Agreement between parental and student reports on respiratory symptoms and school environment in young Romanian children - evidence from the SINPHONIE project.

Background Environmental research involving children often relies on the self-report or parental report of symptoms and environmental issues. While previous studies explored the agreements between child and parental reports, few of them were conducted in younger children and in developing countries. In this study, we addressed the research gaps by assessing the agreement between child and parental report on respiratory symptoms and school environment in Romanian primary schools. Methods Two hundred and eighty students from five schools and their parents participated in this study. Information on child's respiratory symptoms and perceptions of school environment was collected via both student and parent questionnaires. Agreement between the two questionnaires was assessed by absolute agreement rates and kappa statistics. Prevalence index (PI), bias index (BI) and maximum attainable kappas were calculated to identify potential sources of disagreements. Results The agreement between student and parent questionnaires was low. Compared to the student's report, parents often reported more symptoms than their children, particularly flu-like symptoms, and school environment problems. Parent and child tend to agree when there was no symptom reported, but disagreements often occurred when symptoms were reported. After adjusting for the PI, the agreements for asthma and allergic symptoms improved substantially. Disagreement on reporting of flu-like symptoms was strongly affected by pre-existing causes, such as different understandings of the questions between students and parents. Conclusion Parental report may have a higher sensitivity in capturing a child's respiratory symptoms and school environment problems compared to self-report among young children in developing countries.