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Publications (848)
Purpose
This mixed-methods study examined how differences in parental time, knowledge, and economic constraints, as well as community socioeconomic contexts, may contribute to differences in home language environment and child language ability outcomes between peri-urban and rural households in China.
Method
We conducted an explanatory sequential...
The literature has shown that cognitive and non-cognitive development before the age of three is associated with children’s levels of development at later ages. However, the extent to which the different pathways of cognitive and non-cognitive development before age three (between 6–12 months and 22–30 months of age) are associated with development...
Background
Despite the benefits of exclusive breastfeeding, the proportion of exclusively breastfed children remains low in rural China. Self-efficacy is one of the most crucial modifiable factors predicting breastfeeding behavior. However, existing instruments in China do not specifically measure self-efficacy for exclusive breastfeeding but rathe...
To explore the effects of screen time on depression symptoms in Chinese children and adolescents, and to examine the mediating effect role of self-esteem and resilience between the association from a longitudinal perspective. A total of 653 students graded 4th to 8th were selected through a stratified cluster sampling method from Shanghai, China. T...
This study examined the association between visual impairment, visual impairment corrected by wearing eyeglasses, academic performance, and mental health among junior high school students in rural China. Visual acuity assessments were conducted on 19,425 junior high school students by trained medical and research professionals to determine the pres...
Purpose
Depression is a growing public health concern around the world. For adolescents, depression not only impedes healthy development, but is negatively associated with academic performance. The purpose of this paper is to examine the prevalence of adolescent depressive symptoms in a sample of rural primary and junior high school students. Addit...
Cognitive and social-emotional development in the first three years of life is associated with later skills. However, little is known about the paths of developmental delays in both cognitive and social-emotional skills before age 3 or to what extent these paths predict later developmental outcomes. The aim of this study is to examine the associati...
Summary
Background Primary health care is the foundation of high-performing health systems. Achieving an improved
primary care system requires a thorough understanding of the current quality of care among various providers
within the system. As the world’s largest developing country, China has made significant investments in primary
care over the p...
Background:
The association between sleep patterns and young students' mental health, which is crucial for their development, remains understudied in rural China. Therefore, the relationship between sleep patterns and mental health among primary and junior high school students in rural China was examined.
Method:
A total of 1592 primary and juni...
Purpose
Literature has shown that the intergenerational transmission of cognitive abilities is stronger for children raised in more advantaged environments. However, there has never been an empirical investigation of this pattern in China. This study examines differences in the intergenerational transmission of cognitive capabilities among mothers...
Background
To explore the associations between anxiety and depression symptoms and academic burnout among children and adolescents in China, and to examine the role of resilience and self-efficacy in addressing academic burnout.
Methods
A total of 2,070 students in grades 4–8 were recruited from two primary and three middle schools in Shanghai, co...
Improved survival of preterm low birthweight (LBW) infants due to advances in neonatal care has brought issues such as postnatal development trajectories to the foreground. This study pools evidence from three cluster‐randomized experiments evaluating community‐based psychosocial stimulation programs conducted from 2014 to 2017 that included 3571 r...
Background
Poor development of young children is a common issue in developing countries and it is well established that iron deficiency anemia is one of the risk factors. Research has shown that iron deficiency is a common micronutrient deficiency among children in rural China and can result in anemia. A previous paper using data from the same tria...
Introduction
Flourishing is an evolving wellbeing construct and outcome of interest across the social and biological sciences. Despite some conceptual advancements, there remains limited consensus on how to measure flourishing, as well as how to distinguish it from closely related wellbeing constructs, such as thriving and life satisfaction. This p...
Objective
The measures implemented to control the spread of Coronavirus disease 2019 (COVID-19) could affect children’s mental and vision health. Youth particularly from minority and socioeconomically disadvantaged backgrounds were more likely to be impacted by these measures. This study aimed to examine the mental health of children with vision im...
Objective
To investigate factors that differentiate elderly adults in rural China who accept free vision screening and cataract surgery from those who could benefit from vision care but refuse it when offered.
Design
We conducted a population-based, cross-sectional study between October and December 2016. Logistic regression models were used to ex...
Breastfeeding self-efficacy (BSE), defined as a mother’s confidence in her ability to breastfeed, has been confirmed to predict the uptake of exclusive breastfeeding (EBF). Early experiences during the birth hospital stay, especially in-hospital formula feeding (IHFF), can impact both EBF and maternal breastfeeding confidence. Therefore, our object...
The objective of the current study is to examine the impact of an in-school computer-assisted learning (CAL) intervention on the math achievement of rural students in Taiwan, including a marginalized subgroup of rural students called Xinzhumin, and the factors associated with this impact. In order to achieve this, we conducted a cluster randomized...
