Stigma, Perceptions, and Parental Responses to Children's Head Lice Infestation in Greece

BACKGROUND: Head lice remain a frequent concern in schools, with social stigma and misconceptions often influencing parental attitudes more than medical realities. Understanding these psychosocial dimensions is essential for designing effective school health strategies. METHODS: A cross-sectional online survey was conducted among 227 parents of preschool and primary school children across 13 regions in Greece. A structured 20-item questionnaire was used. Exploratory factor analysis identified underlying attitudinal factors, while correlations and latent profile analysis explored distinct psychosocial profiles. RESULTS: Six attitudinal factors emerged: Peer Stigma, Cultural Prejudice, School-Related Concerns, Internalized Shame, Hygiene Beliefs, and Institutional Factors. Stigma-related factors were strongly intercorrelated. Demographic associations were weak, and infestation frequency showed only marginal links to attitudes. Latent profile analysis identified four distinct psychosocial profiles of the parents. Implications for School Health Policy, Practice, and Equity: Findings emphasize the need for stigma reduction, parental education, and improved school-family communication. Tailored interventions can reduce inequities by supporting vulnerable parent groups with culturally sensitive strategies. CONCLUSIONS: Head lice are perceived by many parents as a social rather than medical issue. Addressing stigma is crucial for effective and equitable school health practice.