Adolescent Experiences Research Articles

Association Between Social Determinants of Health and Concussion Among High School Students in the United States.

We examined the association between social determinants of health and the likelihood of sustaining a concussion among adolescents. Participants in this cross-sectional study were 7164 high school students who completed the 2021 Adolescent Behaviors and Experiences Survey (52.7% girls; mean age = 16.0 years, SD = 1.2; age range 12-18 years). Logistic regression was used to determine which social determinants of health variables were associated with a self-reported history of concussion from playing a sport or being physically active over the past year. One in 10 adolescents (n = 716; 10.0% total; 11.8% of boys, 8.3% of girls) reported sustaining a concussion during the past year. Seven of 10 adolescents (70.3%) reported experiencing at least 1 of 8 negative social determinants of health. A multivariable logistic regression was statistically significant (P < .001), indicating that the negative social determinants of health were associated with having sustained a concussion during the past year; the model explained 12.5% (Nagelkerke R2) of the variance in concussion. Controlling for all other predictors, sports participation (odds ratio [OR] = 3.72, medium effect), housing instability (OR = 3.25, small-medium effect) and limited English language proficiency (OR = 3.05, small-medium effect) were the strongest independent predictors of sustaining concussion within the past year. Adolescents who lived in a neighborhood where there is violence (OR = 1.78, small effect), who were bullied (OR = 1.57, very small effect), and who experienced food insecurity (OR = 1.36, very small effect) were more likely to have sustained a concussion. Research is needed to understand the nature of these determinant-injury associations. Whether social determinants of health are associated with specific treatment and rehabilitation needs, and time to recover following concussion, should be examined with prospective studies.

Exploring the experience of stigma among children and adolescents with epilepsy in China: A qualitative study.

Epilepsy-related stigma negatively affects the lives of children and adolescents. This study aims to explore the experience of stigma among children and adolescents with epilepsy in China. This study used purposive sampling to select children and adolescents aged 10-18 diagnosed with epilepsy. A total of sixteen participants with epilepsy engaged in semi-structured interviews. The interviews were audio-recorded, transcribed and translated. The data were then analyzed using a thematic analysis approach to identify themes and subthemes. The study identified four themes in the stigma experiences of children and adolescents with epilepsy: (1) The triggers of stigma, which include epilepsy stereotypes, seizure manifestations, and their unpredictability; (2) Concerns and uncertainties encompassing ASMs, academic pressure, future concerns, and transition uncertainties; (3) The impact of stigma on daily life including sleep and physical activity; and (4) Strategies and resources for addressing stigma, highlighting the importance of education and peer support. Our findings provide a better understanding of the experience of epilepsy-related stigma among children and adolescents in China. The experiences of stigma described reveal the complex causes and the profound negative impact on their lives. However, it's important to note that children and adolescents can also have positive experiences when confronted with stigma. Psychosocial outcomes can be improved through comprehensive education and peer support. Our findings can inform further research into evidence-based strategies for stigma reduction interventions that promote well-being.

The Social Construction of Gender in the Experience of Vocational School Adolescents. A Critical Approach

In the context of vocational high schools, gender role divisions and stereotypes are often reinforced by the educational environment and social practices, which have an impact on career choices, social interactions, and future opportunities for adolescents, so this research aims to analyze how gender norms and stereotypes are formed and maintained in vocational high schools, identifies the social dynamics that influence adolescents' experiences of gender roles, presenting a critical approach to understanding and challenging the social construction of gender in educational institutions. It is also hoped that this research can provide important insight into how vocational education institutions become dynamic spaces in shaping adolescent gender identity. These findings also open a discussion regarding the importance of educational reform that is more inclusive and gender equal, so that it can encourage students to explore their potential without the limitations of gender stereotypes.Through a qualitative approach with in-depth interviews and participant observation, this research explores how patriarchal values, traditional gender norms, and educational policies implicitly shape adolescents' gender identity. This research concludes that the education system in vocational high schools is not gender neutral, but rather reproduces gender-based social injustice. Therefore, efforts are needed to deconstruct gender norms that exist in the curriculum and educational practices, in order to create a more inclusive and fair learning environment for all teenagers, regardless of their gender identity.

