Christopher Forrest

Christopher B. Forrest
Christopher Forrest in 2025.
CitizenshipAmerican
EducationBoston University (BA, MD)
Johns Hopkins University (PhD)
Known forFounding PEDSnet; PROMIS Pediatric Measures; Life Course Health Science; Learning Health Systems Science
AwardsNemours Child Health Services Research Award (2004)
National Academy of Medicine (elected 2023)
Academic Pediatric Association Research Award, Senior (2026)
Scientific career
FieldsPediatrics, health services research, learning health systems
WorkplacesChildren's Hospital of Philadelphia
University of Pennsylvania
Johns Hopkins Bloomberg School of Public Health

Christopher B. Forrest is an American pediatrician and health sciences researcher who is Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and Children's Hospital of Philadelphia (CHOP). He is the Founder and Director of PEDSnet, a national pediatric learning health system comprising the nation's leading pediatric medical centers. His work has helped establish the fields of child health services research, learning health systems science, and life course health science. He co-edited the Handbook of Life Course Health Development, which has been downloaded more than one million times.[promotion?] Forrest is the co-author of the forthcoming book Thriving (MIT Press, 2027), which makes the case for a new science, social contract, and societal transformation approach to ensure that all people have the opportunity for lives filled with health, well-being, and resilience. [promotion?] He was elected to the National Academy of Medicine in 2023.

Early life and education

Forrest was born in New York City and grew up there and in Connecticut. He graduated from Old Saybrook High School. Forrest received a Bachelor of Arts degree in biology from Boston University in 1982 and his MD from Boston University School of Medicine in 1986. He completed his internship, residency, and chief residency in pediatrics at Children's Hospital of Philadelphia, followed by a health services and outcomes research fellowship at Johns Hopkins University. He earned his PhD in health policy and management from the Johns Hopkins Bloomberg School of Public Health in 1995.

Career

Following his doctoral training, Forrest held a faculty position at the Johns Hopkins Bloomberg School of Public Health in the Department of Health Policy and Management, where he served as an Assistant and Associate Professor. His early research, conducted in collaboration with Barbara Starfield, Jonathan Weiner, Anne Riley, and others, focused on primary care system transformation,[excessive citations] subspecialty referral patterns,[excessive citations] and the health status of children and adolescents.[excessive citations]

Forrest is co-developer of the Johns Hopkins Adjusted Clinical Groups (ACGs) System, a widely used health risk assessment tool. ACGs are used by ministries of health, health plans, sickness funds, health systems, and researchers to evaluate the health risk of populations. ACG risk measures are used to adjust for differences in patient mix in provider performance assessment, resource allocation formulas, and case management programs. They are compatible with both health plan claims and electronic health records, and each day they are used in over 20 countries to improve the care and equity of service provision for millions of people. The ACG System received the AcademyHealth Health Services Research Impact Award in 2015.

Forrest subsequently moved to the Children's Hospital of Philadelphia and the University of Pennsylvania, where he holds the title of Professor of Pediatrics. At CHOP, he serves as Director of the Applied Clinical Research Center and Director of PEDSnet. He is also a Senior Scholar at the Leonard Davis Institute of Health Economics at the University of Pennsylvania.

In 2024, Forrest was appointed to the Board of Regents of the National Library of Medicine by the U.S. Secretary of Health and Human Services.

Research

PEDSnet and learning health systems

Forrest founded PEDSnet, a national pediatric learning health system that is one of the clinical research networks within PCORnet, the national patient-centered clinical research network funded by the Patient-Centered Outcomes Research Institute (PCORI). PEDSnet is devoted exclusively to pediatric research and, as of 2026, included twelve pediatric academic health systems with data representing nearly 10 percent of all children in the United States. The network has supported more than 200 observational studies and clinical trials, with cumulative grant funding exceeding $300 million.

Forrest led the development of the AHRQ Learning Health System Researcher Core Competencies, which provided the basis for the AHRQ/PCORI-funded Learning Health Science Centers of Excellence. He directs the PEDSnet Scholars program, an AHRQ/PCORI-funded faculty development initiative that has trained nearly 50 faculty across the country in learning health systems science.

