Institute for Patient-and Family-Centered Care","year":"2012","journal-title":"Pediatrics"},{"issue":"3","key":"zoi260857r2","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1007\/s10995-022-03539-7","article-title":"Contributions of key components of a medical home on child health outcomes.","volume":"27","author":"Arthur","year":"2023","journal-title":"Matern Child Health J"},{"issue":"5","key":"zoi260857r3","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1016\/j.acap.2024.02.014","article-title":"Family-centered care and delayed or missed pediatric preventive care due to the COVID-19 pandemic.","volume":"24","author":"Tabet","year":"2024","journal-title":"Acad Pediatr"},{"issue":"3","key":"zoi260857r4","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1177\/0009922818813568","article-title":"Association between the medical home model of care and demographic characteristics in US children.","volume":"58","author":"Fleary","year":"2019","journal-title":"Clin Pediatr (Phila)"},{"issue":"1","key":"zoi260857r5","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1111\/1475-6773.12488","article-title":"Clarifying the predictive value of family-centered care and shared decision making for pediatric healthcare outcomes using the medical expenditure panel survey.","volume":"52","author":"Lindly","year":"2017","journal-title":"Health Serv Res"},{"issue":"6","key":"zoi260857r6","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1016\/j.acap.2016.10.018","article-title":"Family-centered care measurement and associations with unmet health care need among US children.","volume":"17","author":"Lindly","year":"2017","journal-title":"Acad Pediatr"},{"issue":"7","key":"zoi260857r7","doi-asserted-by":"publisher","first-page":"1926","DOI":"10.1007\/s10826-019-01418-4","article-title":"The benefits of family-centered care for parental self-efficacy and psychological well-being in parents of children with cancer.","volume":"28","author":"Salvador","year":"2019","journal-title":"J Child Fam Stud"},{"issue":"39","key":"zoi260857r8","doi-asserted-by":"publisher","first-page":"2559","DOI":"10.11124\/jbisrir-2012-32","article-title":"Family-centred care for hospitalised children aged 0-12 Years: A systematic review of quasi-experimental studies.","volume":"10","author":"Shields","year":"2012","journal-title":"JBI Libr Syst Rev"},{"issue":"2","key":"zoi260857r9","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.acap.2010.12.014","article-title":"Evidence for family-centered care for children with special health care needs: a systematic review.","volume":"11","author":"Kuhlthau","year":"2011","journal-title":"Acad Pediatr"},{"issue":"1","key":"zoi260857r10","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/s12884-017-1247-2","article-title":"Family-centred interventions by primary healthcare services for Indigenous early childhood wellbeing in Australia, Canada, New Zealand and the United States: a systematic scoping review.","volume":"17","author":"McCalman","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"issue":"5","key":"zoi260857r11","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.amepre.2022.06.015","article-title":"Family-centered care and flourishing in early childhood.","volume":"63","author":"Donney","year":"2022","journal-title":"Am J Prev Med"},{"issue":"8","key":"zoi260857r12","doi-asserted-by":"publisher","first-page":"e356","DOI":"10.1016\/S2468-2667(17)30118-4","article-title":"The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis.","volume":"2","author":"Hughes","year":"2017","journal-title":"Lancet Public Health"},{"issue":"4","key":"zoi260857r13","doi-asserted-by":"publisher","DOI":"10.1177\/21582440241302899","article-title":"Adverse childhood experiences and resilience: family resilience as a promotive factor in young children\u2019s flourishing.","volume":"14","author":"Thompson","year":"2024","journal-title":"SAGE Open"},{"issue":"2","key":"zoi260857r14","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-052580","article-title":"Trauma-informed care.","volume":"148","author":"Forkey","year":"2021","journal-title":"Pediatrics"},{"issue":"1","key":"zoi260857r15","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1001\/jamapediatrics.2015.2206","article-title":"Implementing a trauma-informed approach in pediatric health care networks.","volume":"170","author":"Marsac","year":"2016","journal-title":"JAMA Pediatr"},{"issue":"2","key":"zoi260857r17","doi-asserted-by":"publisher","first-page":"80","DOI":"10.2174\/1874924001003020080","article-title":"Shelter from the storm: trauma-informed care in homelessness services settings.","volume":"3","author":"Hopper","year":"2010","journal-title":"Open Health Serv Policy J"},{"issue":"1","key":"zoi260857r19","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s43058-023-00428-0","article-title":"Barriers and enablers for the implementation of trauma-informed care in healthcare settings: a systematic review.","volume":"4","author":"Huo","year":"2023","journal-title":"Implement Sci Commun"},{"issue":"3","key":"zoi260857r20","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s11414-020-09741-1","article-title":"Trauma-informed pediatric primary care: facilitators and challenges to the implementation process.","volume":"48","author":"Sala-Hamrick","year":"2021","journal-title":"J Behav Health Serv