Chronic (long-term) health conditions affect approximately 40% of children in the United States (Child & Adolescent Health Measurement, 2021). Pediatric chronic conditions are physical, medical, or mental conditions diagnosed between birth and 18 years of age that last more than three months (American Academy of Pediatrics, 2023). Many children with chronic conditions live well into adulthood; thus, effective pediatric-to-adult healthcare transition (HCT) has become a leading health priority (White et al., 2018). HCT encompasses “a potentially stressful and emotional process in which flexibility and negotiation between the patient, parents, pediatric healthcare providers, and adult healthcare providers are necessary to facilitate achievement of autonomous health-related decision-making and self-care within the adult healthcare setting” (Ladores, 2015, p. 126). As this definition emphasizes, families play a pivotal role in HCT. Exploring the dynamic processes that transpire within family systems during HCT can provide insight into improving child- and family-centered (CFCC) support for transitioning youth (Blum, 2002; Committee On Hospital Care Institute For Patient- and Family-Centered Care, 2012; Coyne et al., 2018; Ford et al., 2018; Foster et al., 2023; Ladores, 2015; van Staa et al., 2015).

Youth, defined as individuals between 15 and 24 years of age by the United Nations (2023), encompasses adolescence and young adulthood. Though youth experience HCT at various ages, experts recommend that healthcare providers and families begin discussing HCT around 12 years of age and that transfer to an adult provider occur between ages 18–22 (American Academy of Pediatrics et al., 2011). The goal of effective HCT is for youth to transfer out of pediatric care to be capable of successful chronic disease self-management (Ladores, 2015; Lozano & Houtrow, 2018; Nightingale et al., 2019; Wright et al., 2017). However, evidence shows that emerging adults often struggle after the transfer to adult services—missing medical treatments or dropping out of healthcare follow-up (Campbell et al., 2016). Therefore, further exploration within the healthcare transition process is needed to identify avenues for enhancing young adult outcomes.

Within families, healthcare responsibility must pass from the parents (or caregivers) to youth as part of the preparation for HCT (Betz et al., 2015; Heath et al., 2017; Lee et al., 2021; Shaw et al., 2021). This process requires parents, defined here as an inclusive term encompassing any caregiver assuming a parental role, to relinquish control and entrust youth with healthcare responsibilities and outcomes. While the transfer of responsibility within families has been described within the literature (Betz et al., 2015; Heath et al., 2017; Lee et al., 2021; Lozano & Houtrow, 2018; Shaw et al., 2021), this process lacks conceptual clarity, with various terminology used to describe specific aspects of this phenomenon, thereby impeding the synthesis of knowledge (Rodgers, 2000). Clarifying the parental entrustment of healthcare responsibilities to youth with chronic conditions (hereafter referred to as “parental entrustment”) provides an opportunity to acknowledge families' multifaceted experiences during HCT and explore tailored interventions that support a CFCC approach. This concept analysis aims to systematically synthesize literature, clarify the concept of parental entrustment, and discuss how clarifying this concept can move HCT science and practice forward.