The adolescent experience of hereditary angioedema: a qualitative study of disease burden and treatment experience

BackgroundHereditary angioedema (HAE) is a rare, autosomal dominant disorder causing swelling attacks in various parts of the body, resulting in impacts on health-related quality of life (HRQoL). The symptoms of HAE and its impacts on HRQoL have been well-documented in adults; however, relatively little is known about the experiences of adolescents with HAE. The objective of this study was to use qualitative interviews to investigate how adolescents experience HAE symptoms and how HAE impacts their HRQoL.MethodsThis was a non-interventional, qualitative study of adolescents with HAE. Participants were recruited via a patient advocacy organization and were eligible to take part in this study if they had a confirmed diagnosis of type I or type II HAE and were currently on prophylactic treatment to prevent HAE attacks. All participants completed a one-to-one, 60-minute, remote interview designed to elicit their experiences of HAE. Interview data were coded and analyzed using NVivo qualitative software.ResultsTwelve adolescents took part in this study. HAE attacks were described as painful and uncomfortable. Attacks varied by trigger, frequency, severity, location, and duration. Participants described ways in which HAE impacted their daily lives, including impacts on physical, social, emotional, and cognitive functioning, in addition to sleep disturbance, school-related impacts, and a need to avoid attack triggers. Impacts on emotional and social functioning were particularly noteworthy, as participants reported having to miss or skip social events, and sometimes withdrawing socially. Since initiating prophylaxis, participants reported the frequency, severity, and duration of attacks had been reduced and their HAE-related impacts had been minimized. Participants were satisfied with their current prophylactic and acute treatments, and expressed a preference for treatments that were effective, convenient, self-administered, and had minimal side effects.ConclusionAdolescents with HAE reported experiencing a range of symptoms that, when untreated, impacted their HRQoL in ways that are unique from adults. Further, participants reported that effective treatments (prophylactic and acute) inhibited symptoms and HRQoL impacts with minimal treatment burden. Findings from this study suggest that health care providers and clinical investigators should consider the unique HRQoL impacts experienced by adolescents when evaluating treatment benefit.

Do Defense Mechanisms and Dissociation Symptoms Link the Association Between Adverse Childhood Experience and Somatization Symptoms in Faroese Adolescents

ABSTRACT Exposure to multiple adverse childhood experiences (ACEs) is a risk factor for the development and increase in somatization symptoms among adolescents. Defense mechanisms and dissociation may play a key role in the association between these variables. The aim of the study was to analyze the indirect association between direct and indirect exposure to ACEs with somatization symptoms through defense mechanisms and dissociation symptoms in Faroese adolescents. The sample consisted of 687 Faroese adolescents, who completed validated self-report questionnaires that assessed the variables under study. Serial multiple mediation models were tested by conducting a structural equation modeling employing Preacher and Hayes’ procedures (2008). Results showed that both direct and indirect exposure to multiple types of ACEs was indirectly related to somatization symptoms through immature defenses and dissociation symptoms. Indirect exposure to multiple types of ACEs was also indirectly related to somatization symptoms through neurotic defenses and dissociation symptoms. It was also observed that indirect exposure to multiple types of ACEs was indirectly related to somatization symptoms through immature and neurotic defense mechanisms. The results suggest the central role of both defense mechanisms and dissociation symptoms in the association between direct and indirect exposure to multiple types of ACEs and somatization symptoms in Faroese adolescents.

Suicidal ideation and suicide attempt among pregnant adolescent girls in Ghana: a cross-sectional study

BackgroundGlobally, suicide is the third leading cause of death among girls aged 15–19 years. However, there is a growing concern that suicide research has paid little attention to pregnant adolescent...

Sexual identity is associated with adverse childhood experiences (ACEs) in US early adolescents

