Parent-Child Mutual Influences on Sugar-Sweetened Beverage Consumption Behaviors: Actor-Partner Analysis

Childhood obesity remains a significant global public health issue, with consumption of sugar-sweetened beverages (SSBs) recognized in scientific studies as a key contributing factor. While family influences on children's dietary behaviors and their effects on obesity risk are well-documented, the dynamics between parents and children in shaping SSB consumption remain underexplored.

Drawing on social influence theory, this study examines how parent-child perceptions and consumption intentions regarding SSBs are interrelated and the potential mediating role of attitudes. We also studied how engagement with food-related content on social media may relate to consumption intentions.

We conducted a face-to-face survey of 250 parent-child dyads (N=500) living in public housing in Singapore, a country tackling overweight in its population. Dichotomous items were used to measure cognitive perceptions and attitudes toward SSBs. Both parent and child participants self-reported their intention to consume SSBs. Based on the World Health Organization (WHO) definition of SSBs, visuals of culturally relevant drink products were used in the survey to visualize SSBs. Dyadic data analysis using the MEDYAD tool was conducted to test the actor-partner interdependence model (APIM) and examine the impact of the parent-child dyadic relationship on individuals' intention to consume sugary drinks.

Pearson correlation results indicated positive associations between parent and child cognitive perceptions and intentions to consume SSBs. Path analysis revealed strong actor effects with both parents' (β=.52, P<.001) and children's (β=.43, P<.001) own perceptions predicting their attitudes and subsequent intentions to consume SSBs (parent: β=.32, P<.001; child: β=.31, P<.001). Partner effects also emerged: parental perceptions influenced children's intentions (β=.20, P=.01), while children's perceptions shaped parental attitudes (β=.20, P=.02), highlighting the reciprocal nature of influence. While digital food media engagement was positively associated with consumption intentions, its effects were relatively modest and not central to the dyadic pathways.

Our study findings highlight the reciprocal effects of both parents and children in influencing healthier behaviors and hence provide insights to aid obesity prevention efforts. By addressing the interdependent associations of parent-child dynamics, this research bridges theory and health communication practice, offering a novel framework for combating obesity through family-centered approaches.