The impact of fathers and male role models on recovery and resilience in pediatric victims of violent trauma.

Abstract

Despite the growing awareness of social determinants of health in pediatric trauma care, the influence of fathers and male caregivers on recovery following violent injury remains underexplored. Understanding this potential protective factor is essential to developing wraparound service models and resilience-building strategies for high-risk youth. We conducted a retrospective cohort analysis of a prospectively maintained database of patients aged 0 to 17 enrolled in a hospital-based violence intervention program at an ACS-verified Level I pediatric trauma center. Eligible patients sustained violent injuries, including gunshot wounds, assaults, or stabbings, and received longitudinal case management over 6 to 12 months. Demographic, household, and social data were collected, with specific attention to caregiver composition. Outcomes included school enrollment, violent reinjury, juvenile court involvement, safety assessments, and resilience scores from Coping Orientation to Problems Experienced (COPE). Comparative analyses were performed based on the presence or absence of a father or male caregiver in the home. Among 227 patients enrolled over 3 years, only 31 (14%) had a father present, and 36 (16%) had any male caregiver. Mothers were present in 89% of households. Mean age was 15 years (IQR: 11-16); 67% were male, and 65% were gunshot wound victims. No significant differences were found in baseline social determinants or postdischarge safety concerns. Children with fathers demonstrated higher Coping Orientation to Problems Experienced resilience scores and showed a greater likelihood of accepting emotional support, engaging in prayer or meditation, and finding comfort in spiritual beliefs (all p<0.05). School enrollment postprogram was higher among those with fathers (100% vs. 82%, p=0.016) and was associated with fewer juvenile adjudications (p=0.002). Few violently injured children have a father or male caregiver present. The presence of male caregivers was associated with improved school engagement and psychological resilience following violent trauma, emphasizing the importance of male involvement in recovery and possibly prevention efforts. (J Trauma Acute Care Surg. 2026;101: 233-240. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.). Prognostic/Epidemiological; Level III.