Effect of a Conditional Cash Transfer Program on Nutritional Knowledge and Food Practices among Caregivers of 3–5-Year-Old Left-Behind Children in the Rural Hunan Province
Abstract
:1. Introduction
2. Methods
2.1. Trial Design
2.2. Participants
2.3. CCT Interventions
- Workshop 1—Introduction of basic public health services for LBC
- Workshop 2—Importance of health examination for LBC
- Workshop 3—Importance of nutrition and diet diversity for LBC’s health
- Workshop 4—Common nutrition problems for LBC (stunting)
- Workshop 5—Common nutrition problems for LBC (Iron Deficiency Anemia, DA)
- Workshop 6—Health evaluation and its importance for LBC
2.4. Outcome Measures
2.5. Sample Size
2.6. Randomization
2.7. Participant Recruitment
2.8. Ethical Approval
2.9. Statistical Analysis
3. Results
3.1. General Characteristics of Participants
3.2. Knowledge of Nutrition and Food Practices Related to Children among CLBC
3.3. The Effectiveness of the Intervention on Nutrition Knowledge and Food Practice Behaviors
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
CLBC | Caregivers of left-behind children |
LBC | Left-behind children |
CCT | Conditional cash transfer |
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Variables | Baseline, January–March 2015 (n = 518) | Endpoint, June–July 2016 (n = 447) | ||||
---|---|---|---|---|---|---|
Control (n = 263) | Intervention (n = 255) | p | Control (n = 218) | Intervention (n = 229) | p | |
Household Size | 6.7 ± 2.2 | 6.8 ± 2.0 | 0.643 | 6.7 ± 2.1 | 6.8 ± 2.0 | 0.824 |
Female Caregivers (n, %) | 165 (62.7%) | 178 (69.8%) | 0.095 | 143 (65.6%) | 166 (72.5%) | 0.125 |
Minorities (n, %) | 95 (36.1%) | 98 (38.4%) | 0.325 | 80 (36.7%) | 87 (38.0%) | 0.427 |
Age of Caregivers (years) | 54.3 ± 12.6 | 56.2 ± 12.0 | 0.075 | 55.9 ± 13.0 | 57.6 ± 12.4 | 0.172 |
Number of 3–5-year-old LBC being taken care of #: | ||||||
1 | 205 (78.5%) | 196 (77.5%) | 0.856 | 174 (79.8%) | 181 (79.0%) | 0.979 |
2 | 48 (18.4%) | 47 (18.6%) | 35 (16.1%) | 38 (16.6%) | ||
3 and above | 8 (3.1%) | 10 (4.0%) | 9 (4.1%) | 10 (4.4%) | ||
Education level of caregivers | ||||||
No education (n, %) | 81 (30.9%) | 74 (29.0%) | 0.324 | 67 (30.7%) | 73 (32.0%) | 0.803 |
Less than 3 years (n, %) | 47 (17.9%) | 61 (23.9%) | 43 (19.7%) | 46 (20.2%) | ||
3–6 years (n, %) | 74 (28.2%) | 68 (26.7%) | 64 (29.4%) | 57 (25.0%) | ||
Middle school level (n, %) | 52 (19.8%) | 40 (15.7%) | 37 (17.0%) | 41 (18.0%) | ||
High school level (n, %) | 8 (3.1%) | 12 (4.7%) | 7 (3.2%) | 11 (4.8%) | ||
Caregiver–LBC relationship | ||||||
Mother (n, %) | 29 (11.0%) | 23 (9.0%) | 0.560 | 23 (10.6%) | 21 (9.2%) | 0.636 |
Father (n, %) | 12 (4.6%) | 12 (4.7%) | 8 (3.7%) | 5 (2.2%) | ||
Grandparent (n, %) | 211 (80.2%) | 214 (83.9%) | 180 (82.6%) | 198 (86.5) | ||
Other (n, %) | 11 (4.2%) | 6 (2.4%) | 7 (3.2%) | 12 (2.7%) | ||
Caregiver career | ||||||
Unemployed | 16 (6.1%) | 14 (5.5%) | 0.376 | 14 (6.4%) | 10 (4.4%) | 0.487 |
Farmer | 239 (90.9%) | 227 (89.0%) | 199 (91.3%) | 211 (92.1%) | ||
Employed | 8 (3.0%) | 14 (5.5%) | 5 (2.3%) | 8 (3.5%) | ||
Caregiver marital status | ||||||
Married | 182(83.1%) | 198 (86.8%) | 0.615 | 178 (81.3%) | 194 (85.1%) | 0.514 |
Separated | 3 (1.4%) | 3 (1.3%) | 7 (3.2%) | 3 (1.3%) | ||
