• Yi-Hsuan Wei, Chyi-Her Lin, San-Nan Yang, Chien-Yi Wu, Yung-Ning Yang, Shu-Leei Tey, and Yu-Tsun Su.
• Department of Pediatrics, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan.
• J Formos Med Assoc. 2023 Dec 1; 122 (12): 128212951282-1295.

Background/PurposeThis study examined the practice rate of Anticipatory Guidance (AG) and the gap between knowledge and practice among caregivers.MethodsWe retrospectively collected data from caregivers who brought their children for seven age-based well-child visits (birth to 7 years old) and seven corresponding AG checklists for practice (each ranged from 16 to 19 guidance items, 118 items in total) between 2015 and 2017. Practice rates of guidance items and their association with children's sex, age, residence, and body mass index were collected and analyzed.ResultsWe enrolled 2310 caregivers (330 per well-child visit). Average practice rates of guidance items in the seven AG checklists were 77.6%-95.1%, generally without significant differences between urban/rural or male/female children. However, lower (<80%) rates were observed for 32 items, including dental check-ups (38.9%), use of fluoride toothpaste (44.6%), screen time (69.4%), and drinking less sugar-sweetened beverages (SSBs) (75.5%), with corresponding knowledge-to-practice gap rates of 55.5%, 47.9%, 30.3%, and 23.8%, respectively. "Drinking less SSBs" was the only item with a higher obesity rate in the non-achieved group versus the achieved group (16.7% vs. 7.4%, p = 0.036; odds ratio: 3.509, 95% CI: 1.153-10.677, p = 0.027).ConclusionCaregivers in Taiwan practiced most AG recommendations. However, dental check-ups, fluoride toothpaste use, drinking less SSBs, and limiting screen time were less executed items. A higher obesity rate was found among 3-7-year-old children whose caregivers failed to practice the "Drink less SSBs" guidance. Strategies to overcome the gap between knowledge and practice are needed to improve these less-achieved guidance items.Copyright © 2023 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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