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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]

A large literature has examined early-life insult and later-life health outcomes. However, whether early-life exposure might persist into the outcomes of future generations remains unclear. Using data from the China Family Panel Studies, this study examines the intergenerational effects of early-life health shocks during the great famine in China, distinguishes the intergenerational effects of in utero and early-life famine exposure, and estimates whether there is a sex-specific transgenerational response. Difference-in-difference results show that first-generation male in utero famine exposure (1959–1961) is associated with a series of health and economic disadvantages in the second generation, compared with the unexposed post-famine-born cohort (1964–1965) in China. The effect persists in the third generation but attenuates, and there is no same-sex transgenerational response. These findings may suggest a novel source of multigenerational persistence in health and economic poverty and may point to a need to consider evidence of transgenerational mechanisms. [ABSTRACT FROM AUTHOR]

Temporary workers' health problems in China have raised concerns recently. This study aimed to assess the relationship between temporary employment and three health outcomes with gradient severity and explore mediating mechanisms. Data was obtained from a national cross-sectional survey (China General Social Survey 2018). Compared with regular workers, temporary workers reported more frequent mood disorders (β = 0.197) and disturbance of daily activities (β = 0.132), however, there was no significant difference in serious health risks (inpatient treatment) between temporary and regular workers. Income poverty, subjective social status, and family relative socioeconomic status were significant mediators. The results suggest that temporary workers have higher general health risks, and economic deprivation is the main mechanism. Therefore, Chinese policymakers should provide more inclusive preventive health services beyond the existing health care system focused on critical illness to reduce the general health risks of grassroots workers. [ABSTRACT FROM AUTHOR]

Household income predicts early adolescents' cognitive development. However, the mechanism underlying this association and protective factors are unclear. This study assessed one-year longitudinal data to examine whether perceived discrimination mediated the association between household income and executive function and the moderating role of shift-and-persist. 344 early adolescents in rural China were included in the study (mean = 10.88 years, SD = 1.32 years, girls: 51.74%). The latent variable model revealed that household income predicted early adolescents' cognitive flexibility and working memory in the subsequent year through perceived discrimination. Shift-and-persist moderated the negative effects of perceived discrimination on cognitive flexibility: perceived discrimination impeded cognitive flexibility only among early adolescents with low shift-and-persist. The findings highlight perceived discrimination in the relation between household income and early adolescents' executive function and underscore the protective role of shift-and-persist. [ABSTRACT FROM AUTHOR]

Little is known about the differences in feelings of poverty and social assistance receipt among the different genders of heads of Chinese Dibao families. This article makes a preliminary analysis of the feelings of Chinese female heads of Dibao families about living in poverty and depending on social assistance and compares them with those of male heads. It finds that there are gender differences in the experiences between the female and male heads of Dibao families in China. The article argues that social assistance policies should be constructed or correspondingly adjusted in a targeted manner to become gender-sensitive. [ABSTRACT FROM AUTHOR]

This article contributes to the growing body of research on social assistance (SA) dynamics by analyzing patterns of SA receipt in China, a middle-income country with a large informal employment sector. Using national low-income household survey data and event history analysis, this study explored the mechanisms underlying exit from Dibao (formally known as Minimum Living Security) and changes in exit probability over time. We found that in the context of an informal economy, the 'explicit' change of individual characteristics and employment structure decisively affects receipt duration on the micro and macroeconomic levels, respectively. On the policy level, affected by the informal employment structure, employment services tend to be of low quality and fail to promote Dibao exit effectively. Although the specific Dibao payment strategy, which is used to address the difficulty in means tests, largely curbs the risks of declining working motivation, it considerably increases the possibility of prolonged Dibao use. With this systemic influence of informal employment, a unique pattern of SA receipt characterized by the combination of long-term use and a nondecreasing hazard rate has developed in China. [ABSTRACT FROM AUTHOR]