Patient-reported outcomes (PROMIS)

Forrest has been a central figure in the development of pediatric patient-reported outcome measures within the Patient-Reported Outcomes Measurement Information System (PROMIS), an initiative of the National Institutes of Health. He served as Chair of the PROMIS Executive Committee from 2009 to 2014 and led the NIH PEPR (Pediatric Patient-Reported Outcomes) Consortium as Chair of its Steering Committee. His research group has developed more than 50 pediatric patient-reported outcome measures, covering domains such as sleep, global health, happiness, physical activity, family relationships, and school performance in both child self-report and parent-proxy formats.

Life course health science

Forrest is a major U.S. contributor to the emerging scientific field of life course health science. Life course health science is concerned with how interactions between individuals and their developmental environments produce health and well-being across the lifespan. He co-edited the Handbook of Life Course Health Development (Springer, 2018), an open-access volume that has been downloaded more than one million times.

A 2018 study co-authored by Forrest in Health Affairs compared child mortality rates across 20 OECD nations over a fifty-year period and found that children in the United States were significantly more likely to die than their counterparts in peer nations. The study received coverage in outlets including CNN and ScienceDaily. In 2025, Forrest and colleagues extended this line of work in JAMA, reporting worsening trends in U.S. children's mortality, chronic conditions, obesity, functional status, and symptoms from 2007 to 2023, reinforcing the life course importance of developmental ecosystems and child well-being trajectories. The 2025 study also received media coverage from outlets including NPR, CNN, PBS NewsHour, AP, and Fox News.

Thriving

Beyond his work in health services and outcomes research, epidemiology, data science, and outcomes measurement, Forrest has pursued a broader inquiry into what it means for children and communities to truly thrive, describing the concept as one that unifies health, well-being, and resilience into a single framework. He has argued that American cultural and social systems have become oriented away from investment in children and toward economic output and productivity.

Forrest is currently co-authoring a book titled Thriving that builds the case for a new science of thriving; a new social contract in which people commit to collectively creating a world that promotes thriving for all people; and a new approach for creating the ecosystems that generate thriving as the expected outcome for all. [promotion?]

