Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China.

Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PWHD), and its association with the first experience with care and individual factors in rural Southwestern China. This cross-sectional study was carried out in Yunnan province in 2018 and recruited 292 PWHD and 122 village clinics from 122 villages in 10 counties.

What Can Children Learn from a Free Trial of Eyeglasses Use? Evidence from a Cluster‑Randomized Controlled Trial in Rural China.

Free trial is a widely used business strategy that takes advantage of information asymmetry. However, evidence on what we can learn and how rapidly we can learn from a free trial of health care is limited. This study evaluates the effect of a free trial of eyeglasses on children's 8 items of perception related to eyeglasses use.

Does Performing the Chinese Eye Exercises Help Protect Children's Vision? - New Evidence from Primary Schools in Rural Northwestern China.

Background: The high prevalence of myopia among school-age children in China has raised serious concerns about protecting Chinese students' vision. While the regular performance of the Chinese eye exercises has been adopted as a preventive approach in China since the mid-1960s, these exercises' effectiveness at protecting students' vision has remained largely unknown. This study attempts to provide new evidence of the impact of regularly performing the exercises on Chinese students' visual outcomes, based on a large-scale dataset.

The Effect of Boarding on the Mental Health of Primary School Students in Western Rural China.

Based on the panel data of 20,594 fourth- and fifth-grade students in the western provinces A and B in China, this paper analyzed the effect of boarding at school on the mental health of students using a combination of the propensity score matching (PSM) and difference-in-differences (DID) methods. The results showed that boarding had no significant effect on the mental health of students, but the tendency of loneliness among boarding school students was increased. Heterogeneity analysis found that fifth-grade students whose parents had both left home to work were more likely to have poorer mental health when boarding.

Self-Conscious or Fear of Hurting Another's Feeling? An Experimental Investigation on Promise-Keeping.

We conducted an experimental investigation into whether the effect of non-binding verbal promises in enhancing cooperation among promisors is derived from the internalized norm mechanism or the expectation-based mechanism. We proposed a new experimental design based on the standard trust game to separate the two possible influence mechanisms of promises and assess the empirical support for these two mechanisms for the effect of promises. We also identified individuals' cooperation preferences to further investigate whether the effect of promises and its underlying mechanism differ between individuals with different preferences.

Reliability and validity of the Caregiver Reported Early Development Instruments (CREDI) in impoverished regions of China.

Background: There is a great need in low- and middle- income countries for sound qualitative and monitoring tools assessing early childhood development outcomes. Although there are many instruments to measure the developmental status of infants and toddlers, their use in large scale studies is still limited because of high costs in both time and money. The Caregiver Reported Early Development Instruments (CREDI), however, were designed to serve as a population-level measure of early childhood development for children from birth to age three, and have been used in 17 low- and middle-income countries.

Analysing the preferences for family doctor contract services in rural China: a study using a discrete choice experiment.

Background: Preliminary evaluations have found that family doctor contract services (FDCSs) have significantly controlled medical expenses, better managed chronic diseases, and increased patient satisfaction and service compliance. In 2016, China proposed the establishment of a family doctor system to carry out contract services, but studies have found the uptake and utilization of these services to be limited. This study aimed to investigate rural residents' preferences for FDCSs from the perspective of the Chinese public.

Communication skills of providers at primary healthcare facilities in rural China.

Introduction: Effective provider-patient communication has been confirmed to improve diagnosis, treatment planning, health outcomes, patient satisfaction, and treatment compliance. Few studies have measured the effectiveness of communication between patients and rural providers in China. To fill this gap in the literature, the present study describes the communication skills of providers at primary healthcare facilities in rural China and investigates the provider- and facility-level factors underlying these communication skills.

Conditional cash transfers, uptake of maternal and child health services, and health outcomes in western rural China.

Background: Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that this low uptake may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that a conditional cash transfer (CCT) has on the uptake of MCH services and, ultimately, on child health outcomes.

Using incognito standardised patients to evaluate quality of eye care in China.

Background/aims: Few studies have objectively examined the quality of eye care in China. We assessed refractive care using the incognito standardised patient (SP) approach, a gold standard for evaluating clinical practice.

Methods: A total of 52 SPs were trained to provide standardised responses during eye examinations, and underwent automated and non-cycloplegic, subjective refraction by a senior ophthalmologist from Zhongshan Ophthalmologic Center, a national-level clinical and research centre.

Parental Migration and Early Childhood Development in Rural China.

Nearly one-quarter of all children under age 2 in China are left behind in the countryside as parents migrate to urban areas for work. We use a four-wave longitudinal survey following young children from 6 to 30 months of age to provide first evidence on the effects of parental migration on development, health, and nutritional outcomes in the critical first stages of life. We find that maternal migration has a negative effect on cognitive development: migration before children reach 12 months of age reduces cognitive development by 0.

Visual impairment and spectacles ownership among upper secondary school students in northwestern China.

Purpose: To assess the prevalence of visual impairment and spectacles ownership among academic and vocational upper secondary school students in rural China.

Methods: This cross-sectional study included 5583 students from four academic upper secondary schools (AUSSs) and two vocational upper secondary schools (VUSSs) in Mei and Qianyang counties, Baoji Prefecture, Shaanxi Province. In March and April 2016, students underwent assessment of visual acuity (VA) and completed a questionnaire regarding spectacles use and family characteristics.

Using standardised patients to assess the quality of medical records: an application and evidence from rural China.

Background: Medical records play a fundamental role in healthcare delivery, quality assessment and improvement. However, there is little objective evidence on the quality of medical records in low and middle-income countries.

