Outcomes research on children, adolescents, and their families: directions for future inquiry.

Abstract

Children have been poorly represented in clinical studies and health services research. However, this situation is changing rapidly, and the number of research studies focusing on child outcomes is steadily increasing. The special characteristics of childhood related to health care-developmental change, dependency on adults, different disease epidemiology from adults, and unique demographic characteristics-pose methodologic challenges to researchers. These characteristics also argue for an expanded concept of outcomes research that is centered on a child-specific model of the production of health, its determinants, and its relationship to healthcare services. This article proposes priorities for future inquiry, including developing new measures specific to children; examining the influence of medical, public health, and other community interventions on children's long-term health trajectories; increasing attention to risk behaviors and resiliency factors that influence children's future health status; reconsidering the value of routine child healthcare and pediatric specialty care; examining the financing and organization of children's health care; exploring the importance of family influences on child and adolescent health; and addressing optimal treatment strategies for managing common childhood health problems.