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Objective: To explore the main factors on caregivers' compliance behaviors in nutrition packages feeding in poor rural areas of Southern Shaanxi Province based on PRECEDE theory in terms of the predisposing factors( related knowledge and intentions of themselves), the enabling factors( social conditions and skills of behavior fulfillment) and the reinforcing factors( attitude of the important people around and rewards for persistent behavior)., Methods: The target villages were selected using multistages random sampling method( county-township-village) in the poor counties of Southern Shaanxi Province. Then we investigated all of the main caregivers whose family have an infant aged 6-12 months in these sampling villages. A follow-up investigation was conducted 6 months after the nutrition packages were given. A structured questionnaire was applied to collect data, which including the information about the nutrition packages feeding behavior of the caregivers and the related factors to their behaviors based on the PRECEDE theory, and the social demographic information of infants and their caregivers. Information about the questionnaire by the face-to-face interview at their home was collected. At the same time, we counted empty nutrition packages by the method of onsite enumeration, and checked with the questionnaire to obtain the information of caregivers' feeding behavior. Single factor analysis and multivariate Logistic regression analysis was used to analyze the factors associated with caregivers 'compliance to feed their infants nutrition packages., Results: A total of 910 samples were interviewed, and the rate of caregivers' compliance to feed their infants nutrition packages was 64. 0%. The willing of caregivers to feed their infants nutrition packages( OR = 1. 582, 95% CI1. 117-2. 242) was a favorable predisposing factor to promote caregivers feed their infants nutrition packages. The preference of infants to nutrition packages( OR = 5. 116, 95% CI4. 064-6. 441), villages' encouragement( OR = 1. 527, 95% CI 1. 094-2. 132) as well as infants' changes in health status( OR = 1. 615, 95% CI 1. 231-2. 118) were positive reinforcing factors of feeding nutrition packages compliance of caregivers., Conclusion: The compliance of caregivers feed nutrition packages to their infants is low. The reinforcing factors are the key factors that affected the feeding behavior of caregivers' nutrition packages.

Objectives: To test whether text message reminders sent to caregivers improve the effectiveness of a home micronutrient fortification program in western China., Methods: We carried out a cluster-randomized controlled trial in 351 villages (clusters) in Shaanxi Province in 2013 and 2014, enrolling children aged 6 to 12 months. We randomly assigned each village to 1 of 3 groups: free delivery group, text messaging group, or control group. We collected information on compliance with treatments and hemoglobin concentrations from all children at baseline and 6-month follow-up. We estimated the intent-to-treat effects on compliance and child anemia using a logistic regression model., Results: There were 1393 eligible children. We found that assignment to the text messaging group led to an increase in full compliance (marginal effect = 0.10; 95% confidence interval [CI] = 0.03, 0.16) compared with the free delivery group and decrease in the rate of anemia at end line relative to the control group (marginal effect = -0.07; 95% CI = -0.12, -0.01), but not relative to the free delivery group (marginal effect = -0.03; 95% CI = -0.09, 0.03)., Conclusions: Text messages improved compliance of caregivers to a home fortification program and children's nutrition.

Background and Objectives: Development during the first two years of life is critical and has a lasting impact on a child's health. Poor infant and child nutrition can lead to deficiencies in essential micronutrients, which may cause a weakened immune system and lasting effects on children's growth and development. Recent studies in rural Shaanxi Province found an anemia prevalence of 54.3% among rural children aged six to twelve months. While new large-scale, quantitative research has begun to catalogue the extent of child malnutrition and anemia, no effort has yet been made to look more closely at the potential reasons for rural children's nutritional deficiencies through qualitative analysis. This study aims to elucidate some of the fundamental causes of poor complementary feeding practices that may lead to anemia among children in rural Shaanxi Province, China., Methodology: We interviewed sixty caregivers participating in a large survey on child health and nutrition. We conducted three waves of interviews with children's primary caregivers in seventeen rural villages within four nationally-designated poverty counties in the southern part of Shaanxi Province., Results: The qualitative analysis reveals that poor complementary feeding practices are common across our sample. Information gathered from our interviews suggests that complementary feeding practices are impeded by two constraints: absence of understanding topics related to infant health and nutrition under caregivers, as well as inadequate sources of information on these topics. Poverty does not appear to constrain child feeding practices., Conclusion: Our results uncover lack of proper knowledge on infant and child nutrition among rural caregivers in China. This situation causes them to fail incorporating micronutrient rich foods in their children's diet. Age-appropriate complementary feeding can stimulate children's physical and cognitive development, but in its absence it leads to iron-deficiency anemia. We suggest that steps be taken to educate caregivers to improve complementary feeding of their infants and children.