Selected publications

Awards and honors

References

  1. 1 2 3 4 5 6 7 8 9 10 11 (https://www.chop.edu/doctors/forrest-christopher-b) "Christopher B. Forrest, MD, PhD". Children's Hospital of Philadelphia. Retrieved 2026-04-07.
  2. 1 2 3 4 5 (https://www.chop.edu/news/two-research-leaders-chop-elected-national-academy-medicine) "Two Research Leaders from CHOP Elected to National Academy of Medicine". Children's Hospital of Philadelphia. 2023-10-09. Retrieved 2026-04-07.
  3. ↑ Forrest, CB; Simpson, L; Clancy, C (1997). "Child health services research: challenges and opportunities". JAMA. 277 (22): 1787–1793. doi:10.1001/jama.1997.03540460051032. PMID 9178792.
  4. 1 2 Forrest, CB; Chesley, FD Jr; Tregear, ML; Mistry, KB (2018). "Development of the Learning Health System Researcher Core Competencies". Health Services Research. 53 (4): 2615–2632. doi:10.1111/1475-6773.12751. PMC 6051975. PMID 28777456.
  5. 1 2 Halfon, N; Forrest, CB (2018). "The Emerging Theoretical Framework of Life Course Health Development". In Halfon, N; Forrest, CB; Lerner, RM; Faustman, EM (eds.). Handbook of Life Course Health Development. Springer. doi:10.1007/978-3-319-47143-3. ISBN 978-3-319-47141-9. PMID 31314301.
  6. 1 2 Halfon, N.; Forrest, C. B.; Lerner, R. M.; Faustman, E. M. (2018). Halfon, N; Forrest, CB; Lerner, RM; Faustman, EM (eds.). Handbook of Life Course Health Development. Springer. doi:10.1007/978-3-319-47143-3. ISBN 978-3-319-47143-3. PMID 31314220.
  7. 1 2 3 4 (https://www.research.chop.edu/cornerstone-blog/on-thriving-chop-pediatrician-explores-how-to-care-for-our-neighbors-and-world) "On 'Thriving': CHOP Pediatrician Explores How to Care for Our Neighbors and World". CHOP Research Institute. 2024-07-25. Retrieved 2026-04-07.
  8. ↑ (https://www.med.upenn.edu/apps/faculty/index.php/g275/p8173446) "Christopher B Forrest"]. Perelman School of Medicine at the University of Pennsylvania. Retrieved 2026-04-07.
  9. 1 2 3 4 (https://publichealth.jhu.edu/faculty/231/christopher-b-forrest) "Christopher B. Forrest". Johns Hopkins Bloomberg School of Public Health. Retrieved 2026-04-07.
  10. ↑ (https://academyhealth.org/about/people/christopher-forrest-md-phd) "Christopher Forrest, M.D., Ph.D.". AcademyHealth. Retrieved 2026-04-07.
  11. ↑ Forrest, CB (2002). "Managed care, primary care, and the patient-practitioner relationship". Journal of General Internal Medicine. 17 (4): 270–277. doi:10.1046/j.1525-1497.2002.10309.x. PMC 1495029. PMID 11972723.
  12. ↑ Forrest, CB; Starfield, B (1998). "Entry into primary care and continuity: the effects of access". American Journal of Public Health. 88 (9): 1330–1336. doi:10.2105/ajph.88.9.1330. PMC 1509069. PMID 9736872.
  13. ↑ O'Malley, AS; Forrest, CB; Miranda, J (2003). "Primary care attributes and care for depression among low-income African American women". American Journal of Public Health. 93 (8): 1328–1334. doi:10.2105/ajph.93.8.1328. PMC 1447965. PMID 12893623.
  14. ↑ Grant, CC; Forrest, CB; Starfield, B (1997). "Primary care and health reform in New Zealand". The New Zealand Medical Journal. 110 (1037): 35–39. PMID 9066566.
  15. ↑ O'Malley, AS; Forrest, CB (2002). "Beyond the examination room: primary care performance and the patient-physician relationship for low-income women". Journal of General Internal Medicine. 17 (1): 66–74. doi:10.1046/j.1525-1497.2002.10338.x. PMC 1495002. PMID 11903777.
  16. ↑ Shi, L; Forrest, CB; von Schrader, S; Ng, J (2003). "Vulnerability and the patient-practitioner relationship: the roles of gatekeeping and primary care performance". American Journal of Public Health. 93 (1): 138–144. doi:10.2105/ajph.93.1.138. PMC 1447708. PMID 12511403.
  17. ↑ Forrest, CB (2003). "Primary care gatekeeping and referrals: effective filter or failed experiment?". BMJ. 326 (7391): 692–695. doi:10.1136/bmj.326.7391.692. PMC 152368. PMID 12663407.
  18. ↑ Forrest, CB; Whelan, EM (2000). "Primary care safety-net delivery sites in the United States: a comparison of community health centers, hospital outpatient departments, and physicians' offices". JAMA. 284 (16): 2077–2083. doi:10.1001/jama.284.16.2077. PMID 11042756.
