Preventive Medicine Reports · 6 authors, 4 centres
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This cross-sectional study of 1,746 parents in Weifang, China found that only 56.47% had adequate nutrition knowledge, 85.68% had positive attitudes, and just 38.03% had healthy dietary practices. Female gender, higher education, public employment, normal BMI, and non-smoking/non-drinking were associated with better KAP scores. The findings highlight the need for targeted nutrition education interventions for parents, especially focusing on translating knowledge into practice.
**Background:** Malnutrition, including both deficiencies and excesses, is common among children and adolescents globally and threatens their growth and development. Parents play a critical role in shaping children's dietary habits, yet few studies have examined the nutrition knowledge, attitudes, and dietary practices (KAP) of parents in China, particularly in the Shandong Peninsula region. This study aimed to evaluate the status and contributing factors of nutrition KAP among parents of school-aged children in Weifang, China.
**Methods:** A cross-sectional survey was conducted in August 2021 among parents of students in grades 1-8 at an urban private school in Weifang. Using convenience sampling, 2,000 self-report questionnaires were distributed via students, and 1,746 valid responses were obtained (effective rate 91.9%). The questionnaire included demographic items and 33 KAP items: 20 knowledge questions (max score 19, pass ≥13), 8 attitude questions (max 16, pass ≥12), and 5 practice questions (max 15, pass ≥10). A pilot test (n=450) showed acceptable reliability (Cronbach's alpha: attitude 0.79, practice 0.71) and structural validity (cumulative contribution >80%). Chi-square tests and multivariable robust Poisson regression were used to identify factors associated with passing each KAP domain, reporting prevalence ratios (PR) and 95% confidence intervals (CI).
**Key Results:** Among 1,746 participants, 69.82% were female, 74.17% were aged 35-45 years (mean 39.67±5.38), 98.05% had secondary education or higher, 52.58% were in business/service occupations, 90.25% were non-smokers, 60.70% were non-drinkers, and 31.55% were overweight and 9.05% obese. The pass rates were: knowledge 56.47% (986/1746), attitude 85.68% (1496/1746), and practice 38.03% (664/1746). The overall awareness rate for knowledge was 65.94% [21876/(1746*19)×100%]. Common knowledge gaps included iron sources (nearly 80% unaware), daily maximum oil intake (about 70% unaware), and vitamin A deficiency diseases (only 60% aware). Top knowledge sources were official media/networks (79.4%) and family/friends (50.1%). Correlation analysis showed a weak but significant positive correlation between knowledge and practice (r=0.16, p<0.01), but no significant correlations between knowledge and attitude (r=0.03, p=0.23) or attitude and practice (r=0.02, p=0.34).
For knowledge, females were more likely to pass than males (PR=1.28, 95% CI 1.13-1.45); higher education strongly increased likelihood (secondary: PR=4.64, 95% CI 1.60-13.50; junior college: PR=5.87, 95% CI 2.01-17.13; college or above: PR=6.58, 95% CI 2.25-19.23 vs. primary or below); public employees had higher knowledge than other occupations (PR=1.24, 95% CI 1.09-1.42); smokers were less likely to be knowledgeable (PR=0.76, 95% CI 0.61-0.95). For attitude, older age (35-45: PR=1.50, 95% CI 1.34-1.68; >45: PR=1.53, 95% CI 1.36-1.72 vs. <35) and public employment (PR=1.08, 95% CI 1.00-1.17) were associated with positive attitudes, while obesity was negatively associated (PR=0.90, 95% CI 0.83-0.98). For practice, females had healthier practices (PR=1.42, 95% CI 1.14-1.76), while drinking (PR=0.83, 95% CI 0.71-0.97), overweight (PR=0.86, 95% CI 0.74-0.99), and obesity (PR=0.76, 95% CI 0.56-0.99) were associated with lower practice scores.
**Clinical Implications:** This study reveals that a substantial proportion of parents in Weifang have inadequate nutrition knowledge (43.53% failed) and poor dietary practices (61.97% failed), despite generally positive attitudes (85.68% passed). The weak correlation between knowledge and practice suggests that simply providing information may not translate into behavior change. Interventions should target males, those with lower education, smokers, drinkers, and individuals with overweight/obesity. Public health strategies should leverage official media and networks to disseminate practical, actionable nutrition guidance, and incorporate behavior change techniques to bridge the knowledge-practice gap. The findings support the need for school-based and community nutrition education programs that address micronutrient knowledge (especially iron and vitamin A) and promote healthy dietary habits among parents, ultimately benefiting their children's nutritional status.