ObjectiveTo determine disparities in adverse childhood experiences (ACEs) by sexual identity in a national cohort of early adolescents. MethodsWe analyzed cross-sectional data from year 2 of the Adolescent Brain Cognitive Development Study (N=10,934, 2018-2020, ages 10-14 years). Disparities in ACE score across lesbian, gay, or bisexual (LGB), not sure, and heterosexual adolescents were assessed using multinomial logistic regression analyses. Logistic regressions estimated the associations between sexual identity and each individual ACE. Analyses were adjusted for potential confounders. ResultsIn adjusted models, LGB adolescents had higher risk of experiencing 2, 3, or ≥4 ACEs (Relative Risk Ratios [RRR] =1.57, 95% CI 1.01-2.42), 3 (RR=1.78, 95% CI 1.100-2.88), or ≥4 ACEs (RRR=3.20, 95% CI 1.92-5.32), and not sure adolescents had a higher risk of having ≥4 ACEs (RRR=2.17, 95% CI 1.22-3.87), compared to heterosexual adolescents. LGB and not sure adolescents had higher risks of reporting emotional abuse (“yes” OR =4.21, 95% CI 1.84-9.61; “maybe” OR=6.20, 95% CI 2.91-13.19) and parent mental illness (“yes” OR=1.95, 95% CI 1.48-2.57; “maybe” OR=1.63, 95% CI 1.21-2.18) compared to heterosexual adolescents. ConclusionsLGB adolescents and those questioning their sexual identity were at greater risk of having higher ACE scores, with LGB adolescents experiencing the highest risk of experiencing ACEs. LGB adolescents also had higher odds of reporting emotional and parent mental illness. Recognizing this heightened risk of ACEs in early adolescence is critical for designing clinic and school-based interventions.

Riley and representation: Challenging assumptions of generalizability in the Inside Out franchise

The following commentary calls to question the assumptions of generalizability in the Inside Out franchise, specifically the notion that Inside Out 2 depicts an authentic adolescent experience. It uses specific examples from the sequel in conversation with intersectionality to demonstrate how both films reflect a world from the eyes of a white, upper-middle-class, non-disabled, neurotypical girl and therefore should be regarded as a reflection of one type of teenage experience. This particular piece makes an effort, however, to acknowledge the progressive attempts the franchise makes at providing an educational opportunity for youth audiences, but cautions scholars and the public against assuming the applicability of the film’s elements to each and every viewer.

See us, hear us! children, adolescents and families in Saskatchewan coping with mental health during the COVID-19 pandemic

ABSTRACT Purpose To examine the lived experiences of children and adolescents coping with mental health issues and seeking mental health services in Saskatchewan during the COVID-19 pandemic. Methods In our descriptive phenomenological qualitative study, we interviewed forty-six individuals, including children aged 8–15 and their parents. Thematic analysis was applied to interpret the interview data. Results Our analysis identified three key themes: pyscho-behavioural impact, academic impact, and social impact. The pandemic adversely affected children due to factors like changes in behaviours such as increased screen time and decreased physical activity, limited access to mental health services, and disruptions to schooling and social interactions. Coping mechanisms varied, ranging from the utilization of available mental health supports and services to individual and family-based strategies. Disparities in timely access to mental health services were evident, with financially stable families accessing private services, while others struggled, particularly in rural areas. Families demonstrated resilience through parental efforts to seek balance and prioritize safety amidst COVID-19 challenges. Conclusions Social connectedness served as a crucial buffer against pandemic-induced stress. Children faced difficulty in accessing timely mental health services and supports. Echoing participant experiences, our findings emphasize the urgency of targeted interventions and policy adjustments to address existing gaps in mental health service accessibility and availability.

Living with a new kidney from the perspective of adolescents: A mandala-supported qualitative study.

Despite advances in transplant procedures, children and adolescents still face some challenges post-transplant and are at high risk for psychiatric, academic, and social problems. This study aims to explore the lived experiences of adolescent kidney transplant recipients through interviews and the use of mandala art therapy. This study adopted a descriptive phenomenological design and thematic analysis approach based on Husserl's philosophy. The sample included kidney transplant recipients aged 12-18 years admitted to the pediatric nephrology polyclinic of a university hospital in southern Türkiye. Data were collected through in-depth interviews conducted during a mandala art activity with 14 adolescent kidney transplant recipients. The qualitative data were analyzed using Colaizzi's seven-stage qualitative analysis method, which is suitable to the descriptive phenomenological design employed in the present study. Four themes and seven subthemes emerged from the data related to the problems and experiences of adolescents with kidney transplantation and growing up with a new kidney. (1) Education, (2) Ideas about the kidney; including the sub-themes "What the kidney transplant process gave them, Feelings about their kidneys", (3) Family; including the sub-themes "Relationship with the donor, Relationship with siblings", (4) Social environment; including the sub-themes "Experiences with hospital, Relationship with friends and Desire for friendship with a transplanted Peer". Mandala art therapy-assisted interviews are an effective communication method for adolescent kidney transplant recipients to express their feelings and thoughts and to look at life from a broader perspective. Understanding the life experiences of adolescents with kidney transplantation and the difficulties they face may enable better and more systematic planning of the care to be given to them.

