Parental knowledge, attitudes, and practices regarding myopia in Chinese children: a multicenter cross-sectional study

This study aimed to quantitatively investigate parental knowledge, attitudes, and practices (KAP) and identify key parent-related factors associated with myopia outcomes in Chinese children. A multicenter, cross-sectional study was conducted from February to June 2023 across 17 urban hospitals in China. Parents of myopic children aged 3–16 years were administered a structured, anonymous questionnaire developed based on prior validated instruments. Data on demographics, parental KAP, and children’s refractive status were collected. Multivariate logistic regression analyses were used to identify risk factors for children’s refractive status and parent-reported 1-year myopia change, with results expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Among 1,653 valid responses, multivariate analysis revealed that higher parental education was significantly associated with more favorable refractive outcomes (OR 0.701; 95% CI 0.524–0.939). Conversely, delayed initial parental concern about vision (ages 6–12: OR 1.886, 95% CI 1.444–2.464; >12 years: OR 1.952, 95% CI 1.194–3.190) and symptom-prompted concern (OR 1.882, 95% CI 1.298–2.728) were independent risk factors for adverse refractive outcomes. For 1-year change, delayed concern and extended or irregular follow-up intervals were significantly associated with increased odds of change (ORs ranging from 1.477 to 1.921; P < 0.05). Behavioral modifications were the most common intervention strategy (63.6%), while evidence-based optical and pharmacological methods remained underutilized. Parental factors, particularly education level and timeliness of concern, are significant determinants of childhood myopia outcomes. These findings highlight the critical need for parent-centered education and early vision screening programs to bridge the gap between clinical guidelines and parental practices.