Poverty impedes children's executive function (EF). Therefore, it is necessary to mitigate the negative effect of poverty by developing efficient interventions to improve poor children's cognitive function. In three studies, we examined whether high‐level construals can improve EF among poor children in China. In Study 1, we observed a positive relationship between family socioeconomic status and children's EF, which was moderated by construal level (n = 206; Mage = 9.71; 45.6% girls). In Study 2a, we experimentally induced high‐ versus low‐level construals and found that poor children with high‐level construals exhibited better EF than those with low‐level construals (n = 65; Mage = 11.32; 47.7% girls). However, the same intervention did not affect the performance of affluent children in Study 2b (n = 63; Mage = 10.54; 54% girls). Moreover, we found that the interventional effects of high‐level construals improved the ability of children living in poverty to make healthy decisions and delayed gratification in Study 3 (n = 74; Mage = 11.10; 45.9% girls). These findings may have implications for using high‐level construals as an effective intervention to improve poor children's EF and cognitive capacity. [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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Background: Although stigma and caregiving burden are important in relation to mental health recovery, few studies have been conducted on affiliate stigma and caregiving burden among family caregivers of persons with schizophrenia (FCPWS) in rural China. Aims: This study aimed to examine the severity level of affiliate stigma and caregiving burden, and identify the correlates among FCPWS in rural China. Methods: A mental health survey was conducted (N = 253 FCPWS) in Xinjin county, Sichuan province, China. Affiliate Self-Stigma Scale and Zarit Burden Interview Short Form were used. The regression analysis was performed to explore the correlates of stigma and burden. Results: Most FCPWS reported experiencing high and severe level of affiliate stigma (78.66%) and caregiving burden (95.26%). Family caregivers who were middle aged, unemployed, with high caregiving burden and low quality of life (QoL), showed more severe affiliate stigma. Family caregivers who were female, older, with low income, high affiliate stigma and low QoL, experienced greater caregiving burden. Conclusions: The large majority of FCPWS in rural China experienced severe affiliate stigma, caregiving burden and poor QoL. It is crucial to develop culture-specific anti-stigma interventions to reduce caregivers' stigma and caregiving burden, and improve QoL. Specific risk factors of family caregivers' affiliate stigma and caregiving burden should be considered for development of health policy and community-based mental health services. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to examine the mediating effect of perceived social support in the relationship between loneliness and social isolation among Chinese older adults relocated for poverty relief. Methods: We surveyed 128 older migrants from four resettlement areas in Guizhou Province, southwest China. A general information questionnaire, the Lubben Social Network Scale‐6, the Perceived Social Support Rating Scale, and the Single Item Loneliness Scale were used in our study. We also used the SPSS macro PROCESS to test a mediation model and the Bootstrap method to assess its significance. Results: The prevalence of social isolation among older relocators was 85.9%; the mediation model showed that loneliness had a direct negative effect on social isolation (B = −1.25, p < 0.01), and that perceived social support fully mediated this effect (−1.18), with a total effect of −1.25 (p < 0.01) and a mediating proportion of 94.4%. Conclusions: Older relocators in poverty alleviation areas experienced high levels of social isolation. Perceived social support might buffer the negative impact of loneliness on social isolation. We suggest that interventions should be designed to enhance perceived social support and reduce social isolation among this vulnerable population. [ABSTRACT FROM AUTHOR]

• There is a reasonable range for financial risk perception, and neither too high nor too low is reasonable. • Teenagers with different initial financial risk perceptions respond differently to the same intervention. • Teenagers in low-risk perception group show more pronounced changes after intervention than those in high-risk perception group. • Bayesian statistical analysis is used for small samples to enhance the confidence of the results. This study examined the effects of a single-group pretest–posttest intervention in changing the level of financial risk perceptions among teenagers from the perspective of the financial resilience framework. 37 teenagers completed the six-week nonrandomised intervention with follow-up tests at Weeks 8 and 22. Based on the pretest scores of the Internet Financial Risk Perception Scale, the participants were divided into high- and low-risk perception groups. Bayesian repeated variance analysis was then used to evaluate the influence of the intervention on financial risk perception. Compared with the baseline level, the low-risk perception group showed an increase in total financial risk perception and each subdimension. Decreased changes were observed in the long term, although no sufficient evidence was found for changes in the high-risk perception group after the intervention. The financial resilience-focused framework and its corresponding program neutralizes the perceived risk. Furthermore, similar interventions should consider the initial level of risk perception among participants. [ABSTRACT FROM AUTHOR]

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]

(1) Background: Low-income rural residents in China are disadvantaged due to their financial vulnerability and insufficient access to resources, and this situation demands more research effort. This study examined the pattern of outpatient service satisfaction and its determinants among low-income adults in rural China. (2) Methods: Rural low-income respondents who used outpatient services in their local healthcare facilities in Jiangsu, China evaluated the access, cost, environment, doctor–patient interaction, and other topics during their outpatient visit (N = 662). Latent class analysis was used to identify the groups characterized by various dimensions of outpatient satisfaction. Multinomial logistic regression explored the determinants of class membership. (3) Results: Three latent classes were identified: 28.70% had low satisfaction, unsatisfied with every dimension; 20.69% reported medium satisfaction that valued doctor–patient relationships; and 50.60% had high satisfaction but thought that costs were high. Both low and medium satisfaction were associated with a higher proportion of self-paid fees. (4) Conclusions: Healthcare costs were an important determinant of outpatient service satisfaction. Medical social workers are suggested to be included in the medical team to help patients identify financial assistance. Special aid programs may be developed to help relieve rural low-income patients' medical cost-related burden. [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]