103 - The Impact of Parental and Neighborhood Support in Promoting Childhood Flourishing in Children with Adverse Childhood Experiences

Publication Number: 2098.103

Katherine E. McGreal, Wright State University Boonshoft School of Medicine, Beavercreek, OH, United States; Adrienne Stolfi, Wright State University Boonshoft School of Medicine, Dayton, OH, United States; Nora L. Vish, Dayton Children's Hospital, Dayton, OH, United States

Background: Flourishing is a common outcome used to quantify positive childhood development and well-being and correlates with later educational attainment and decreased mental illness. Adverse childhood experiences (ACEs) decrease a child's flourishing and have long-lasting health impacts. Protective factors, such as interpersonal and community support, have been shown to buffer against these negative effects.

Objective: This study examined the role of parental emotional support (PES) and neighborhood support (NS) on childhood flourishing in children aged 6 months-17 years.

Design/Methods: The 2022 National Survey of Children's Health was used to examine the influence of PES, NS, and ACEs on flourishing in children aged 6 months-17 years. Flourishing was defined as positive responses to 3 of 3 questions about a child's ability to stay in control, learn new things, and finish tasks. ACEs were grouped into 0, 1, 2-3, and 4-7. PES was classified as yes or no based on whether a parent had someone to turn to for daily emotional support with parenting. NS was classified as yes or no based on living in a neighborhood where people help and watch out for each other, and know where to go for help. Adjusted odds ratios (aOR, 95% confidence interval, CI) of flourishing were determined for PES, NS, and ACEs using multiple logistic regressions. All analyses were performed using IBM SPSS Statistics for Windows Complex Samples module with weighting.

Results: A total of 18,004 children aged 6 months-5 years and 34,362 aged 6-17 years, representing a total population of 71,269,136, were included. The prevalence of not flourishing was 20.7% and 40.0% in the younger and older groups respectively. Characteristics of the groups are shown in Table 1. In older children, as the number of ACEs increased the aORs of not flourishing increased, but in younger children, this association was not observed (Table 2). Not living in a supportive neighborhood was associated with increased aORs of not flourishing in both age groups. Not having PES increased the aOR of not flourishing only in younger children (Table 2).

Conclusion(s): This study reinforces previous findings of the effects of ACEs on childhood flourishing in older children. It adds to previous findings by also examining the protective factors of PES and NS. Among younger children, lacking PES and NS increased the odds of not flourishing. As we learn more about the role of protective factors in long-term health and well-being, strategies should focus on increasing opportunities to support parents and on strengthening neighborhood and community support to promote flourishing across all ages.

Table 1. Sample characteristics and weighted population percentages
Abbreviations: ACEs, adverse childhood experiences; CI, confidence interval; GED, General educational development test

Table 2. Results of multiple logistic regression analyses predicting odds of not flourishing
Abbreviations: ACEs, adverse childhood experiences; aOR, adjusted odds ratio; CI, confidence interval; GED, General educational development test