  19. ↑ Bindman, AB; Forrest, CB; Britt, H; Crampton, P; Majeed, A (2007). "Diagnostic scope of and exposure to primary care physicians in Australia, New Zealand, and the United States: cross sectional analysis of results from three national surveys". BMJ. 334 (7606): 1261. doi:10.1136/bmj.39203.658970.55. PMC 1892467. PMID 17504790.
  20. ↑ Forrest, CB (2006). "Strengthening primary care to bolster the health care safety net". JAMA. 295 (9): 1062–1063. doi:10.1001/jama.295.9.1062. PMID 16507809.
  21. ↑ Forrest, CB (1999). "Gatekeeping and referral of children and adolescents to specialty care". Pediatrics. 104 (1): 28–34. doi:10.1542/peds.104.1.28. PMID 10390256.
  22. ↑ Forrest, CB; Glade, GB; Baker, AE; Bocian, A; von Schrader, S; Starfield, B (2000). "Coordination of specialty referrals and physician satisfaction with referral care". Archives of Pediatrics & Adolescent Medicine. 154 (5): 499–506. doi:10.1001/archpedi.154.5.499. PMID 10807303.
  23. ↑ Mehrotra, A; Forrest, CB; Lin, CY (2011). "Dropping the baton: specialty referrals in the United States". The Milbank Quarterly. 89 (1): 39–68. doi:10.1111/j.1468-0009.2011.00619.x. PMC 3160594. PMID 21418312.
  24. ↑ Forrest, CB (2001). "Self-referral in point-of-service health plans". JAMA. 285 (17): 2223–2231. doi:10.1001/jama.285.17.2223. PMID 11325324.
  25. ↑ Forrest, CB; Reid, RJ (2001). "Prevalence of health problems and primary care physicians' specialty referral decisions". The Journal of Family Practice. 50 (5): 427–432. PMID 11350708.
  26. ↑ Forrest, CB (2011). "Pediatric subspecialty referral completion". The Journal of Pediatrics. 158 (1): 3–4. doi:10.1016/j.jpeds.2010.08.049. PMID 20888574.
  27. ↑ Forrest, CB; Nutting, PA; von Schrader, S; Rohde, C; Starfield, B (2006). "Primary care physician specialty referral decision making: patient, physician, and health care system determinants". Medical Decision Making. 26 (1): 76–85. doi:10.1177/0272989X05284110. PMID 16495203.
  28. ↑ Starfield, B; Forrest, CB; Nutting, PA; von Schrader, S (2002). "Variability in physician referral decisions". The Journal of the American Board of Family Practice. 15 (6): 473–480. PMID 12463293.
  29. ↑ Guevara, JP; Hager, A; Mbamalu, O; Forrest, CB (2011). "Performance measures of the specialty referral process: a systematic review of the literature". Pediatrics. 128 (1): 182–193. doi:10.1186/1472-6963-11-168. PMC 3155905. PMID 21752285.
  30. ↑ Schuchard, J; Blackwell, CK; Ganiban, JM; Giardino, AP; McGrath, M; Sherlock, P; Dabelea, DM; Deoni, SCL; Karr, C; McEvoy, CT; Patterson, B; Santarossa, S; Sathyanarayana, S; Tung, I; Forrest, CB (2022). "Influences of chronic physical and mental health conditions on child and adolescent positive health". Academic Pediatrics. 22 (6): 1024–1032. doi:10.1016/j.acap.2022.01.013. PMC 9339582. PMID 35121190.
  31. ↑ Blackwell, CK; Elliott, AJ; Ganiban, J; Herbstman, J; Hunt, K; Forrest, CB; Camargo, CA Jr (2019). "General health and life satisfaction in children with chronic illness". Pediatrics. 143 (6): e20182988. doi:10.1542/peds.2018-2988. PMC 6564050. PMID 31061222.
  32. ↑ Forrest, CB; Schuchard, J; Bruno, C; Blackwell, CK (2022). "Self-reported health outcomes of children and youth with 10 chronic diseases". The Journal of Pediatrics. 246: 207–212.e1. doi:10.1016/j.jpeds.2022.02.052. PMC 9232908. PMID 35247394.
  33. ↑ Kallen, MA; Bevans, KB; Teneralli, RE; Moon, J; Forrest, CB (2022). "Measuring PROMIS® Global Health in Early Childhood". Journal of Pediatric Psychology. 47 (5): 523–533. doi:10.1093/jpepsy/jsac026. PMC 9113277. PMID 35552435.
  34. ↑ Bevans, KB; Meltzer, LJ; de la Motte, A; Kratchman, A; Viél, D; Forrest, CB (2019). "Qualitative development and content validation of the PROMIS Pediatric Sleep Health items". Behavioral Sleep Medicine. 17 (5): 657–671. doi:10.1080/15402002.2018.1461102. PMID 29693445.
  35. ↑ Bevans, KB; Moon, J; Becker, BD; Carle, A; Forrest, CB (2020). "Development of patient-reported outcome measures of children's oral health aesthetics". Community Dentistry and Oral Epidemiology. 48 (5): 423–432. doi:10.1111/cdoe.12555. PMC 8629137. PMID 32776585.
