Caring Against the Odds
The Role of Patient-Centered Care in Adverse Childhood Environments
Bibliographic Data
| ID | 22006115 |
|---|---|
| Authors | Qiwei Wu (0000-0002-6179-9755, Texas Tech University), Grace Ellen Brannon (0000-0003-1116-9015, The University of Texas at Arlington, corresponding author) |
| Year | 2026 |
| Volume | 16 |
| Issue | 2 |
| Publication date | 2026-04-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | SAGE Open (JOURNAL) |
| Journal identifiers | ISSN: 2158-2440 • E-ISSN: 2158-2440 |
| Publisher | SAGE Publications (PUBLISHER • US) |
| DOI | 10.1177/21582440261454864 |
| OpenAlex | W7163882569 |
| Language | EN |
| References cited | 77 |
Incidence rates of childhood overweight and obesity continue to grow in the United States, threatening children’s health and social development. The aim of this study was to explore how patient-centered care (PCC) at individual and system levels can influence children’s physical, mental, and social well-being. Using the National Survey on Children’s Health (NSCH), data were drawn from 4,045 parents of children aged 6 to 17 who were overweight or obese and had seen a doctor in the past year. Parents reported their child’s adverse childhood experiences (ACEs), difficulty paying medical bills, PCC, system of care, expression of weight concerns, physical activity, forgone mental healthcare, and ability to make friends. Structural equation modeling tested whether PCC mediated the effects of social determinants of health on physical, mental, and social outcomes. Unaffordable medical bills and ACEs significantly worsened children’s mental, physical, and social outcomes. Both system-level and interpersonal PCC mediated these effects. A well-functioning healthcare system predicted greater physical activity, while interpersonal PCC predicted increased use of mental healthcare, improved physical activity, and fewer difficulties making friends. However, provider expression of concern about overweight status was associated with reduced physical activity. PCC and system-level support enhance children’s well-being but cannot fully offset adverse environments. This shows the urgency of addressing broader social determinants. Providers should attend to children’s needs and avoid relying solely on weight-focused messaging, which may inadvertently harm physical activity and social adjustment
Childhood obesity · Harm · Health care · Interpersonal communication · Mental health · Overweight · Social determinants of health · Social support · Child Abuse and Trauma · Obesity and Health Practices · Obesity, Physical Activity, Diet
How does communication heal? Pathways linking clinician–patient communication to health outcomes
Multicollinearity
Resiliency Theory
ACEs and counter-ACEs
Associations of loneliness and social isolation with physical and mental health among adolescents and young adults
Neighborhood Socioeconomic Conditions, Built Environments, And Childhood Obesity
A systematic review of racial/ethnic and socioeconomic disparities in Covid-19
Impact of weight bias and stigma on quality of care and outcomes for patients with obesity
Patient-centered communication in cancer care: Promoting healing and reducing suffering
Age-Related Consequences of Childhood Obesity
The global obesity pandemic
It Takes a Village to Raise a Child
Collaborative Care and Healthcare Usage in Families with Pediatric Patients During Covid-19
“I Remember Feeling Pretty Darn Lucky”
Domestic Violence During the Covid-19 Pandemic
Understanding recent trends in childhood obesity in the United States
Changes in mental health problems and access to mental health care among US adolescents before and during the Covid-19 pandemic
Relationship between physical exercise, bullying, and being bullied among junior high school students
Health Care Access and Quality Among Children Exposed to Adversity
Adverse childhood experiences, health behaviors, and associations with obesity among youth in the United States
Obesity and social marginalization
Early exposure to environmental chaos and children's physical and mental health
A Framework for Increasing Equity Impact in Obesity Prevention
Early Adverse Childhood Experiences and Social Skills Among Youth in Fragile Families
The relationship between physical and mental health
| Citation velocity | historical |
|---|---|
| Highly cited | No |