Objective: To provide an unbiased assessment of the quality of medical records for outpatient visits to rural facilities in China.

[Association between the introducing time of complementary food and growth of infants and young children in poor rural areas in Shaanxi Province].

Objective: To study the introducing time of complementary food in poor rural areas and its association with the growth of infants and young children.

Methods: In total of 1802 infants and young children aged 6-12 months from 11 poverty counties in southern Shaanxi Province were selected by stratified random cluster sampling. These infants were surveyed four times, and once every 6 months.

Concurrent validity of the Ages and Stages Questionnaire and the Bayley Scales of Infant Development III in China.

Choosing a valid and feasible method to measure child developmental outcomes is key to addressing developmental delays, which have been shown to be associated with high levels of unemployment, participation in crime, and teen pregnancies. However, measuring early childhood development (ECD) with multi-dimensional diagnostic tests such as the Bayley Scales of Infant and Toddler Development III (Bayley-III) can be time-consuming and expensive; therefore, parental screening tools such as the Ages and Stages Questionnaire (ASQ-3) are frequently an alternative measure of early childhood development in large-scale research. The ASQ is also becoming more frequently used as the first step to identify children at risk for developmental delays before conducting a diagnostic test to confirm.

Stimulation and Early Child Development in China: Caregiving at Arm's Length.

Objective: To provide an empirical overview of the parenting landscape in rural China, focusing on 18- to 30-month-old children and their caregivers in rural Shaanxi province.

Methods: We collected unique data on 1442 caregiver-toddler dyads in rural areas of Shaanxi province and examined caregiver attitudes toward parenting, sources of information about parenting, and interactive parenting practices, and how each of these differed across generations. We measured how parenting attitudes and sources of information informed parenting practices.

Breastfeeding and the Risk of Illness among Young Children in Rural China.

Poor rural areas in China exhibit the country's highest rates of child mortality, often stemming from preventable health conditions such as diarrhea and respiratory infection. In this study, we investigate the association between breastfeeding and disease among children aged 6⁻24 months in poor rural counties in China. To do this, we conducted a longitudinal, quantitative analysis of socioeconomic demographics, health outcomes, and breastfeeding practices for 1802 child⁻caregiver dyads across 11 nationally designated poverty counties in southern Shaanxi Province in 2013⁻2014.

Caregiver Depression and Early Child Development: A Mixed-Methods Study From Rural China.

Half of rural toddlers aged 0-3 years in China's Qinling Mountainous region are cognitively delayed. While recent studies have linked poor child development measures to the absence of positive parenting behaviors, much less is known about the role that caregiver depression might play in shaping child development. In this paper, a mixed methods analysis is used to explore the prevalence of depression; measure the association between caregiver depression and children's developmental delays, correlates of depression, and the potential reasons for caregiver depression among women in rural China.

The Effect of Providing Free Eyeglasses on Children's Mental Health Outcomes in China: A Cluster-Randomized Controlled Trial.

If children with common vision problems receive and use eyeglasses, their educational performance rises. Without proper treatment, visually impaired children may not achieve educational gains and could suffer from poor mental health. We use a randomized controlled trial to study the impact of an eyeglasses promotion program in rural China on the mental health of myopic primary school students.

Impact of a Local Vision Care Center on Glasses Ownership and Wearing Behavior in Northwestern Rural China: A Cluster-Randomized Controlled Trial.

Visual impairment is common among rural Chinese children, but fewer than a quarter of children who need glasses actually own and use them. To study the effect of rural county hospital vision centers (VC) on self-reported glasses ownership and wearing behavior (primary outcome) among rural children in China, we conducted a cluster-randomized controlled trial at a VC in the government hospital of Qinan County, a nationally-designated poor county. All rural primary schools ( = 164) in the county were invited to participate.

The cost-effectiveness of alternative vision screening models among preschool children in rural China.

Purpose: To explore the accuracy and cost-effectiveness of three vision screening models among preschool children in rural China.

Methods: Vision screening was carried out among children aged 4-5 years in 65 preschools in two counties in Northwest China, using Crowded Single Lea Symbols to test visual acuity. Children were assigned randomly by school to one of three screening models: screening by teachers (15 schools, 1835 children), local optometrists (30 schools, 1718 children) or volunteers (20 schools, 2183 children).

Diagnostic ability and inappropriate antibiotic prescriptions: a quasi-experimental study of primary care providers in rural China.

Background: China has one of the highest rates of antibiotic resistance. Existing studies document high rates of antibiotic prescription by primary care providers but there is little direct evidence on clinically inappropriate use of antibiotics or the drivers of antibiotic prescription.

Methods: To assess clinically inappropriate antibiotic prescriptions among rural primary care providers, we employed unannounced standardized patients (SPs) who presented three fixed disease cases, none of which indicated antibiotics.

Anxiety in Rural Chinese Children and Adolescents: Comparisons across Provinces and among Subgroups.

China's competitive education system has produced notably high learning outcomes, but they may be costly. One potential cost is high levels of anxiety. China has launched several initiatives aimed at improving student mental health.

The Quality of Tuberculosis Care in Urban Migrant Clinics in China.

Large and increasing numbers of rural-to-urban migrants provided new challenges for tuberculosis control in large cities in China and increased the need for high quality tuberculosis care delivered by clinics in urban migrant communities. Based on a household survey in migrant communities, we selected and separated clinics into those that mainly serve migrants and those that mainly serve local residents. Using standardized patients, this study provided an objective comparison of the quality of tuberculosis care delivered by both types of clinics and examined factors related to quality care.