Agreement between parent and child report of physical activity, sedentary and dietary behaviours in 9-12-year-old children and associations with children’s weight status

Abstract

BackgroundTo date, population based surveys aimed at gaining insight in health related behaviour of children have often used either child self-reports or parent proxy reports. It remains unclear however, if surveys using different sources of information from either parents or children are comparable. In addition, (over)weight status of children can lead to under- and over reporting by parents and children as a result of social desirability bias. We aimed at gaining insight in the level of agreement between parents and child reports regarding aspects of certain dietary, physical activity and sedentary behaviours, and whether there are differences in agreement between parents and child reports in healthy-weight and overweight children.MethodsWeighted kappa was used to determine the level of agreement between child and parent reports on health-related behaviour in 1998 parent-child dyads. We also stratified for weight status of the children. Information on children’s health related behaviours was obtained by parental and children’s questionnaires, and children’s height and weight were measured. Associations between children’s weight status and children reporting less, reporting more and reporting the same amount of health behaviour as their parents were investigated with multinomial logistic regression analysis.ResultsThe Cohen’s kappa coefficients ranged from almost perfect agreement for the variable means of transportation, fair for the variables breakfast consumption and frequency of outside play to slight for the variables duration of outside play, frequency and duration of TV/DVD viewing and family dinner. Overweight children were significantly more likely to report less breakfast consumption (OR = 2.6 (95% CI: 1.3 – 5.1)) and lower frequency of outside play than their parents (OR = 1.8 (95% CI: 1.1 – 2.9)).ConclusionThere can be considerable disagreement between the health related behaviours of children as reported by parents or the children themselves. Based on the present study, it cannot be concluded whether parents’ or children’s reports are more accurate. For future studies, social desirability and recall bias would be best demonstrated in a validation study comparing child and parent self-reports with more objective measures of physical activity and food intake.Electronic supplementary materialThe online version of this article (10.1186/s40359-018-0227-2) contains supplementary material, which is available to authorized users.

Parent-child agreement in different domains of child behavior and health

“…With respect to children's diet, the amount of parent-child agreement has been shown to differ depending on the type of food assessed, with low agreement for the consumption of fruits and vegetables [5][6][7], but slightly higher agreement for sweetened beverages [7,8], and moderate agreement for the consumption of fish, eggs, and fast food [7]. Regarding aspects of eating culture, e.g., having breakfast or sharing dinners, agreement between child and parent reports has been shown to be low to fair [9]. In a study that compared dietary reports completed by 8-to 11-year-old children and their parents with energy expenditure as measured by the doubly labeled water technique revealed that child reports were more accurate than parent reports [10].…”

“…Parents, especially mothers, have been shown to overestimate the energy intake of their children [10]. Regarding physical activity or outdoor play, agreement between child and parent reports has been reported to be fair [9,11]. Interestingly, agreement has been shown to be higher for organized than for non-organized physical activity [12].…”

“…This finding suggests that agreement for well-defined and regular activities is much higher than for activities that may take place irregularly and without the knowledge of parents. With respect to media use, parent-child agreement has been shown to be low to fair [9,12]. In two studies, children reported longer screen times than their parents [4,12].…”

“…In two studies, children reported longer screen times than their parents [4,12]. In another study, parents reported a higher frequency of TV use than their children [9]. For sleep problems and sleep quality in children, parent-child agreement has been found to be low [13][14][15][16].…”

Interventions to increase the consumption of water among children: A systematic review and meta‐analysis

“…Risk of bias was high in most studies, which was, to a large part, due to measurement of outcomes. Retrospective report, which was most commonly used in the studies included in this review, is considered to be imprecise because of poor recall and (parents of) children with low levels of water consumption reporting higher amounts than actual amounts consumed . For our meta‐analysis, we estimated water consumption in millilitres per day for studies that did not report water consumption in volume per day by using a serving size of 225 mL.…”