Cardiovascular
Agreement between parent and adolescent report of adolescent cardiovascular health behaviors: The Young Hearts Study Rachel Zmora* Rachel Zmora Yaojie Wang Lucia Catherine Petito Aashima Chopra Darci Phillips Ileah Rios Amy Yu Amanda M Perak Donald M Lloyd-Jones Sarah De Ferranti Holly Gooding Stephen Daniels Darwin Raymond Labarthe Matthew M. Davis Marc Brian Rosenman Rashmi Narayan Mark Pletcher Francis Alenghat Rupali Gandhi Cheryl Lefaiver Amanda Luff Huma Khan Brad Appelhans Karen Lui Rachel Caskey Norrina Allen
Background
Accurate assessment of cardiovascular health (CVH) behaviors among adolescents is critical to the study of the early origins of cardiovascular disease. However, the agreement between parents and adolescents when reporting CVH behaviors is poorly understood.
Methods
We compared self and parent reports of CVH behaviors among adolescent-parent dyads in the Young Hearts study, an ongoing diverse pediatric cohort study based in Chicago, IL. Adolescents aged 12-17 and their parents responded to identical questions about diet, physical activity, sleep, and screen utilization of the adolescent. As identical reporting is highly implausible and these variables are skewed, we examined the adolescent-parent agreement falling within the lowest quartile for each CVH behavior using Kappa statistics. The thresholds for the lowest quartile were defined within adolescents and parents, respectively.
Results
Of 589 included adolescents, 55.7% were female and 54.5% were non-Hispanic White, with an average age of 14.8 (SD 1.71) years. Agreement within adolescent-parent dyads varied by CVH behavior but overall was low (kappa range 0.282 – 0.565). Agreement was highest for infrequent weekly family dinners (kappa = 0.565, adolescent Q1 = 3, parent Q1 = 2). Agreement was lowest for daily average hours of sleep among those most lacking sleep (kappa = 0.282, adolescent Q1 = 7.9, parent Q1 = 8.3). Agreement was also low for low levels of screentime (daily average kappa = 0.290) and low levels of weekly physical activity (kappa = 0.297).
Conclusion
Agreement between parents and adolescents regarding adolescent CVH behaviors ranged from poor to moderate, suggesting that misclassification within low or high-risk categories may occur. This work emphasizes the need for improved approaches to self-report of CVH behaviors as well as objective assessment of CVH behaviors among adolescents.
