Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Highly Accessed Research article

Agreement between parent and child report on parental practices regarding dietary, physical activity and sedentary behaviours: the ENERGY cross-sectional survey

Cornelia E Rebholz1, Mai JM Chinapaw1, Maartje M van Stralen1, Elling Bere2, Bettina Bringolf34, Ilse De Bourdeaudhuij5, Nataša Jan6, Eva Kovacs7, Lea Maes8, Yannis Manios9, Luis Moreno10, Amika S Singh11, Johannes Brug11 and Saskia J te Velde11*

Author Affiliations

1 EMGO Institute for Health and Care Research and the Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands

2 Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway

3 Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland

4 University of Basel, Basel, Switzerland

5 Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium

6 Slovenian Heart Foundation, Ljubljana, Slovenia

7 Department of Paediatrics, Pecs University, Pecs, Hungary

8 Department of Public Health, Ghent University, Ghent, Belgium

9 Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

10 GENUD (Growth, Exercise, Nutrition and Development) Research Group. E.U. Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain

11 EMGO Institute for Health and Care Research and the Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands

For all author emails, please log on.

BMC Public Health 2014, 14:918  doi:10.1186/1471-2458-14-918

Published: 5 September 2014



Parents and their parenting practices play an important role in shaping their children’s environment and energy-balance related behaviours (EBRBs). Measurement of parenting practices can be parent- or child-informed, however not much is known about agreement between parent and child perspectives. This study aimed to assess agreement between parent and child reports on parental practices regarding EBRBs across different countries in Europe and to identify correlates of agreement.


Within the ENERGY-project, a cross-sectional survey was conducted among 10–12 year old children and their parents in eight European countries. Both children and parents filled in a questionnaire on 14 parental practices regarding five different EBRBs (i.e. soft drink, fruit juice and breakfast consumption, sports activity and watching TV) and socio-demographic characteristics. Children’s anthropometric measurements were taken at school. We calculated percentages of agreement between children and their parents and weighted kappa statistics (for ordinal variables) per practice and country and assessed factors associated with agreement using multilevel linear regression.


Reports of 6425 children and their parents were available for analysis. Overall mean agreement between parent and child reports was 43% and varied little among countries. The lowest agreement was found for questions assessing joint parent–child activities, such as sports (27%; Kappa (κ) = 0.14) or watching TV (30%;κ = 0.17), and for parental allowance of the child to have soft drinks (32%;κ = 0.24) or fruit juices (32%;κ = 0.19), or to watch TV (27%;κ = 0.17). Having breakfast products available at home or having a TV in the child’s bedroom were the only practices with moderate to good agreement (>60%;κ = 0.06 and 0.77, respectively). In general, agreement was lower for boys, younger children, younger parents, parents with less than 14 years of education, single parents, parents with a higher self-reported body mass index and parents who perceived their child to be underweight.


Parents and children perceive parental practices regarding dietary, physical activity and sedentary behaviours differently in all parts of Europe, with considerable variation across specific practices and countries. Therefore, future studies should assess both, parents and children’s view on parental practices.

Children; Parent; Parenting; Questionnaire; Inter-observer agreement; Inter-observer variability; Health behaviour; Overweight