Journal Article

Associations between parental protective motivation, behaviors, and child outcomes in allergic diseases: a cross-sectional study based on protection motivation theory

He, Yinan, Wu, Jinghua, Zhang, Qinzhun, Yu, Yi, Tang, Weihong, Ye, Chengyin, Yao, Xinmeng, Huang, Xianglong

2025

Overview

Background The rising burden of pediatric allergic diseases underscores parental intentions and behaviors as critical to allergic prevention and management. This study aims to develop and validate a Protection Motivation Theory (PMT) based scale for parents of children with allergic diseases, and to examine the associations between parental protection motivation, their management intentions and behaviors, and pediatric health outcomes. Methods We conducted a cross-sectional study among parents of children with allergic diseases at Hangzhou Children’s Hospital, Zhejiang Province, China, from July to December 2022. The PMT scale was developed using data from a pilot survey ( N  = 440) and validated in an empirical study ( N  = 443). Structural equation modeling mapped interconnections between parental protective motivation, intention, and behavior. Multiple linear regression explored PMT dimensions’ association with parental intentions and behaviors, while machine learning models evaluated their clinical relevance to children’s disease outcomes. Results The PMT scale demonstrated good reliability (Cronbach’s α coefficient = 0.844) and validity (χ 2 /df = 2.918, RMSEA = 0.066, GFI = 0.906, CFI = 0.937, NFI = 0.908, IFI = 0.937, TLI = 0.919). In structural equation model, protection motivation showed significant overall interconnections with parental intention (0.78, p  < 0.001). PMT dimensions were associated to 48.2% and 45.5% of the variance in parental intention and behavior related to allergic diseases in multiple linear regressions, with self-efficacy and perceived susceptibility being the most strongly associated factors. Random forest models demonstrated good discrimination in identifying associations between PMT dimensions and children’s atopic severity and attacks, achieving AUC of 0.84 and 0.88 respectively, with all six PMT dimensions among the top-15 related variables. Conclusions Our findings reveal the relevance of measuring parental protective motivation as captured by the developed PMT scale. It had significant associations with key parental intentions and behaviors in managing childhood atopy. This implies the necessity of refined PMT-based interventions to support outcomes in childhood allergic disease management.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Allergic disease / Allergic diseases / Allergy in children / Asthma / Atopy / Behavior / Biostatistics / Care and treatment / Caregivers / Child / Child, Preschool / Childhood / Children / Children & youth / China / Chronic illnesses / Cross-Sectional Studies / Decision making / Disease prevention / Environmental Health / Epidemiology / Female / Food allergies / Humans / Hypersensitivity - prevention & control / Hypersensitivity - psychology / Hypersensitivity - therapy / Hypotheses / Immunization / Intention / Interconnections / Knowledge / Machine learning / Male / Medicine / Medicine & Public Health / Motivation / Parental behavior / Parents / Parents & parenting / Parents - psychology / Pediatric research / Pediatrics / Pilot projects / Prevention and control path / Protection motivation theory / Protective motivation theory / Public Health / Reproducibility of Results / Response rates / Scale development / Self-efficacy / Social aspects / Surveys / Surveys and Questionnaires / Vaccine