Consensus Statement on Pediatric Disaster Medicine Research Priorities

Importance: Children in the US are disproportionately affected by disasters. However, pediatric-specific disaster medicine research remains limited, underscoring an urgent need for a pediatric-focused disaster medicine research agenda for the US to improve outcomes and preparedness for future events. Objective: To describe an expert consensus-driven research agenda that will help guide the field of pediatric disaster medicine during the next decade. Design, Setting, and Participants: On the basis of the findings from a previously conducted scoping review of published pediatric disaster research, this consensus statement convened a panel of 48 pediatric health care and disaster medicine subject matter experts in a Delphi process conducted between July 1 and July 17, 2024, to establish a pediatric disaster research agenda. Expert input was leveraged to enable participants to refine their responses based on feedback until consensus was achieved through 3 rounds of surveys, discussions, and voting. A deductive approach to the transcripts of these Delphi sessions was performed to enhance the quantitative results from the voting rounds surrounding the high priority, uncertain consensus results. This process identified key research areas and determined a prioritized consensus research agenda for pediatric disaster medicine. Main Outcomes and Measures: Consensus agenda of pediatric disaster medicine research priorities. Results: A total of 48 subject matter experts from 28 different institutions representing 26 US states participated in the modified Delphi process. A total of 106 research questions were generated from the gaps in the literature, and the Delphi panelists contributed an additional 155 research questions or areas, resulting in a total of 261 research questions or research areas. These questions were categorized into 20 subtopics across 5 main topics: preparedness, mitigation and prevention, response, recovery, and education. The panel prioritized 5 subtopics as high priority, high consensus: capacity and capability, community involvement, health equity considerations, mental health needs, and technology. The panel identified 5 additional high priority, high consensus subtopic areas (disaster-specific metrics, disaster research infrastructure, disaster research methodology, infectious disease, and natural disasters) that did not meet the criteria for inclusion. Conclusions and Relevance: This consensus statement using a modified Delphi Process established a national consensus-driven research agenda for pediatric disaster medicine, providing a roadmap for future research initiatives. By addressing identified gaps in research for disaster preparedness and response for children, this US-based agenda guides future research, enhances evidence-based practices, and ultimately improves the health and safety of pediatric populations during disasters.