Introduction
The high incidences of both the developmental delay among young children and the mental health problems of their caregivers are major threats to public health in low-income and middle-income countries. Parental training interventions during early childhood have been shown to benefit early development, yet evidence on strategies to prom...
The home language environment is a critical point of investment in early language skills. However, few studies have quantitatively measured the home language environment of low-socioeconomic-status households in non-western settings. This mixed methods study describes the home language environment and early child language skills among households in...
In low‐ and middle‐income countries, urbanization has spurred the expansion of peri‐urban communities, or urban communities of formerly rural residents with low socioeconomic status. The growth of these communities offers researchers an opportunity to measure the associations between the level of urbanization and the home language environment (HLE)...
Background:
Prenatal anaemia causes serious consequences for both mother and foetus, and dietary factors are suggested to be associated with anaemia. However, research in pregnant women living in rural areas is limited. We aim to assess the contribution of dietary diversity to the magnitude of prenatal anaemia in rural China and identify the inter...
Infants born small for gestational age (SGA) remains a significant global public health concern, with potential interconnections among maternal diet, pre-pregnancy BMI, gestational weight gain (GWG), and SGA. This prospective study investigated the association between dietary diversity (DD) during pregnancy and the risk of SGA, as well as the syner...
Objectives
To clarify the associations between screen time and depression symptoms among Chinese adolescents, as well the mediating roles of self-esteem and resilience.
Methods
A total of 1,624 primary and middle school students aged 9 to 16 years-old from five schools in China were recruited by stratified cluster sampling. The Center for Epidemio...
Objective
To test the feasibility and effectiveness of a mindfulness-based intervention in rural-to-urban migrant Chinese children using trained community volunteers.
Method
Migrant students ages 9 to 16 from 5 schools in Shanghai (N = 653) were randomly assigned to a mindfulness only group (n = 167), a mindfulness plus life skills group (n = 118)...
Many Chinese adolescents suffer from academic burnout, and parenting stress may be a risk factor. The mediating mechanisms underlying this relationship are less known. This study examines the association between parenting stress and adolescent academic burnout, and tests whether adolescent mental health symptoms such as depression and anxiety sympt...
This study investigated the association between household characteristics, perceived family support (PFS), and the developmental outcomes (resilience, academic performance, and prosociality) among at-risk students. Our large sample included 1564 primary and secondary school students from poor rural China (M = 11.55 years old). Having a caregiver wh...
Using premier Language Environment Analysis technology to measure and analyze the home language environment, this observational study aims to describe the home language environment and child language ability, drawing on empirical data from 77 households with children aged 18–24 months from rural China. The results show large variation in measures o...
Purpose
We examine how adolescent free time allocation—namely, screen time and outdoor time—is associated with mental health and academic performance in rural China.
Methods
This paper used a large random sample of rural junior high school students in Ningxia (n = 20,375; $$\bar X$$age=13.22), with data collected from self-reported demographic que...
Background
A rich language environment is an important element of a nurturing home environment. Despite their proven importance, vocabulary and conversation have been shown to vary widely across households—even within the same socio-economic class. One significant gap in the existing literature is its nearly exclusive geographic focus on Western an...
Family-level factors that characterize the home environment are critical inputs to early language and cognitive development, and potential mechanisms for improving developmental outcomes in vulnerable populations. Many studies conducted in high-income and Western settings highlight stimulating parenting, the home language environment, and parental...
Research suggests that elements of the family environment may have significant associations with cognitive and language development outcomes. Less is known, however, about the family environment in peri-urban China, where rates of cognitive and language delay in children aged 0-3 years are as high as 51% and 54%, respectively. Using data collected...
Introduction
Millions of young rural children in China still suffer from poor health and malnutrition, partly due to a lack of knowledge about optimal perinatal and child care among rural mothers and caregivers. Meanwhile, there is an urgent need to improve maternal mental health in rural communities. Comprehensive home visiting programmes delivere...
Background
Improving type 2 diabetes (T2D) care is key to managing and reducing disease burden due to the growing prevalence of diabetes worldwide, but research on this topic, specifically from rural areas, is limited. This study uses standardized patients (SPs) to assess T2D care quality among primary care providers to access the healthcare system...
After nearly two decades of rising wages for those in the unskilled sectors of China's economy, in the mid-2010s employment and wages in China began to experience new polarizing trends. Using data from the National Bureau of Statistics of China, this paper examines trends in multiple sectors and subeconomies of China, revealing the substantial rise...