The intimate lives of hunter-gatherer children and adolescents

The primary aim of this paper is to provide an overview of the daily lives and experiences of children and adolescents in contemporary hunter-gatherer societies. The study focuses on cultural and demographic factors that influence children’s experiences and examines general characteristics of childhood among forager communities. A secondary aim of the paper is to discuss, when possible, links between hunter-gatherer children’s lives and the archaeological record. This review focuses on the Aka and other Congo Basin hunter-gatherer because of the extensive amount of recent research on childhood in these groups, but also includes comparisons with foragers in other natural and social settings. The study analyses multiple features of childcare and children’s experiences, such as infant care, physical and emotional intimacy, play, co-sleeping and social learning. Hunter-gatherer societies have relatively unique cultural practices common to many groups living in diverse natural environments and which seem to have been conserved over time and space (Hewlett BS et al 2024). The archaeological record may have limited physical artefacts associated with children, but their lived experiences and activities can still manifest as discernible archaeological signatures. The examination of childhood in hunter-gatherer societies yields valuable insights into the breadth of human experiences and the impact of cultural practices on and by children. Understanding the cultural diversity, life experiences, and behavioural patterns of contemporary hunter-gatherer children holds promise for enriching our understanding and interpretation of children in prehistoric archaeological contexts. The findings demonstrate that children played an active and influential role within their communities, engaging in, learning from, and contributing to cultural practices and archaeological signatures.

Optimization of a digital health intervention to enhance well-being among adolescent and young adult cancer survivors: Design and methods of the EMPOWER full factorial trial.

Adolescent and young adult cancer survivors (AYAs) experience clinically significant distress and have limited access to supportive care services. Interventions to enhance psychological well-being have improved positive affect and reduced depression in clinical and healthy populations and have not been routinely tested in AYA survivors. We are optimizing a web-based positive skills intervention for AYA cancer survivors called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) by: (1) determining which intervention components have the strongest effects on well-being and (2) identifying demographic and individual difference variables that mediate and moderate EMPOWER's efficacy. EMPOWER is a five-session online intervention that teaches behavioral and cognitive skills for increasing psychological well-being. Guided by the Multiphase Optimization Strategy (MOST), we assign two levels (yes, no) to each of five intervention components (positive events, capitalizing, & gratitude; mindfulness; positive reappraisal; personal strengths & goal-setting; acts of kindness), allowing us to evaluate the effects of individual and combined intervention components on positive affect in a full factorial design. Post-treatment AYA cancer survivors (N = 352) are recruited from participating NCI-designated comprehensive cancer centers and randomized to one of 32 experimental conditions. Our primary outcome is positive affect; potential mediating and moderating variables include coping self-efficacy and emotional support, respectively. Upon trial completion, we will have an optimized, digital health intervention to enhance psychological well-being among AYA cancer survivors. EMPOWER will be scalable and primed for a large, multi-site trial among AYAs who would otherwise not have access to supportive care interventions to manage distress and enhance well-being.

Early Lifespan Trauma in Finnish Young Adults With an Out‐of‐Home Care Background—An Ecological Systems Perspective

ABSTRACTYoung people living in out‐of‐home care often have a history of adverse childhood experiences which are traumatic in nature and have long‐term influence on individuals. This article analyses the experiences of Finnish young adults with a history of out‐of‐home care and mental health challenges, in regard to their experienced trauma and interpretations of the traumatizing factors during their early lifespan. The ecological systems theory by Bronfenbrenner is used as a tool in the analysis. The article sheds light on how the experiences of trauma are connected to the levels of the ecological systems theory and how different social factors can contribute to the experience of trauma. Understanding the traumatic experiences of adolescents with an OOHC background requires a thorough consideration of all the levels of the ecological systems theory. Traumatization is often a fusion of acute, chronic and complex traumas that should be better acknowledged in child welfare work.

