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VP20 Beyond the individual: Bronfenbrenners ecological systems theory as a proxy for understanding pediatric health-related quality of life Angel Sheu 1 , Raika Bourmand 1 1 Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas, USA Journal of Patient-Reported Outcomes 2026 , 10(Suppl 1) :VP20 Aims Pediatric Health-Related Quality of Life is typically assessed via tools that focus on physical, emotional, and social functioning