  36. ↑ Bevans, KB; Riley, AW; Moon, J; Forrest, CB (2010). "Conceptual and methodological advances in child-reported outcomes measurement". Expert Review of Pharmacoeconomics & Outcomes Research. 10 (4): 385–396. doi:10.1586/erp.10.52. PMC 3205357. PMID 20715916.
  37. ↑ Gluck, CA; Forrest, CB; Davies, AG; Maltenfort, M; McDonald, JR; Warady, BA (2023). "Patient-reported outcomes over 24 months in pediatric CKD: findings from the MyKidneyHealth Cohort Study". American Journal of Kidney Diseases. 82 (2): 213–224.e1. doi:10.1053/j.ajkd.2022.12.014. PMC 10440290. PMID 36889426.
  38. ↑ Forrest, CB; Meltzer, LJ; Marcus, CL; de la Motte, A; Kratchman, A; Buysse, DJ; Pilkonis, PA; Becker, BD; Bevans, KB (2018). Developing Sets of Survey Questions to Measure Children's Sleep Health. Patient-Centered Outcomes Research Institute. PMID 38033153.
  39. ↑ Forrest, CB; Bevans, KB; Tucker, C; Riley, AW; Ravens-Sieberer, U; Gardner, W; Pajer, K (2013). "Health and school outcomes during children's transition into adolescence". Journal of Adolescent Health. 52 (2): 186–194. doi:10.1016/j.jadohealth.2012.06.019. PMC 3552248. PMID 23332483.
  40. ↑ "Johns Hopkins ACG System". Johns Hopkins Bloomberg School of Public Health. Retrieved 2026-04-21.
  41. ↑ "HSR Impact Award Past Recipients". AcademyHealth. Retrieved 2026-04-21.
  42. ↑ (https://ldi.upenn.edu/fellows/fellows-directory/christopher-b-forrest-md-phd/) "Christopher B. Forrest, MD, PhD". Leonard Davis Institute of Health Economics. Retrieved 2026-04-07.
  43. ↑ Forrest, CB; Margolis, P; Seid, M; Colletti, RB (2014). "PEDSnet: how a prototype pediatric learning health system is being expanded into a national network". Health Affairs. 33 (7): 1171–1177. doi:10.1377/hlthaff.2014.0127. PMID 25006143.
  44. 1 2 3 4 (https://www.research.chop.edu/people/christopher-b-forrest) "Christopher B. Forrest". CHOP Research Institute. Retrieved 2026-04-07.
  45. ↑ Forrest, CB; Bevans, KB; Riley, AW; Crespo, R; Louis, TA (2012). "The patient-reported outcome measurement information system (PROMIS®) for children and youth: application to pediatric psychology". Journal of Pediatric Psychology. 37 (6): 614–621. doi:10.1093/jpepsy/jss038. PMC 3381710. PMID 22362923.
  46. ↑ Forrest, CB; Meltzer, LJ; Marcus, CL; de la Motte, A; Kratchman, A; Buysse, DJ; Pilkonis, PA; Becker, BD; Bevans, KB (2018). "Development and validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks". Sleep. 41 (6) zsy054. doi:10.1093/sleep/zsy054. PMID 29546286.
  47. ↑ Thakrar, AP; Forrest, AD; Maltenfort, MG; Forrest, CB (2018). "Child Mortality In The US And 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis". Health Affairs. 37 (1): 140–149. doi:10.1377/hlthaff.2017.0767. PMID 29309221.
  48. ↑ "US child mortality ranks worst among 20 wealthy countries, study finds". CNN. 2018-01-08. Retrieved 2026-04-14.
  49. ↑ "US childhood mortality rates have lagged behind other wealthy nations for the past 50 years". ScienceDaily. 2018-01-08. Retrieved 2026-04-14.
  50. ↑ Forrest, CB; Koenigsberg, LJ; Eddy Harvey, F; Maltenfort, MG; Halfon, N (2025). "Trends in US Children's Mortality, Chronic Conditions, Obesity, Functional Status, and Symptoms". JAMA. 334 (6): 509–516. doi:10.1001/jama.2025.9855. PMC 12235530. PMID 40622733.
  51. ↑ "American kids have become increasingly unhealthy over nearly two decades, new study finds". NPR. 2025-07-08. Retrieved 2026-04-14.
  52. ↑ "US child death and sickness study shows worsening trends in health". CNN. 2025-07-07. Retrieved 2026-04-14.
  53. ↑ "Why American children are less healthy now than nearly two decades ago". PBS NewsHour. 2025-08-03. Retrieved 2026-04-14.
  54. ↑ "Children's health has declined over the past 17 years, study finds". AP News. 2025-07-08. Retrieved 2026-04-17.
  55. ↑ "Children's health declines last 17 years, study finds". Fox News. 2025-07-08. Retrieved 2026-04-17.
  56. ↑ (https://academyhealth.org/page/child-health-services-research-award-winners) "Child Health Services Research Award Winners". AcademyHealth. Retrieved 2026-04-07.
  57. ↑ (https://www.academicpeds.org/announcements/congratulations-to-the-2026-apa-award-winners/) "Congratulations to the 2026 APA Award Winners!". Academic Pediatric Association. 2026-03-10. Retrieved 2026-04-07.