Peran Pendidikan Agama Islam dalam Kekerasan Berbasis Gender Online pada Remaja di Cirebon

In facing the impact of digitalization, it is necessary to control the use of technology. This can be seen from the many cases of gender violence in adolescents. This study aims to investigate the role of Islamic Religious Education (PAI) in dealing with online gender-based violence among adolescents in Cirebon. Through a qualitative phenomenological approach, this research focuses on adolescents' understanding, perception, and experience of PAI teaching related to the phenomenon of gender violence in the digital realm. In-depth interviews with adolescents, PAI teachers, and related individuals were conducted to explore how the religious values taught in PAI affect adolescents' attitudes, behaviors, and thoughts towards online gender-based violence. The data analysis carried out includes data reduction, data presentation, and making conclusions. The results of this study are the importance of the role of PAI in shaping the moral and ethical awareness of adolescents against online gender-based violence. Understanding religious values in this context encourages more responsible online behavior and reduces the risk of engaging in gender violence. The implications of this study can be the basis for the development of more effective educational strategies in preventing and tackling online gender-based violence among adolescents.

Adolescent experiences of weight-related communication: Sociodemographic differences and the role of parents.

Weight-related conversations are common between adolescents and parents. However, there is limited understanding of how these conversations vary across sociodemographic groups, such as sex, sexual orientation, race/ethnicity, or parents' level of education. This study assessed the prevalence of weight-related communication among adolescents and parents across sociodemographic characteristics, and identified adolescents' preferred sources for these discussions. Quantitative data were collected through online surveys from two independent U.S. adolescents aged 10-17 years of age (N = 2032), and parents of children aged 10-17 years of age (N = 1936). Frequency and sources of weight-related communication were assessed. Sociodemographic factors were analysed for their associations with these communication patterns. While few differences emerged based on race/ethnicity or grade level, significant variation was observed for sex, sexual orientation, and parental education. Girls, sexual minority youth, high school students, and those with college-educated parents were more likely to communicate about their own weight, whereas boys were more likely to comment on others' weight. Most adolescents preferred healthcare professionals (71%) and parents (69%) for these conversations, although sexual minority youth preferred mental health professionals considerably more than parents. Among parents, 77% discussed their child's weight, with fathers and Latinx parents engaging more frequently in these conversations, and Black parents engaging least frequently. Weight-related communication is prevalent among adolescents and parents, with variation across sociodemographic characteristics. As healthcare professionals and parents were identified as the preferred sources for weight-related communication by adolescents across sociodemographic groups, it is important that paediatricians and parents are equipped to engage in these conversations without imparting stigma.

Return-to-School Experiences of Adolescents After Allogeneic Hematopoietic Cell Transplant: A Qualitative Interview Study of Transplant Recipients.

Returning to school after allogeneic hematopoietic cell transplant (HCT) can improve quality of life and promote positive adjustment. However, this process may be challenging, and there is a limited understanding of school-aged children and adolescents' perspectives on this process. We conducted semi-structured interviews over video with pediatric recipients of HCT (10-18years of age at HCT; 1-7years post HCT) who were treated at our institution and had returned to in-person school post HCT. We performed a thematic network analysis focused on exploring salient challenges regarding the return-to-school process post HCT and potential areas for improvement. We interviewed 16 participants (mean age 13.8years at HCT). Four themes emerged: (i) challenges of returning to school, (ii) keys for a successful return-to-school experience, (iii) overall perceptions of the process, and (iv) recommendations for improvement. HCT recipients described several social/emotional, physical, and academic challenges while returning to school and cited strong sources of support as critical to a successful transition. Recommendations for a better transition process included the following: (a) fostering peer support, (b) establishing social connections, (c) providing mental health support, (d) identifying a go-to point of contact for issues, and (e) maintaining academic support. Our findings highlight perspectives from school-aged recipients of HCT regarding gaps in support and areas for improvement to facilitate successful return to school after HCT. Additional assistance throughout the process may optimize academic and social reintegration and support recovery after HCT.

