Health-related knowledge, attitudes and practices among parents of children aged 10 - 17 years, Singapore

Abstract

Parents play an important role in shaping the health-related behaviors of their children through their practices, parenting styles, parental modeling and communication with their children. This study assessed the health-related knowledge, attitudes and practices among Singaporean or Singapore permanent resident parents pertaining to the health of their children aged 10-17 years. A nation-wide community based cross-sectional household survey was conducted on a random sample of 1169 Singaporeans or Singapore permanent residents who were parents or primary caregivers of adolescents aged 10 to 17 years. Participants who resided in HDB households(78% of the households) were interviewed face-to-face using a questionnaire on their socio-demographics, life style, health education sources and parenting styles as well as their knowledge, attitudes and practices on their adolescents? diet, physical activity, smoking issues, mental health and sexuality issues. The same questionnaire was posted to private/condominium households (22% of the households), because interviewers were not allowed to enter condominiums. The overall individual response rate from eligible households was 81.4%. One-third (32.4%) of the caregivers reported that they had never discussed sexuality issues with their adolescents. Although caregivers reported a high mean score (8.0/10) of perceived importance on communicating with their adolescents regarding sexuality issues, they felt less comfortable and confident (mean scores: 6.3/10 and 6.2/10 respectively) in communicating with their adolescents in this area. One-third (33%) of the respondents were aware that two servings of fruit and two servings of vegetables should be served daily to adolescents, while a lower proportion (23.9%) practiced this. Two-thirds (70.5%) and three-quarters (77.6%) of the parents limited the amount of time their adolescents watched TV and played video games respectively, whilst one-third (34.4%) of the parents offered them electronic games as a reward for good behavior. Multiple logistic regressions showed a significant independent association between caregivers? communication on sexuality issues (with their adolescents) and their perceived importance (adjusted OR: 1.09 [95% CI: 1.03-1.16]) and comfort (adjusted OR: 1.16 [95% CI: 1.07-1.25]) to communicate on sexuality. In addition the caregivers? correct practice on giving two servings of fruits and vegetables to their adolescents daily was associated with the caregivers? awareness of the correct portions of daily fruits and vegetables servings for adolescents (adjusted OR: 3.42 [95% CI: 2.53-4.62]) and the caregivers? engaging in regular physical activity (adjusted OR: 1.54 [95% CI: 1.05-2.25]). In addition, in a multiple logistic regression model, caregivers? limitation on their adolescents? sedentary activities (watching television and playing video games) was found to be significantly associated with age of the adolescent(adjusted OR: 0.84 [95% CI: 0.79-0.89]) , and parenting style(adjusted OR:1.01 [95% CI: 1.00-1.03]). Parent-adolescent communication on sexuality was lacking among respondents with a lack of parental perceived comfort and confidence being possible causes. In addition, only a low proportion of the adolescents? parents reported adequate knowledge on correct amounts of fruit and vegetables consumption and a lower proportion of parents reported correct dietary behaviors accordingly. On the contrary, more than two-thirds of the respondents limited the amount of time their adolescents watched TV and played video games. Improving parent-adolescent communication skills on sexuality issues through community outreach workshops or activities can be an effective measure to improve parent-adolescent communication in Singapore. Public education to parents on dietary practices using a positive appeal may help improve parental dietary practices for their adolescents.