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Parental Perception of Flourishing in School-Aged Children

2011–2012 National Survey of Children's Health

Kandasamy, Veni, MSPH*; Hirai, Ashley H., PhD; Ghandour, Reem M., DrPH; Kogan, Michael D., PhD

Journal of Developmental & Behavioral Pediatrics: July/August 2018 - Volume 39 - Issue 6 - p 497–507
doi: 10.1097/DBP.0000000000000559
Original Articles
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Objective: Flourishing reflects positive mental health and thriving and is important for children's development and well-being. Few national studies of flourishing among school-aged children exist. Exposure to socioeconomic disadvantage is negatively associated with social and health outcomes, including flourishing. This analysis describes independent associations of the child, family, school, and neighborhood factors with flourishing, which we hypothesized may contribute to sociodemographic disparities.

Methods: Data from the 2011–2012 National Survey of Children's Health were used to examine parental perception of flourishing among school-aged children (6–17 years of age; n = 59,362). Flourishing was defined as curiosity about learning, resilience, and self-regulation. Unadjusted and adjusted associations between sociodemographic, child, family, school and neighborhood factors and flourishing were explored using χ2 tests and sequential logistic regression models.

Results: Overall, 48.4% of school-aged children were perceived by parents to be flourishing. There were significant sociodemographic disparities with non-Hispanic black children (37.4%) and those below the federal poverty level (37.9%) among the least likely to flourish. After adjustment, sex, race/ethnicity, parent education, child's age, physical activity, special health care needs status, adequate sleep, adverse childhood experiences, family meals, hours of television watched, extracurricular activities, school safety, neighborhood safety, neighborhood support, and presence of amenities were significantly associated with flourishing (p < 0.05). Disparities by poverty level and household structure were no longer significant.

Conclusion: Addressing factors associated with parent-perceived flourishing including child, family, school and neighborhood factors such as physical activity, adequate sleep, and school/neighborhood safety may promote flourishing and reduce disparities.

*Oak Ridge Associated Universities, Oak Ridge Institute for Science and Education, Oak Ridge, TN;

US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Rockville, MD.

Address for reprints: Veni Kandasamy, MSPH, 5600 Fishers Lane, 18N124B, Rockville, MD 20852; e-mail:

Supported in part by an appointment to the Postgraduate Research Participation Program at the U.S. Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and HRSA.

Disclosure: The authors declare no conflict of interest.

The views contained in this article are those of the authors and do not necessarily reflect the official position of the Health Resources and Services Administration or the US Department of Health and Human Services.

See the Video Abstract at

Received September , 2017

Accepted January , 2018

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