This study aims to investigate the developmental status of rural Chinese children, the extent of interactive parenting they receive, and the relation between the two. A sample of 448 six to eighteen-month-old children and their caregivers were randomly selected from two rural counties in Hebei and Yunnan provinces. According the third edition of the Bayley Scales of Infant and Toddler Development, 48.7% of sample children exhibited cognitive delays, 40.6% language delays, and 35% social-emotional delays. According to responses from caregivers, parenting in rural China is largely passive, lacking in interactive practices like storytelling, singing, and playing. Children-with-siblings, left-behind children, and children with less-educated mothers were even less likely to receive interactive practices. Children of caregivers who did engage in best parenting practices showed better cognitive, language, and social-emotional development; however, the public health system provides no platform for learning about optimal parenting. [ABSTRACT FROM AUTHOR]

The overall goal of this study is to examine whether infant feeding practices differ between mothers and grandmothers in rural China. We randomly sampled 1383 caregivers of infants aged 18 to 30 months living in 351 villages across 174 townships in nationally designated poverty counties in rural areas. Results show that a high fraction of caregivers of 18- to 30-month-old children living in low-income areas of rural China do not regularly engage in positive infant feeding practices. Only 30% of children in our sample achieved adequate dietary diversity. Only 49% of children in our sample were fed meat in the day prior to survey administration. Few caregivers reported giving any vitamin supplements (such as calcium or iron supplements) to their children. We find that 33% of the children were cared for by grandmothers rather than mothers, and that grandmothers feed a less diversified diet to children than do mothers. Most (84%) caregivers rely solely on their own experiences, friends, and family members in shaping their feeding behaviors. Overall infant feeding practices are poor in rural China. Grandmothers engage in poorer feeding practices than do mothers. Grandmothers have improved their feeding practices compared to when their own children were young. Our results suggest shortcomings in the quality of infant feeding practices, at least in part due to an absence of reliable information sources. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of daily text messages as a means to improve caregivers’ adherence to infant micronutrient powder (MNP) in rural Shaanxi Province of China. Methodology: 638 infants aged 6–11 months in 234 villages were involved in a cluster-randomized controlled trial (RCT). All caregivers were given free infant MNP packets at baseline in April 2013 and the follow-up survey was in July 2013. We randomly assigned 318 infants in 117 villages to treatment group (receiving daily text message) and 320 infants in the other 117 villages as control group. Results: On average, daily text messages increased the number of MNP packets fed (marginal effect = 4.63; 95% confidence interval (CI) = 0.16, 9.10). The text message is more likely to increase the consumption of MNP packets if the primary caregiver was the mother (marginal effect = 12.19; 95% CI = 0.69, 23.68). Receiving the text message appears to significantly increase the likelihood of full adherence when the primary caregiver can either check (odds ratio = 2.93; 95% CI = 1.34, 6.40) or knows how to send (odds ratio = 3.26; 95% CI = 1.53, 6.97) text messages. Conclusion: Daily text messages improved the consumption of infant MNP packets. However, the impact was not large enough to increase the probability of caregivers being fully adherent to the feeding instruction, which is to feed 5–7 packets per week as recommended. In addition, when the mother is the caregiver and when the caregiver can check or knows how to send text messages there is greater adherence by the primary caregivers. Trial registration: [ABSTRACT FROM AUTHOR]