Intervention-specific knowledge, attitudes, and practices among guardians of children with myopia: a multicity cross-sectional survey in China

Objective To compare guardians’ knowledge, attitudes, and practices (KAP) across three commonly used myopia-management modalities and to identify associated sociodemographic factors. Methods A multicity cross-sectional survey was conducted among guardians of children aged 6–12 years in eight Chinese cities using convenience and snowball sampling. The self-administered questionnaires assessed general myopia-related knowledge, awareness of the effects of interventions, and intervention-specific KAP regarding 0.01% atropine eye drops, spectacles, and orthokeratology. Exploratory psychometric properties were assessed, and generalized estimating equations (GEE), Spearman correlations, logistic regression, and bootstrap linear regression were applied. Results Among 1,509 valid questionnaires, 726 guardians reported having a child with myopia (48.1%). With multiple responses permitted, reported use was most frequent for spectacles (82.1%), followed by 0.01% atropine eye drops (15.8%) and orthokeratology (15.0%). Orthokeratology had the highest adjusted KAP scores (4.17, 3.98, and 4.23, respectively), followed by spectacles and 0.01% atropine. KAP domains were positively intercorrelated for both spectacles and orthokeratology. For 0.01% atropine, attitude and practice scores were negatively correlated (ρ = −0.538, p < 0.001) and no significant association was identified between knowledge and practice. Among guardians of spectacle users, practice scores were lower among those aged 19–34 years compared with those aged 35–49 years ( B = −1.17, 95% CI: −1.74 to −0.58; p < 0.001; q = 0.024) and among those with less than a bachelor’s degree ( B = −0.79, 95% CI: −1.25 to −0.35; p = 0.001; q = 0.024). Conclusion Guardians’ KAP levels and inter-domain correlations differed across interventions. These findings may support intervention-specific education and balanced clinician-guardian communication.