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The purpose of this study was to examine the dietary views and practices and to identify associated barriers to and facilitators of healthy eating of rural residents emerging from poverty in the context of rapid socio-economic development. A qualitative design with semi-structured interviews was utilized to collect detailed insights into the dietary behaviors of 22 rural residents from 10 villages in Fengshan town, Dafang county, Guizhou province, China. Thematic analysis was applied to interpret the interview data, guided by the socio-ecological model. Four themes were identified: traditional eating patterns, factors influencing food choice, limited knowledge of healthy diet, and lack of nutritional guidance. Barriers to healthy eating included traditional but unhealthy foods, limited nutritional knowledge, inadequate understanding of nutritional requirements, overwhelming nutritional information, and limited professional guidance. Facilitators encompassed healthy traditional eating patterns, household composition, home gardening, preference for traditional bean and soy products, improved food supply and availability owing to poverty alleviation efforts, and being open to receiving professional dietary guidance. As a preliminary investigation into the dietary views and practices of this population, the study highlights a significant gap in the nutritional knowledge and guidance available to rural residents in China, emphasizing the need for comprehensive strategies that address the complex socio-ecological factors influencing dietary behaviors. [ABSTRACT FROM AUTHOR]

We aimed to investigate health care needs, health service utilization, and their socio-economic and health-related determinants in people with spinal cord injury (SCI) living in Jiangsu and Sichuan Provinces of China. A total of 1355 participants with SCI living in the community were recruited using a multi-stage stratified random sample and surveyed by telephone or online. Outcomes evaluated included the presence of health care needs, mode of health service utilization, and specific provider types seen within 12 months preceding the survey. The prevalence of healthcare needs was 92%. Needs were higher in Sichuan (98%) as compared to Jiangsu (80%). Of those in need of health care, 38% reported not having utilized care, more in Sichuan (39%) than in Jiangsu (37%). In Jiangsu, inpatient care was more often used than in Sichuan (46% vs. 27%), while in Sichuan outpatient services were utilized more often (33% vs. 17%). On average, 1.6 provider types were seen, with Sichuan reporting fewer different provider types. Considerable differences in the prevalence of health care needs and service utilization patterns were found between provinces, mostly in favour of the economically more developed Jiangsu Province. People with low income, particularly those below the World Bank poverty line for middle-income countries, had increased health care needs but utilized health care less often. Moreover, environmental barriers contributed significantly to unmet health care needs. This implies the necessity to provide better accessible and more affordable rehabilitation services for people with spinal cord injury (SCI) in China such as community-based rehabilitation programming. Policies for alleviation of poverty in the case of SCI including insurance for catastrophic health expenditure should also be reviewed and adapted where applicable. [ABSTRACT FROM AUTHOR]

Growing evidence exists about the candidate factors of childhood cognitive performance, but mainly limited to single-exposure studies. We sought to systematically and simultaneously identify and validate a wide range of potential modifiable factors for childhood cognitive performance. We used data from five waves of data from the China Family Panel Studies (CFPS-2010, 2012, 2014, 2016 and 2018). Our analytical sample was restricted to those children aged 2–5 at baseline with valid exposure information. A total of 80 modifiable factors were identified. Childhood cognitive performance was assessed using vocabulary and mathematics test at wave 5. We used an environment-wide association study (EnWAS) to screen all exposure-outcome associations independently and used the least absolute shrinkage and selection operator (LASSO) variable selection algorithm to identify factors associated with cognitive performance. Multivariable linear model was then used to evaluate causal relationships between identified factors and cognitive performance. Of the 1305 participants included in the study (mean ± SD, 3.5 ± 1.1 years age at baseline, 45.1% girls). Eight factors were retained in the LASSO regression analysis. Six factors across community characteristics (percentage of poverty in the community; percentage of children in the community), household characteristics (family size), child health and behaviors (mobile internet access), parenting behaviors and cognitive enrichment (parental involvement in child' s education), and parental wellbeing (paternal happiness) domains were significantly associated with childhood cognition. Using a three-stage approach, this study validates several actionable targets for improving childhood cognitive performance. [ABSTRACT FROM AUTHOR]

