Parental knowledge–attitude–practice profiles in childhood myopia: a comprehensive evaluation integrated with clinical findings

PURPOSE: Childhood myopia is increasing globally, yet limited evidence exists on how parental knowledge, attitudes, and practices (KAP) relate to children's myopia status. This study aimed to evaluate parental KAP regarding childhood myopia and examine their associations with refractive outcomes. METHODS: This cross-sectional study included parents of myopic children aged 6-18 years presenting to an ophthalmology clinic between July and November 2025. A structured KAP questionnaire assessed parental knowledge of risk factors and control methods, attitudes toward myopia severity and management, and daily preventive practices. KAP scores were analyzed as continuous variables. Annual myopia progression was categorized according to refractive change (< - 0.50 D, 0.50-1.00 D, > 1.00 D). RESULTS: A total of 303 parents were enrolled. The mean knowledge, attitude, and practice scores were 4.68 ± 2.44, 8.12 ± 3.37, and 3.59 ± 1.52, respectively. Higher educational level, urban residence, and a family history of myopia were consistently associated with higher KAP scores. Parental KAP also varied by the child's myopia severity: parents of children with high myopia demonstrated markedly higher knowledge and attitude scores than those of children with mild or moderate myopia. Correlation analysis showed a moderate positive association between knowledge and attitude scores (r = 0.360, p < 0.001). Annual myopia progression was negatively correlated with knowledge (r = - 0.263, p < 0.001), attitude (r = - 0.127, p = 0.027), and practice scores (r = - 0.123, p = 0.033), indicating that children of parents with higher KAP scores tended to show less refractive progression. CONCLUSIONS: Parental KAP profiles were associated with clinically relevant patterns of refractive progression in childhood myopia. Despite generally positive attitudes, substantial gaps persisted in parental knowledge and daily implementation of protective practices. Strengthening parental education and improving access to evidence-based interventions may support better behavioral engagement in myopia management.