How Short is Too Short According to Parents of Primary Care Patients

Abstract

Objective Height is a physical trait on a continuum. The threshold between normal and abnormal is arbitrarily set, potentially influencing medical decision-making. We sought to examine parents’ perceptions of adult heights and associated demographic factors. Methods Parents of pediatric primary care patients of various heights completed a one-time survey. Parents answered, “How short is too short?” for adult males and females. Results were summarized as median [interquartile range]. Factors significantly associated with height threshold by simple linear regression were included in a multivariable mixed effects analysis of covariance model. Results 1820 surveys were completed (83% response rate; 1587 female, 231 male). Median threshold height deemed too short for adult females was 56 inches [48, 59] among male respondents and 57 inches [50, 60] among female (p<.05). Median threshold height for adult males was 61 inches among males [60, 64] and females [59, 66] (p<.05). The median of male minus female heights per respondent (delta heights) was 5 [2, 7] inches. Factors found to be significant main effects in a parsimonious model were sex of adult considered, height of respondent, sex of respondent, respondent race, primary care practice, income and having concerns about their child's height. Conclusion Taller acceptable height thresholds were perceived by respondents who were taller, wealthier, white, female, from non-urban practices or who had a personal concern about their child's height. Male heights were expected to be taller than female. Such traits may influence who is concerned and more likely to seek medical treatment for their children.

Growth hormone therapy and short stature‐related distress: A randomized placebo‐controlled trial

“…Some studies indicate that most ISS children have normal psychosocial functioning, but others reported that ISS children referred for evaluation have more behaviour problems and poorer social skills than nonreferred ISS children . Short children referred to endocrine clinics represent a selected population reflecting a higher level of parental concern about their current psychosocial adaptation and future well‐being . Interestingly, in our study, the parental perception of their child's well‐being with regard to general psychosocial functioning, school performance, peer and family relations was found to be normal or slightly below the normal range.…”

Parental Concerns Influencing Decisions to Seek Medical Care for a Child's Short Stature

“…The surveys were collected in practices located in nonurban (51%) and urban (49%) areas, and 7% were completed in Spanish. The respondent characteristics were described previously in detail [15]. Of note, the highest educational level completed by the respondents was a master’s or doctorate degree for 21%, a college degree for 29%, some college education for 15%, graduation from high school for 20% or trade school for 9%, and partial high school for 6%.…”

“…Recruitment was conducted without regard to height or age of the children, and different pediatric practices were selected to prevent contamination of the survey results by parents who may have participated in the previous group discussions. Full details of the subject recruitment and methodologies of the first 3 phases were reported previously [15]. The fourth phase included 12 explanatory focus groups, composed of parents recruited from the same population used for the first 2 phases and designed to explore the meanings and ramifications of the survey results.…”

“…The survey was beta-tested on parents of patients in the outpatient diabetes clinic and translated into Spanish, as previously described [15]. …”

Electronic Health Record Mid-Parental Height Auto-Calculator for Growth Assessment in Primary Care

“…Data have shown that individuals in positions of power overestimate their own height 15 and that parents of white pediatric primary care patients reported higher acceptable height thresholds than parents of other races/ethnicities. 16 …”