Although overeating increases risk for chronic illness and premature mortality, evolutionary life-history theorists posit that such behaviors arise as a potential outcome of using fast life-history strategies to function in environments that are harsh or unpredictable. To test this premise, we examined links between harsh, unpredictable living conditions (HULC), the adoption of fast life-history (LH) strategies, and overeating among early adolescents using a four-wave longitudinal design. Participants were 2547 Chinese adolescents (1202 girls, 1345 boys) who completed baseline questionnaires assessing experiences of HULC, preferences for use of fast LH strategies, and overeating. Measures were re-administered in follow-ups 7, 13, and 20 months later. Analyses indicated HULC predicted increased use of fast LH strategies within each gender. However, fast LH strategy adoption contributed to increases in overeating only among girls. Findings supported specific tenets of life-history theory and underscored gender as an important consideration in understanding links between living conditions, the adoption of fast LH strategies, and risk for overeating. Interventions focused on reducing poverty and increasing stable, nurturing family, and community environments may aid in reducing overeating and obesity for adolescents. [ABSTRACT FROM AUTHOR]

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The parental expectation in adolescents' education is an essential factor of adolescents' social and emotional development. However, little is known about how it is related to adolescents' mobile phone addiction, especially for adolescents from low-income families. To address this issue, this study investigated the relationship between parental expectation and mobile phone addiction, and its underlying mechanisms in adolescents from low-income families. We hypothesized that parental expectation would negatively predict mobile phone addiction, and self-esteem and social anxiety would play multiple mediation roles in this relationship. Results from a sample of 1,953 Chinese adolescents in low-income families revealed that (a) parental expectation was negatively associated with adolescents' mobile phone addiction, (b) both social anxiety and self-esteem played partial and parallel mediating roles between parental expectation and mobile phone addiction, and (c) social anxiety and self-esteem mediated the association between parental expectation and mobile phone addiction sequentially. This study would advance our understanding of how proper parenting styles and social networks helped to prevent children's mobile phone addiction. The limitations and implications of this study are discussed. [ABSTRACT FROM AUTHOR]

Based on the ecological systems theory, this study examined the multiple risk factors experienced by children from low-income families in China and their subsequent impact on children's psychological adaptation. A cumulative ecological risk questionnaire was constructed to examine the exploratory and descriptive risk factors most commonly exposed to children in families, schools and communities. The study sample consisted of 428 children from low-income families (N = 428; Mage = 12.35, SD = 2.51) from 20 ordinary primary and secondary schools across China. We conducted an exploratory latent class analysis using the responses from the cumulative ecological risk questionnaire. The results showed that a three-group solution fit the data best, with the following breakdown: "low-risk" = 41.1%, "family-risk" = 21.7%, and "school-risk" = 37.2%. The three groups showed significant differences in terms of psychological adaptation. The "low-risk" group exhibited fewer problem behaviors and higher prosocial behavior than the other groups. The "family-risk" group showed more significant adaptation difficulties, while the "school-risk" group showed lower levels of prosocial behavior. The results suggest that the ecological risks experienced by children from low-income families had significant group heterogeneity, which may further affect their psychological adaptation. Highlights: The ecological risks of children from low-income families were heterogeneous and may affect children's psychological adaptation. Latent class analysis favored a three-group solution: low-risk, family-risk, and school-risk groups. The three groups showed significant differences in terms of the children's psychological adaptation. [ABSTRACT FROM AUTHOR]

This study aimed to examine the perspective of person-in-environment by identifying whether social work students in China held a dominant orientation. The study was based on a sample of over 1,000 final-year social work students in Guangdong Province. It was revealed that although respondents prioritised the profession's individual-oriented goals, their practice preferences were indeterminate. Moreover, society-orientation was far from absent because social causes of poverty received most support. Paradoxically, micro practice was the preferred way of dealing with poverty. Ambiguity and discrepancy in the orientations of Chinese social work students not only reflected the evolving and pragmatic nature of social work in China, but also indicated the importance of understanding person-in-environment within an authoritarian context. IMPLICATIONS Chinese social work educators should provide integrative learning with both individual and society orientations. The international community of social work educators needs to be more culturally sensitive in their teaching regarding person-in-environment. [ABSTRACT FROM AUTHOR]

