Effects of early comprehensive interventions on child neurodevelopment in poor rural areas of China: a moderated mediation analysis

被引：10
作者：
Liu, S. [1 ]
Wang, Z. [1 ]
Zhao, C. [2 ]
Huang, X. [2 ]
Liang, X. [1 ]
Wang, X. [3 ]
Lu, S. [1 ]
Scherpbier, R. W. [2 ]
机构：
[1] Capital Normal Univ, Beijing Key Lab Learning & Cognit, Res Ctr Child Dev, Sch Psychol, Beijing, Peoples R China
[2] UNICEF China Off, Beijing, Peoples R China
[3] Peking Univ, Hlth Sci Ctr, Sch Publ Hlth, Dept Child Adolescent & Womens Hlth, Beijing, Peoples R China
来源：
PUBLIC HEALTH | 2018年 / 159卷
基金：
中国国家自然科学基金;
关键词：
Comprehensive interventions; Home environment; Child neurodevelopment; Poor rural areas; SOCIOECONOMIC-STATUS; DEVELOPING-COUNTRIES; HOME-ENVIRONMENT; STIMULATION; TEMPERAMENT; POVERTY; HEALTH; RISK; AGES; CARE;
D O I：
10.1016/j.puhe.2018.02.010
中图分类号：
R1 [预防医学、卫生学];
学科分类号：
1004 ; 120402 ;
摘要：
Objectives: To examine the effects of early comprehensive interventions on home environment and child neurodevelopment among children younger than 3 years in poor rural areas of China, as well as the underlying mediating and moderating mechanisms. Study design: Non-randomized intervention study was conducted among 216 children aged 0-3 years in Shanxi province of China. Based on a 2 x 2 factor design, children in Lin and Fenxi County were assigned to an intervention group with duration less than 1 year (n = 26) or an intervention group with duration longer than 1 year (n = 82), while children in Fangshan County served as a control group with duration less than 1 year (n = 30) or a control group with duration longer than 1 year (n = 78). Methods: The control group received national public health services (NPHS), while the intervention group received NPHS plus comprehensive interventions covering health, nutrition, early psychosocial stimulation, and child protection. Home environment (Infant-Toddler Home Observation for Measurement of the Environment [HOME]) and child neurodevelopment (Ages and Stages Questionnaire [ASQ]) were measured by observation and interview with mothers after the intervention program. Results: The intervention group showed significantly higher overall HOME, organization, learning materials, and involvement than the control group, only for a duration longer than 1 year. Children in the intervention group performed better in overall ASQ, fine motor, problem-solving, and personal-social than children in the control group. Moderated mediation analyses indicated that there were significantly indirect effects of treatment on overall ASQ through overall HOME, organization, and involvement only when the duration was longer than 1 year. Conclusions: Early comprehensive interventions longer than 1 year improve home environment and promote child neurodevelopment among children younger than 3 years in poor rural areas. What is more, effects of early comprehensive interventions longer than 1 year on child neurodevelopment were mediated by home environment. (c) 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码：116 / 122
页数：7
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