Published online September 28, 2009
PEDIATRICS Vol. 124 No. 4 October 2009, pp. 1100-1109 (doi:10.1542/peds.2008-0797)
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ARTICLE

Do Parents Understand Growth Charts? A National, Internet-Based Survey

Elana Pearl Ben-Joseph, MD, Steven A. Dowshen, MD and Neil Izenberg, MD

Nemours Center for Children's Health Media (KidsHealth), Alfred I. DuPont Hospital for Children, Wilmington, Delaware

OBJECTIVE: The objective of this study was to assess parental knowledge and understanding of growth charts.

METHODS: An online survey was conducted with 1000 parents selected to be demographically representative of the US population. Questions explored awareness of, knowledge of, and attitudes toward growth monitoring, as well as the ability to interpret growth chart data.

RESULTS: Seventy-nine percent of parents surveyed claimed to have seen a growth chart before, with the majority thinking that they understood it well. Sixty-four percent of parents thought it was important to be shown growth charts to see how their child was growing, and 40% expressed the need to see their child's growth chart as confirmation of their health care provider's verbal interpretation. However, when provided with multiple-choice questions and answers, only 64% could identify a child's weight when shown a plotted point on a growth chart. Ninety-six percent had heard of the term "percentile," but only 68% identified the percentile of the plotted point, and only 56% could identify the definition of percentile. Up to 77% interpreted incorrectly charts containing height/weight measurements in tandem.

CONCLUSIONS: Although growth charts are used frequently as visual aids to educate parents about their children's growth, many parents cannot comprehend the data. This finding is significant because many parents prefer to be shown growth charts by their health care provider, and many parents report recording their children's measurements on growth charts at home.

Key Words: child • growth • height • parents • weight • growth chart • obesity • BMI • health literacy • numeracy

Abbreviations: CDC—Centers for Disease Control and Prevention

Accepted May 28, 2009.


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