Background. Effective functional family was beneficial for older adults' health, which may affect the quality of life (QoL) in hypertension patients. This study aimed to clarify the association between family function, anxiety, and QoL for older adults with hypertension in low-income communities. Methods. A questionnaire survey was conducted on 363 older adults with hypertension in low-income communities in Wuhan from September 2019 to November 2019. The relationships among the variables were examined by Pearson's correlation analysis. Predictor effects were tested using hierarchical multiple regressions, controlling for demographic characteristics. The structural equation model (SEM) was used to test the mediation effects of anxiety on the pathway from family function to QoL. Results. Family function was negatively correlated with the self-rating anxiety scale (SAS) score and positively correlated with the mental component score (MCS), but had no influence on the physical component score (PCS). Both PCS and MCS were negatively correlated with SAS. Anxiety was the negative predictor of MCS and PCS. Family function was the positive predictor of MCS, but had no influence on PCS. The path model indicated that anxiety significantly mediated the link between family function and QoL (R2 = 32.8%), but only partially. Conclusion. A significant correlation between anxiety, family function, and QoL was found. Anxiety had a partial mediating effect on the relationship between family function and QoL. Further research should focus on increasing the level of family function and reducing the perceived anxiety of older adults with hypertension to improve their QoL level. [ABSTRACT FROM AUTHOR]

We tracked the motor skill development of young children aged 3–6 years and investigated the influence of middle-income home environment on the development of motor skill. 268 children were selected from kindergartens in Beijing. The Test of Gross Motor Development (TGMD) tool was used to test the development of locomotor and object-control skills (LS and OS), and a survey of children's behaviour and home environment was conducted. During the follow-up, the LS and OS of children aged 3–6 years continued to grow, with an annual growth rate of 20% and 30%. Five LS indicators and two OS indicators were significantly higher in the 3–4-year group than in the 4–5 and 5–6-year groups (p < 0.01). The age-sex trend model showed that girls' locomotor skill developed at a significantly higher rate than that of boys (β = 6.3004 and 4.6782, p < 0.001). Three-year-old boys performed significantly better than girls on object-control motor skill (p < 0.05). Factors affecting the rate of children's motor skill development in middle-income families included the frequency of playing with friends (β = 0.133 , p = 0.032) and the frequency of bicycling, skateboarding, dancing, running, and jumping (β = 0.041 , p = 0.042). Family income, parents' education level, and family activity area did not significantly affect the growth rate of motor skills. For middle-income families, the improvement of material environment at home like more playing spaces and toys did not speed up the motor development, while more opportunities to play with friends and engage in a variety of sports activities could promote children's motor skill development. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we explored the association between sleep quality, duration and prevalence of rheumatoid arthritis (RA) among low-income adults in rural areas of China. Methods: Face-to-face investigation were conducted in 2017, and completed questionnaires were obtained from 16,648 individuals. Sleep quality and duration were evaluated using the standard Pittsburgh Sleep Quality Index. RA was based on self-reported physician diagnosis. Logistic regression analysis and restricted cubic spline models were performed. Results: Sleep duration shorter than 7 hours was associated with increased odds of RA, with an odds ratio (OR) of 1.49 for 6–<7 hours and 1.70 for <6 hours. Poor sleep quality was associated with RA, with an OR of 1.68. The combination category of poor sleep quality and any group of sleep duration was associated with a significantly increased risk of developing RA. Combined groups of good sleep quality with short sleep duration (<7 hours) were also found to be related to prevalence of RA. There was a non-linear relationship between sleep quality, duration and the odds of RA. Conclusions: Poor sleep quality and short sleep duration may be trigger or risk factors for RA. [ABSTRACT FROM AUTHOR]

Poverty and poverty reduction in mainland China are the main concerns of development discourse and policy. Among poor individuals, children are the most vulnerable. This study aimed to investigate how multidimensional child poverty influenced children's academic achievement in poor rural areas in China. This study examined how this effect might be mediated by the stock of social relationships. Data were obtained from a questionnaire survey of 775 children (grades 4 to 9) living in the most underdeveloped rural areas in southwest China (Eryuan County). Results showed that multidimensional child poverty was negatively related to children's academic achievement. Social relationships played a significant role in mediating the effects of multidimensional child poverty on children's academic achievement. These findings provided valuable insights into the multidimensions of poverty and the underlying mechanisms from poverty to children's academic achievement. Implications in theory, social work practice, and social policy were discussed. Social work intervention and prevention were also developed in terms of fostering the growth of social relationships. • Poverty and poverty reduction in mainland China are currently the central concerns of development discourse and policy. • Multidimensional child poverty was negatively related to children's academic achievement. • Social relationships significantly mediated the effects of multidimensional child poverty on children's academic achievement. [ABSTRACT FROM AUTHOR]

