Influence of parental behavior on myopigenic behaviors and risk of myopia: analysis of nationwide survey data in children aged 3 to 18 years

Background Preventive parental behavior may play an important role in the outcomes of children’s myopia. We investigated associations between parental behavior and children’s myopia status and daily activities using data from the most recent myopia survey in Taiwan. Methods In total, 3845 children aged 3 to 18 years who completely responded to the questionnaire were included (total score ranging from 0 to 75). A score of ≥ 50 was considered to indicate beneficial parental behavior. Time allocation data for near-work activities, using electronic devices, and outdoor activities were collected using a separate self-reported questionnaire. Associations between beneficial parental behavior and children’s myopia status and activity patterns were analyzed and stratified by school level. Results Beneficial parental behavior was positively associated with children’s myopia in the overall samples [adj. odds ratio (OR): 1.31, 95% confidence interval (CI): 1.08–1.59, p = 0.006)] and at the elementary school level (adj. OR: 1.43, 95% CI: 1.11–1.83, p = 0.005). However, a negative association with high myopia was observed in the overall samples (adj. OR: 0.71, 95% CI: 0.50–0.99, p = 0.049) and high school level (adj. OR: 0.62, 95% CI: 0.41–0.92, p = 0.02). Beneficial parental behavior was associated with less time spent on near work (≥ 180 min/day) and electronic device use (≥ 60 min/day), but not with outdoor activities. Conclusion In Taiwan, children’s myopia is associated with higher rate of parents’ beneficial behaviors, which suggests that regular vision surveillance is necessary to promote better parental behavior toward children’s eye care. Certain parental practices may influence children’s behavior pattern and reduce the risk of children’s high myopia development in the long run.