How prior spectacle prescriptions shape diagnostic behavior: evidence from a randomized field experiment on vision care in Western China.

Background: Diagnostic errors remain a pressing challenge in health systems with uneven provider capacity and limited diagnostic standardization. In such environments, cognitive biases, particularly anchoring effect, may compromise diagnostic independence and reinforce structural disparities in care quality.

Methods: We conducted a randomized field experiment in western China using standardized patients (SPs) to examine how prior spectacle diagnostic prescriptions influence the behavior and accuracy of second-opinion optometrists.

Gender differences in early childhood development in rural China: a sibling structure perspective.

Background: This study examines gender differences in early childhood cognitive development in rural China, focusing on the role of sibling structure. While gender disparities have narrowed in recent decades, concerns remain regarding unequal household resource allocation in low- and middle-income countries, particularly in contexts shaped by traditional son preference.

Methods: Data from 1,320 children aged 3 to 7 years across 11 nationally designated poverty counties in the Qinling Mountain region of western China were analyzed.

Facilitators and barriers to implementing a social franchising model of delivering eye care services in rural China: a qualitative study using the updated Consolidated Framework for Implementation Research.

Objectives: To identify the barriers and facilitators to implementing the social franchising model '' for delivering eye care services to children in rural China, using the updated Consolidated Framework for Implementation Research (CFIR 2.0) as a theoretical basis to evaluate implementation performance drivers and propose strategies for effective scaling and sustainability.

Design: This qualitative study involved semi-structured interviews with key stakeholders from both the supply side and demand side.

Examining the relationship between commuting time, academic achievement, and mental health in rural China: a cross-sectional analysis.

Background: Rearranging school layouts in rural areas has been one of the most important changes to basic education in China since the early 2000s. The layout adjustment has increased the service radius of rural primary schools and increased the distance for students to go to school. While numerous studies have revealed that reducing commuting time would improve positive emotions, limited attention has been given to examining the relationship between commuting time, academic performance, and mental health in China.

The association between unintended pregnancy and maternal mental health in rural China.

Background: Unintended pregnancies are common in rural China. However, the association between unintended pregnancy and maternal mental health remains poorly understood. This study aimed to assess the prevalence of unintended pregnancies, their association with mental health concerns, and the contributing factors in rural China.

Association between chronic diseases and depressive inclinations among rural middle-aged and older adults.

This study investigates the association between chronic diseases and depressive inclinations among middle-aged and older adults in rural Northwest China, emphasizing the moderating role of social relationships. Data collected via face-to-face surveys in a cross-sectional design conducted in March 2021, encompassing 395 participants aged 45 and above, were analyzed using Ordinary Least Squares (OLS) regression. The results indicate that, excluding metabolic diseases (such as dyslipidemia and diabetes), other chronic diseases significantly increase depressive inclinations, particularly eye diseases, chronic lung diseases, heart disease, rheumatoid arthritis, and gastrointestinal diseases.

Challenges in rural maternal health: how received public services and policy awareness affect health knowledge and practices.

Purpose: This study evaluates the effectiveness of rural maternal health services in improving pregnant women's health knowledge, practices, and outcomes in northwestern China, focusing on the roles of received public services and policy awareness.

Methods: Baseline surveys were conducted in rural Shaanxi Province in 2021 and 2023, involving 1,152 pregnant women from 85 townships, selected via multistage cluster random sampling. Data were collected through structured face-to-face interviews, covering health knowledge and behaviors.

Corrected Myopia and Its Association with Mental Health Problems Among Rural Primary School Students in Northwest China.

Purpose: The aim of this study was to evaluate the myopia correction and its association with mental health problems among rural primary school students in China.

Methods: Using survey data from 17,950 students in 251 rural primary schools, this study examines the association between corrected myopia and mental health problems, as well as academic performance among rural students in China. Vision exams were offered to sample students, and student mental health status was measured using the Mental Health Test (MHT).

Impact of peer interaction on maternal health service utilization in rural northwest China.

Background: Effective use of health services by pregnant and postpartum woman (PPWs) is crucial to maternal and child health. Most maternal deaths are attributed to inadequate maternal health services, especially in rural areas. As a vulnerable group, rural PPWs can effectively prevent and reduce maternal and infant health risk factors through whole-process health management and ensure the health and safety of mothers and infants.

Mothers' Gender-role Ideologies and Exclusive Breastfeeding in Western Rural China: A Cross-Sectional Study.

Background: Shifts in women's maternal roles may contribute to the global low prevalence of exclusive breastfeeding.

Research Aim: To investigate the association between maternal gender-role ideologies and exclusive breastfeeding in rural China.

Methods: Cross-sectional studies were conducted in 10 counties in Shaanxi Province using random sampling in 2021 and 2023.

Time's ticking! Effects of deadline on the utilization of health services: Evidence from a cluster-randomized controlled trial.

The low utilization of health services in rural areas is an essential factor affecting the health level of rural residents. Based on insights from behavioral economics, this study evaluates the average treatment effect of imposing a deadline on vision-care vouchers (i.e.

