Parents’ social norms and children’s exposure to three behavioral risk factors for chronic disease

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Oliver Drouin
Jonathan P. Winickoff
Anne N. Thorndike


Descriptive norms, Counseling, Behavioral risk factors, Children, Health


Social norms predict health behaviors of adults and adolescents. We aimed to determine if parents’ beliefs about social norms were associated with children’s exposure to three behavioral risk factors. We asked 648 parents of children ages 0-18 years old attending two pediatric practices about their children’s exposure to smoking at home. Parents of 341 parents with children >2 years old were also asked about insufficient dental care, and 435 with children aged >12 months about their children’s sugar-sweetened beverage (SSB) consumption. Children were categorized as “at risk” or “not at risk” for each factor.The primary outcome was the parent-reported estimate of neighborhood prevalence of those same risk factors.Of eligible participants, 8% reported smoking at home, 23% that their child hadn’t seen a dentist for 6 months, and 35% that their child drank SSBs once a day or more. In multivariate analyses, parents with children in the “at risk” group estimated that the prevalence of each risk factor was higher in their neighborhood, than did participants with children in the “not at risk” group: difference of 12.2% [95% CI, 5.8%-18.6%] for tobacco-smoke exposure, 18.6% [95% CI, 10.7%-26.5%] for lack of regular dental visits and 12.1% [95% CI, 5.1%-19.0%] for SSB consumption (P<0.001 for all comparisons).Parents of children exposed to three behavioral risk factors reported higher perceived prevalence of each risk factor compared to parents of children not at risk. Addressing parents’ social norms beliefs could help promote healthier behaviors of children.

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