Despite major advancements in China’s K-12 educational outcomes over the past several decades, large regional inequities in academic achievement still exist, a proximal cause of which are gaps in teaching quality. Although conventional approaches to improving teaching quality for disadvantaged populations have overall been unsuccessful in China (i....
Background:
The WHO recommends daily use of micronutrient powder for infants and toddlers at risk of micronutrient deficiencies in low-and-middle-income countries. China has established a micronutrient powder distribution program in many rural townships and villages, yet adherence to micronutrient powder remains suboptimal; a little is known about...
As digital devices like computers become more widely available in developing countries, there is a growing need to understand how the time that adolescents spend using these devices for recreational purposes such as playing video games is linked with their mental health outcomes. We measured the amount of time that adolescents in rural China spent...
The correlation between parenting style and child cognitive development has been widely documented in Western societies. There has been far less research, however, in non-Western societies and none at all in rural China. This study aimed to investigate the association between parenting style and child cognitive development in rural China. Participa...
Over the past two decades, the literature has shown a clear gradient between child health and wealth. The same health–wealth gradient is also observed among children in China, with a large gap in health between rural and urban children. However, there are still unanswered questions about the main causes of China’s rural–urban child health inequalit...
The self-esteem of students may be significantly associated with their academic performance. However, past research in developing contexts on this issue is limited, particularly among early adolescents. Using a sample of 3101 students from rural primary and junior high schools in China, this study measured their self-esteem by the Rosenberg Self-Es...
As part of its effort to balance economic development with environmental objectives, China has established a new national park system, with the first five locations formally established in 2021. However, as the new parks all host or are proximate to human populations, aligning the socioeconomic needs and aspirations of local communities with conser...
One out of every three children under age 5 in developing countries lives in conditions that impede human capital development. In this study, we survey the literature on parenting training programs implemented before age 5, with the aim to increase parental investment in human capital accumulation in developing countries. Our review focuses on the...
Although eyeglasses have been considered a cost-effective way to combat myopia, the empirical evidence of its impacts on improving learning outcomes is inconsistent. This paper provides empirical evidence examining the effect of providing eyeglasses on academic performance between provinces with a different economic level in western China. Overall,...
Behavioral strengths and difficulties among children and adolescents may be significantly associated with their academic performance; however, the evidence on this issue for rural youth in developing contexts is limited. This study explored the prevalence and correlates of mental health from three specific dimensions—internalizing problems, externa...
Resilience can play an important role in enabling disadvantaged students to succeed academically. However, few studies in low-resource contexts have evaluated resilience as a process (including a child’s internal capabilities and external resources, like the internal capabilities of a child’s caregiver) and as an outcome (e.g., academic achievement...
Proper management of non-communicable diseases (NCDs) is a severe challenge to China's rural health system. This study investigates what influences the poor medical treatment of NCDs (diabetes and angina) by evaluating the “know-do gap” between provider knowledge and practice. To determine whether low levels of provider knowledge low quality of pat...
Objective
To examine haemoglobin level and anaemia status among infants under six months of age in rural China.
Design
A cross-sectional survey collected data among infants under six months and their primary caregivers in Sichuan, China. Anaemia was defined using both the WHO and China Pediatrics Association thresholds. Multivariable linear regres...
Objectives
To examine the association between mental health and executive dysfunction in general adolescents, and to identify whether home residence and school location would moderate that association.
Design
A population-based cross-sectional study.
Setting
A subsample of the Shanghai Children’s Health, Education, and Lifestyle Evaluation-Adoles...
Background
High adherence and proper usage of micronutrient powder (MNP) influence child nutritional outcomes, yet few studies explore the role of delivery patterns. This study explores the association between MNP delivery patterns and MNP feeding behaviors among Han and minority caregivers in rural Western China.
Methods
In August 2019, a total o...
Background
Improving primary care providers’ competence is key to detecting and managing hypertension, but evidence to guide this work has been limited, particularly for rural areas. This study aimed to use standardized clinical vignettes to assess the competence of providers and the ability of the primary healthcare system to detect and manage hyp...
This paper examines the impact of parental beliefs on child development outcomes (for both cognitive and social–emotional skills) based on a three-wave longitudinal survey in rural China. The survey waves were conducted when the sample children were 18–30 months, 22–36 months, and 49–65 months, respectively. A total of 815 children and their primar...
The objectives of this paper were to examine the risk of depression and depressive symptoms among Han and minority children and adolescents in rural China, the links between academic performance and depressive symptoms, and the prevalence of these links among specific subgroups. A total of 8392 4th, 5th, and 6th grade students at 105 sample rural s...