It has been shown that food insecurity is associated with poor diet quality and unfavourable health outcomes. However, little is known about the potential effects of food insecurity on the overall malnutrition status among children. In this study, we investigated the prevalence of food insecurity among 1583 elementary school students, aged 6–14 years, living in Chinese rural areas and examined its association with four malnutrition signs, including rickets sequelae, anaemia, stunting and wasting. Information on food security was collected via questionnaires. Rickets sequelae were assessed by an experienced paediatrician during the interview. Anaemia was determined by the WHO Hb thresholds adjusted by the local altitude. Weight and height were measured during the interview. Stunting and wasting were then evaluated according to WHO child growth standards (2007). We examined the association between food insecurity and the number of malnutrition signs (total number=4), and the likelihood of having severe malnutrition (presence of 3+ signs), after adjusting for potential confounders, such as age, social-economic status and dietary intakes. During the previous 12 months, the overall prevalence of food insecurity was 6·1 % in the entire studied population and 16·3 % in participants with severe malnutrition. Participants with food insecurity had a slightly higher number of malnutrition signs (1·14 v. 0·96; P=0·043) relative to those who were food secure, after adjusting for potential confounders. Food insecurity was also associated with increased likelihood of having severe malnutrition (adjusted OR 3·08; 95 % CI 1·47, 6·46; P=0·003). In conclusion, food insecurity is significantly associated with malnutrition among Chinese children in this community. [ABSTRACT FROM PUBLISHER]

With China’s gender imbalance and increasingly severe male marriage squeeze, patterns of intergenerational support in rural areas are likely to undergo significant change. Using data from a survey of four towns from X county in Anhui province carried out in 2008, this article analyzes the effects of sons’ marital status on intergenerational support. Random-effect regression analysis shows that son’s marital status has strong effects on financial support to and coresidence with parents. Compared with married sons, older unmarried sons (so-called forced bachelors) tend to provide less financial support to their parents and are more likely to live with their parents. Parents’ support of sons, as well as the parents’ own needs and sons’ capabilities all affect the support provided by sons. These results show that both theories of exchange and altruism are simultaneously relevant in the context of the marriage squeeze of contemporary rural China. [ABSTRACT FROM AUTHOR]

We examine the role of hopeful thinking in enhancing life satisfaction among a minority group facing pervasive group-based discrimination: country migrant workers' children in China. Positive psychology reasoning suggests that hopeful thinking can attenuate the negative impact of perceived discrimination on life satisfaction. This moderation model is compared to a mediation model, which predicts that reduced hopeful thinking explains the negative impact of perceived discrimination on life satisfaction. Study 1 showed that hopeful thinking did not moderate the relationship between discrimination and life satisfaction. Rather, the negative impact of discrimination on life satisfaction was mediated through diminished hopeful thinking. Study 2 manipulated perceived discrimination and replicated Study 1 findings. The results reveal that hopeful thinking can indeed have positive consequences, but that hopeful thinking is also constrained by perceiving discrimination. This suggests that there are limits to the extent to which hopeful thinking can be developed when facing group-based discrimination. [ABSTRACT FROM AUTHOR]

Following the dramatic socioeconomic transition since the 1980s in China, some people became unemployed and experienced a significant drop in income. The aim of this study was to assess the effects of low income on health-related quality of life (HRQOL) among the population in northeast China. A total of 5100 individuals in northeast China were randomly sampled and investigated using the 36-item Short-Form Health Survey (SF-36) from November 2005 to October 2006. According to the monthly per capita income level, the population was divided into different groups for analysis. Multiple linear regressions showed that low income, older age, disease, and unemployment were the important factors that could lead to worse HRQOL. Covariance analysis showed that there were significant differences in HRQOL scores among the subgroups of the low-income population. When the income level increased, HRQOL scores improved. This study could provide valuable information for planning integrated economic and public health policies to improve the health of people living in poverty. [ABSTRACT FROM PUBLISHER]