Res"},{"issue":"5","key":"zoi260857r21","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1377\/hlthaff.2018.05425","article-title":"Family resilience and connection promote flourishing among US children, even amid adversity.","volume":"38","author":"Bethell","year":"2019","journal-title":"Health Aff (Millwood)"},{"issue":"4","key":"zoi260857r22","doi-asserted-by":"crossref","DOI":"10.1177\/21582440241302899","article-title":"Adverse childhood experiences and resilience: Family resilience as a promotive factor in young children\u2019s flourishing.","volume":"14","author":"Thompson","year":"2024","journal-title":"SAGE Open"},{"issue":"7","key":"zoi260857r23","doi-asserted-by":"publisher","first-page":"1861","DOI":"10.1038\/s41390-020-01188-6","article-title":"Influence of race\/ethnicity and income on the link between adverse childhood experiences and child flourishing.","volume":"89","author":"Goldstein","year":"2021","journal-title":"Pediatr Res"},{"issue":"2","key":"zoi260857r25","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1542\/peds.2012-1535","article-title":"Disparities in unmet need for care coordination: the national survey of children\u2019s health.","volume":"131","author":"Toomey","year":"2013","journal-title":"Pediatrics"},{"issue":"6","key":"zoi260857r26","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1542\/peds.2009-1994","article-title":"Family-centered care for US children with special health care needs: who gets it and why?","volume":"125","author":"Coker","year":"2010","journal-title":"Pediatrics"},{"issue":"4","key":"zoi260857r27","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1111\/1475-6773.12160","article-title":"The effect of response scale, administration mode, and format on responses to the CAHPS Clinician and Group survey.","volume":"49","author":"Drake","year":"2014","journal-title":"Health Serv Res"},{"key":"zoi260857r28","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/j.jad.2021.07.073","article-title":"Behavioral and mental health problems in adolescents with ADHD: exploring the role of family resilience.","volume":"294","author":"Song","year":"2021","journal-title":"J Affect Disord"},{"issue":"4","key":"zoi260857r29","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2025.102807","article-title":"The association of food hardship with family resilience and connection: does participation in Supplemental Nutrition Assistance Program modify this association?","volume":"25","author":"Frank","year":"2025","journal-title":"Acad Pediatr"},{"key":"zoi260857r30","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.chiabu.2019.02.011","article-title":"Directed acyclic graphs: an under-utilized tool for child maltreatment research.","volume":"91","author":"Austin","year":"2019","journal-title":"Child Abuse Negl"},{"key":"zoi260857r31","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.jclinepi.2019.06.011","article-title":"Who is in this study, anyway? guidelines for a useful Table 1.","volume":"114","author":"Hayes-Larson","year":"2019","journal-title":"J Clin Epidemiol"},{"issue":"1","key":"zoi260857r33","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/168521","article-title":"Geographic, racial\/ethnic, and sociodemographic disparities in parent-reported receipt of family-centered care among US children.","volume":"2015","author":"Azuine","year":"2015","journal-title":"Int J Family Med"},{"issue":"2","key":"zoi260857r34","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-052582","article-title":"Preventing childhood toxic stress: partnering with families and communities to promote relational health.","volume":"148","author":"Garner","year":"2021","journal-title":"Pediatrics"},{"issue":"2","key":"zoi260857r35","doi-asserted-by":"publisher","DOI":"10.1016\/j.focus.2022.100039","article-title":"Recommendations for population-based applications of the adverse childhood experiences study: position statement by the American College of Preventive Medicine.","volume":"1","author":"Sherin","year":"2022","journal-title":"AJPM Focus"},{"key":"zoi260857r16","unstructured":"Data Resource Center for Child & Adolescent Health. NSCH codebooks. 2025. Accessed December 29, 2025. https:\/\/www.childhealthdata.org\/learn-about-the-nsch\/nsch-codebooks"},{"key":"zoi260857r18","unstructured":"Substance Abuse and Mental Health Services Administration. SAMHSA\u2019s Concept of Trauma and Guidance for a Trauma-Informed Approach. 2014. Accessed February 13, 2026. https:\/\/store.samhsa.gov\/sites\/default\/files\/d7\/priv\/sma14-4884.pdf"},{"key":"zoi260857r24","unstructured":"Data Resource Center for Child & Adolescent Health. NSCH Survey Methodology. 2025. Accessed December 29, 2025. https:\/\/www.childhealthdata.org\/learn-about-the-nsch\/methods"},{"key":"zoi260857r32","unstructured":"American Statistical Association. Statement on statistical significance and P values. 2016. Accessed February 13, 2026. https:\/\/www.amstat.org\/asa\/files\/pdfs\/P-ValueStatement.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2854834\/austin_2026_oi_260857_1790603770.60201.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:00:26Z","timestamp":1791212426000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2854834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":35,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.31265","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]}}}