Enhancing vaccination uptake through community engagement: evidence from China.

With growing recognition of the importance of community engagement in addressing public health challenges, its role in promoting healthy behaviors and preventing infectious diseases has gained attention. However, vaccination coverage remains a significant concern in many developing countries. While previous studies have linked community engagement to positive health outcomes, there is a gap in understanding its influence on individual vaccination choices, particularly in the context of developing countries.

The impact of provider-patient communication skills on primary healthcare quality and patient satisfaction in rural China: insights from a standardized patient study.

Objectives: In middle-income countries, poor physician-patient communication remains a recognized barrier to enhancing healthcare quality and patient satisfaction. This study investigates the influence of provider-patient communication skills on healthcare quality and patient satisfaction in the rural primary healthcare setting in China.

Methods: Data were collected from 504 interactions across 348 rural primary healthcare facilities spanning 21 counties in three provinces.

Effect of no eyeglasses sales on the quality of eye care: an experimental evidence from China.

Background: Eye examinations and eyeglasses acquisition are typically integrated into a cohesive procedure in China. We conducted a randomized controlled trial using incognito standardized patient (SP) approach to evaluate the impact of separating eyeglasses sales on the accuracy of final prescription.

Methods: 52 SPs were trained to provide standardized responses during eye examinations, and undergoing refraction by a senior ophthalmologist at a national-level clinical center.

Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study.

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 examine the predictors of accepting free vision screening and cataract surgery.

Preschool or/and kindergarten? The long-term benefits of different types of early childhood education on pupils' skills.

Background: Developing countries have witnessed great progress in early childhood education (ECE) enrollment rate over the past three decades. Preschool and kindergarten are the two most common types of ECE in developing countries. Questions remain as to which of the two types of ECE is more effective in promoting child development in developing countries, including both cognitive and non-cognitive skills.

Beyond mothers: the crucial role of family caregivers' knowledge on exclusive breastfeeding in rural western China.

Background: The exclusive breastfeeding rate in China remains significantly low. Numerous studies have identified the impact of maternal characteristics on exclusive breastfeeding; however, the correlation between primary family caregivers' characteristics, such as health and nutrition knowledge, and exclusive breastfeeding still lacks clarity. The aim of this study is to investigate the association between the health and nutrition knowledge of primary family caregivers and exclusive breastfeeding in rural China.

Applying Rasch analysis in refinement and validation of interpersonal skills measure for gifted children.

Background: Interpersonal characteristics of gifted adolescents is important because of the potential influence on individuals' psychological health and future professional success. Understanding the interpersonal characteristics requires valid and reliable measures. This study attempted to explicitly describe the application of Rasch analysis in the validation and development process of an existing measure of interpersonal skills among gifted adolescent in Ohio.

Anaemia prevalence and risk factors among children aged 6 to 23 months in rural China.

Introduction: Anaemia is a global public health problem among children. However, few studies have examined anaemia prevalence and risk factors among Chinese children of different ages, particularly in poor rural areas. This study investigated these two aspects among children aged 6 to 23 months in poor rural areas of China.

Exploring the contribution of the river chief system on controlling industrial water pollution under quasi-natural experimental conditions.

The innovative environmental system known as the river chief system (RCS) was developed in China to limit water pollution by appointing provincial, prefectural, county, and township officials as "river chiefs" as guardians of every river under their control. Our research project developed a quasi-natural experiment to investigate if the RCS effectively reduces the intensity of industrial water pollution. A multi-period difference-in-difference (DID) method was employed in the experiment with a total of 3808 samples from 272 prefecture-level cities.

Unraveling controversies over civic honesty measurement: An extended field replication in China.

Cohn et al. (2019) conducted a wallet drop experiment in 40 countries to measure "civic honesty around the globe," which has received worldwide attention but also sparked controversies over using the email response rate as the sole metric of civic honesty. Relying on the lone measurement may overlook cultural differences in behaviors that demonstrate civic honesty.

Measuring the Relative Utility Loss of Legitimacy Deviation: A Discussion Based on the Public Goods Experiment.

In order to understand the differences in individual behavior across different contexts, this study introduces legitimate behavior and its deviation into a utility function. We hypothesize that people have preferences for adhering to the legitimate behavior that is required by the behavioral norm embedded in a particular context; furthermore, deviating from this legitimate behavior may generate a utility loss for them. We apply our model in the context of conditional contributions in a public goods experiment; moreover, we verify that the behavioral pattern of this conditional cooperation is derived from subjects' preferences for complying with the legitimate behavior required by the norm of the conditional cooperation activated in the experimental context.

Gender differences in vision health-seeking behavior and vision health outcomes among rural Chinese schoolchildren by birth order and family size.

Background: The gender gap remains a major impediment in the path toward equality, and it is especially wide in low-income countries. Gender differences in health-seeking behaviors may be a factor. Family size and childbirth order are two critical factors affecting family resource allocation.