Parental perspectives on primary school-based health cohorts: A qualitative study in Greece

Background

School-based health cohorts can be instrumental in exploring how cumulative environmental exposures shape children’s health outcomes and development. However, international data on parental perspectives regarding participation in such cohorts is currently lacking. This qualitative study investigated parents’ motives, concerns, and suggestions for optimizing recruitment strategies in a primary school-based health cohort.

Methods

Four in-person focus groups were conducted with parents of first-grade students across four primary schools in West Thessaloniki, in Spring 2024. Following informed consent, sessions were recorded, and transcribed verbatim. Data was analyzed using thematic analysis.

Results

A total of twenty-two parents participated of whom 70% were women. Five key drivers of parental participation interest emerged: 1. Children’s health surveillance at school; 2. A study design that ensures minimal disruption to family life; 3. Future utility; 4. Establishment of a national biological data registry, and 5. Institutional integrity. Conversely, parents articulated four significant concerns: 1. Possible unauthorized dissemination or secondary use of sensitive personal data; 2. The ethics regarding the long-term storage of biological samples; 3. The perceived burden of a multi-year longitudinal commitment; 4. Possible interference with established family routines. To optimize enrollment, participants recommended multimodal recruitment via in-person and social media channels. Messaging should prioritize data security assurances, emphasize minimal family burden, and highlight the unique value of long-term health assessments.

Conclusions

Establishing a primary school-based health cohort is feasible provided that strategic emphasis is placed on transparent family engagement. Success hinges on effectively communicating the longitudinal benefits and providing rigorous clarification regarding ethical and moral safeguards to build parental trust.

Key messages

• School-based health cohorts are feasible if recruitment prioritizes transparency, institutional trust, and explicit assurances regarding the security of children’s biological and personal data.

• To optimize participation, researchers should employ multimodal communication that highlights long-term health benefits while minimizing the perceived procedural burden on family routines.