Adolescents’ Self-Regulation of Social Media Use During the Beginning of the COVID-19 Pandemic: An Idiographic Approach

AbstractAdolescent social media serves a broad range of functions, which may be helpful for some and harmful for others. During the COVID-19 lockdown, social media evolved considerably, occupying an even more central role in adolescents’ lives. This study leverages a new approach to measuring social media use behaviors—passive smartphone sensing. Specifically, we aimed to test if and how adolescents self-regulate their social media use in response to how they feel during and after use. This study followed 19 adolescents for 1 month. Participants completed baseline measures, assessing demographic and clinical characteristics. We used passive smartphone sensing to measure objective social media use behaviors (“screen time” and checking) for a 1-month period. Adolescents also completed daily diary questions on their mood. Analyses took an idiographic (n = 1) approach. Dynamic structural equation models tested daily and next-day relationships between social media use behaviors and mood for each adolescent. Most adolescents (n = 13 of 19) did not self-regulate their social media use in relation to their mood. Most importantly, they did not use it less when they felt more negative mood during use. That said, some adolescents (n = 6) did alter their social media use behaviors depending on their mood. Each adolescent’s pattern of social media use and mood was also qualitatively interpreted within their context of demographic (e.g., experience of holding a minoritized identity) and clinical characteristics (e.g., history of suicidal thoughts and behaviors). These results highlight the next steps for possible intervention points to help adolescents adjust their use patterns to maximize mental health benefits while minimizing possible harm. Findings also begin to develop a template for applying social media use recommendations, while centering the experiences of individual adolescents.

An Overview of the Religiosity of Adolescents at GMIT Efata Liliba Church.

Religiosity includes beliefs and religious teachings, religious practices, commitment and identity, participation in religious communities, spiritual experiences, and the application of ethics and morality, which vary according to the intensity and manner in which individuals practice their faith. This study aims to describe the dimensions of religiosity—belief, connection, behavior, and togetherness—among adolescents at GMIT Jemaat Efata Liliba. The research employs a qualitative method. To obtain accurate data and information, the study uses interview techniques for data collection. Purposive sampling is used for participant selection, with a total of 6 adolescents from GMIT Jemaat Efata Liliba. Involvement in religious activities is influenced by parental guidance and social interactions, providing both personal and social benefits, and fostering a deep relationship with God. This study illustrates how various aspects of religiosity affect and shape the religious experiences of adolescents.

Health care transition for autistic adolescents and young adults: A pilot rural and urban comparison survey study.

Autistic adolescents and young adults in rural areas face significant challenges in health care transition compared to their urban counterparts. Health care transition, the process of moving from pediatric to adult health care, is crucial for the long-term health outcomes of adolescents and young adults. Previous research indicates rural adolescents and young adults often have greater unmet medical and financial needs, affecting their transition experiences, but there was no study focusing on rural autistic adolescents and young adults' health care transition experiences. This pilot study provides a comparative analysis of the health care transition experiences of rural and urban autistic adolescents and young adults. Ninety-six urban and 84 rural participants (14-25 years old) participated in the study. Their average age was 19.67 years. Just over half of the participants had completed the transition to adult care, typically reporting finishing this process at around 18 years old. A majority had limited discussions with their doctors about transitioning, and those who had discussions often started these conversations late. It also reveals that the responses completed by or with parents of autistic adolescents and young adults tend to indicate that the adolescents and young adults would not make future medical decisions or are uncertain about it. The findings underscore the necessity for targeted support for autistic adolescents and young adults during their health care transition process, regardless of their residence. There is a clear need for targeted health care transition interventions for adolescents and young adults, parents, and health care providers to ensure autistic adolescents and young adults and their families receive adequate support during the health care transition process.

Food insecurity and pediatric HIV: patient perspectives on clinical solutions

ABSTRACT Food insecurity is a prevalent social determinant of health for people living with HIV and is associated with suboptimal treatment outcomes. While clinic-based efforts to address food insecurity have increased over the past decade, few studies have explored the perspectives of paitents and caregivers managing chronic illnesses such as HIV. Caregiver insights are particularly critical in pediatric HIV care, where caregivers often play a central role in screening and referral processes. This study examined the experiences of adolescents and young adults living with HIV and caregivers of children with HIV, to inform screening and referral practices within a pediatric palliative care clinic in Atlanta, GA. We conducted audio-recorded, in-depth interviews (n = 14) and focus groupswith 10 patients and caregivers living with food insecurity. Thematic analysis, guided by our interview topics, revealed five key themes: (1) trust in providers, (2) coping by “making it work”, (3) barriers to healthy eating, (4) challenges to medication adherence, and (5) recommendations for cross-sector resource connection. Our findings underscore the need for partnerships between clinics and community-based organizations, bolstered by structural and systems-level interventions and policies, to promote food security and well-being for pediatric patients in complex care settings.