209 - Who to Ask? A Cross-Sectional Study Assessing Agreement in Child and Caregiver Reported Health Behaviors

Poster Number: 209
Publication Number: 209.1454

Background: Team Kid Power Orange County (KiPOW OC) is a community-academic partnered program that encourages healthy lifestyle choices in public elementary schools through weekly coaching and lessons. Its impact is evaluated, in part, through child and caregiver responses to a modified version of the validated HABITS questionnaire (HQ); a 19-item survey used for child and parent reporting of child health-related habits. Little is known about the relative reliability between child and caregiver responses to the HQ.

Objective: This study aimed to investigate agreement between child and caregiver responses to the HQ.

Design/Methods: This is a retrospective, cross-sectional study of survey data collected from participants in KiPOW OC. Participants were recruited from 5th grade classrooms in Orange County, CA between 2019 and 2022. Child participants and their caregivers completed modified versions of the HQ. Responses were matched, and paired t-tests were used to analyze child-caregiver agreement. ANOVA tests were used for subgroup analyses with child gender and BMI class as control variables.

Results: Sixty-one child-caregiver pairs (n=122) completed the HQ. On average, children reported significantly more time spent watching television (p=.002), exercising (p <.001), and sleeping (p <.001), as well as higher desired weight change (p=.012) than caregivers. Additionally, caregivers perceived children’s weights as significantly higher than children (p <.001). There was no significant difference between child and caregiver reports of diet, beverage, and junk food consumption. Female children reported perceived weight as significantly lower compared to caregiver reports (p <.001). Children with a healthy BMI reported significantly more time spent watching television (p=.004) and exercising (p <.001) compared with caregiver reports. Finally, children with a healthy BMI reported significantly lower perceived weight status compared with caregiver reports, while no such effect was seen in children with a high BMI (≥85th percentile).

Conclusion(s): Child and caregiver reports regarding television and exercise time, hours of sleep, perception of weight, and desire for weight change were found to be significantly different. No statistically significant difference was found for responses relating to dietary intake. Child gender and BMI class may modify child-caregiver agreement. Studies assessing child behaviors via surveys may benefit from examining agreement between caregiver and child responses. Further study is needed to identify at which ages, and for which behaviors, child or caregiver responses are more accurate.