Parents’ knowledge, attitude, and practice toward mouth breathing in children: a mediation analysis

This study aims to assess parents’ knowledge, attitude, and practice (KAP) regarding mouth breathing in children. This multicenter cross-sectional study was conducted from July to October 2024 among parents. A total of 1,966 valid responses were analyzed. Among the children, 1,074 (54.63%) were male, and 597 (30.37%) were identified as mouth breathers. The knowledge, attitude, and practice scores were 11.52 ± 6.47 (range: 0–26), 28.74 ± 2.34 (range: 8–40), and 39.22 ± 6.51 (range: 10–50), respectively. Mediation analysis revealed that knowledge was significantly associated with both attitude (β = 0.09, P < 0.001) and practice (β = 0.41, P < 0.001). Additionally, attitude was associated with practice (β = 0.75, P < 0.001) and mediated the relationship between knowledge and practice (β = 0.07, P < 0.001). Parents demonstrated inadequate knowledge, a generally positive but not optimal attitude, and suboptimal practice concerning mouth breathing in children. Strengthening parental knowledge may indirectly improve practice by fostering a more positive attitude toward the management of mouth breathing. Not applicable.