Abstract: Objective: To study the impact that the cognitive level and knowledge of vision has on parents seeking vision health services for their children. This can provide a scientific basis for effectively preventing and controlling poor vision in students. Methods: This was a cross-sectional investigation. The study was based on the survey data of 5 236 students from 252 rural primary schools in Shaanxi and Gansu provinces. A multivariate logistic regression model was used to analyze the impact that varying knowledge and cognitive levels have on parents seeking vision health services for their children. Propensity matching was used to test the results for robustness. Results: Based on the overall sample of 5 236 students, the myopia rate among students in the sample area was as high as 46.31%, of which 74.54% of students had not undergone a vision exam. Of the 2 425 myopic students, only 15.09% wore eyeglasses. Parents had a big misunderstanding of vision problems. The correct answer rates for parents on visual health knowledge in the full sample and myopic samples were low, respectively. Logistic regression analysis indicated that parental knowledge of vision health has a significant impact on seeking vision health services for their children. Some misunderstandings included the following: Myopia and its causes (OR=1.15, 95%CI: 1.00-1.33, P=0.043; OR=1.20, 95%CI: 1.03-1.41, P=0.023), wearing glasses will make vision worse (OR=1.23, 95%CI: 1.06-1.46, P=0.007), students should check their eyesight (OR=1.40, 95%CI: 1.15-1.69, P=0.001) and students should not wear glasses (OR=1.05, 95%CI: 0.91-1.22, P<0.001). These misunderstandings have a significant effect on whether parents take their children for vision checkups. Parents know that myopia cannot see far away (OR=1.35, 95%CI: 1.04-1.76, P=0.024) and that learning is affected if myopes do not wear glasses (OR=1.54, 95%CI: 1.16-2.05, P=0.003) but feel that primary school students should not wear glasses (OR=1.61, 95%CI: 1.23-2.10, P=0.001). All of these factors have a significant effect on whether or not children wear glasses. Conclusions: Poor eyesight among students in rural areas of China has become a serious problem because parents have big misunderstandings about vision problems. Since parents make decisions for their children, their perceptions and knowledge of vision health can influence their behavior in seeking vision services for their children.
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