Children's Physical Resilience Outcomes: Meta-Analysis of Vulnerability and Protective Factors

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Resilience has generally been understood as positive coping and adaptation despite stress and adversity and as a buffer against stress. Researchers examining resilience have typically focused on children's psychological resilience because of the well-established impact of stress on children's mental health. However, although it has also been well-established that high levels of stress can impact children's physical health, their physical health has received little attention in resilience research.

Eligibility criteria

Articles were selected for review if they (1) had a variable that was in some way a measure of physical health in response to a psychosocial stressor; (2) had participants who were children or adolescents within the age range of 4–18 years; and (3) were a peer-reviewed, empirical study.


Two random-effect meta-analyses were conducted with a sample of 12,772 participants across 14 studies to determine the influence of protective and vulnerability factors on children's physical health in adverse experiences.


Protective factors had a moderate effect and vulnerability factors had a small–moderate effect on health measures across domains of physiological, sleep behavior, and overall health. The type of health measure moderated the effect size for vulnerability factors, but not for protective factors.


These findings suggest that protective factors may be associated with an environment that encourages children to thrive, as apparent by their physical health.


The results of this review and meta-analysis can be used to guide the methodological design of future studies on childhood resilience and to inform clinical practice with children and adolescents.


This article was originally published in Journal of Pediatric Nursing. The full-text article from the publisher can be found here.

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Journal of Pediatric Nursing


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