Divorced | 6 (2.7%) | 3 (1.3%) | 5 (2.3%) | 4 (1.8%) | ||
Widowed | 28 (12.8%) | 24 (10.5%) | 29 (13.2%) | 27 (11.8%) | ||
Socioeconomic status (tertiles) * | ||||||
Low | 83 (31.6%) | 89 (35.0%) | 0.418 | 66 (30.3%) | 80 (35.2%) | 0.158 |
Middle | 95 (36.1%) | 78 (30.7%) | 82 (37.6%) | 66 (29.1%) | ||
High | 85 (32.3%) | 87 (34.3%) | 70 (32.1%) | 81 (35.7%) | ||
Number of LBC in the family | 2.0 ± 1.0 | 2.1 ± 1.0 | 0.537 | 2.1 ± 1.1 | 2.2 ± 1.1 | 0.345 |
Knowledge Item | Correct Responses (%) | p | |
---|---|---|---|
Control Group (n = 218) | Intervention Group (n = 229) | ||
K1: It is important to know the child’s height and weight. | 144 (66.1%) | 196 (85.6%) | <0.001 |
K2: When child is not hungry this means he/she gets enough nutrients. | 37 (17.0%) | 42 (18.3%) | 0.712 |
K3: Skipping breakfast is not good for the child. | 61 (28.0%) | 81 (35.4%) | 0.104 |
K4: Eating a variety of food is good for the child. | 165 (75.7%) | 209(88.2%) | 0.001 |
K5: Eggs are a healthy food choice for the child. | 167 (76.6%) | 209 (91.3%) | <0.001 |
K6: Dairy products are a healthy food choice for the child. | 150 (68.8%) | 182 (79.5%) | 0.013 |
K7: Is able to recognize the symptoms of iron deficiency anemia (pale skin, weakness, dizziness, headache, etc.) | 49 (22.5%) | 75 (32.8%) | 0.02 |
K8: Is able to identify iron-rich food (can give examples, like liver, beef, pork, and fish, etc.). | 19 (8.7%) | 54 (23.6%) | <0.001 |
Variables | Control Group (n = 218) | Intervention Group (n = 229) | p |
---|---|---|---|
B1: Prepares breakfast for the family. | |||
Less than 2 times per week | 22 (10.0%) | 31 (13.6%) | 0.149 |
3–4 times per week | 18 (8.2%) | 10 (4.4%) | |
5–7 times per week | 179 (81.7%) | 187 (82.0%) | |
B2: Prepares a separate meal for child (meat, fish, etc.) | |||
Less than 2 times per week | 165 (75.3%) | 162 (71.1%) | 0.325 |
3–4 times per week | 25 (11.4%) | 24 (10.5%) | |
5–7 times per week | 29 (13.2%) | 42 (18.4%) | |
B3: Prepares two dishes or more for each meal. | |||
Less than 2 times per week | 79 (36.1%) | 64 (28.1%) | 0.129 |
3–4 times per week | 73 (33.3%) | 77 (33.8%) | |
5–7 times per week | 67 (30.6%) | 87 (38.2%) | |
B4: Provides eggs for the child. | |||
Less than 2 times per week | 146 (66.7%) | 129 (56.6%) | 0.040 |
3–4 times per week | 44 (20.1%) | 69 (30.3%) | |
5–7 times per week | 29 (13.2%) | 30 (13.2%) | |
B5: Provides dairy products for the child. | |||
Less than 2 times per week | 159 (72.6%) | 140 (61.4%) | 0.034 |
3–4 times per week | 35 (16.0%) | 56 (24.6%) | |
5–7 times per week | 25 (11.4%) | 32 (14.0%) |
Variables | Baseline | Endpoint | p-Value | p-Value Adjusted ϕ |
---|---|---|---|---|
Nutrition Knowledge Score | ||||
Intervention (n = 228) | 3.68 ± 1.43 | 4.47 ± 1.44 | 0.02 * | 0.007 ** |
Control (n = 219) | 3.72 ± 1.56 | 3.67 ± 1.73 | ||
Food Practice Score | ||||
Intervention (n = 228) | 8.65 ± 1.85 | 9.35 ± 1.80 | 0.057 | 0.031 * |
Control (n = 219) | 8.54 ± 1.80 | 8.89 ± 1.95 |
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Share and Cite
Zhang, Y.; Ji, M.; Zou, J.; Yuan, T.; Deng, J.; Yang, L.; Li, M.; Qin, H.; Chen, J.; Lin, Q. Effect of a Conditional Cash Transfer Program on Nutritional Knowledge and Food Practices among Caregivers of 3–5-Year-Old Left-Behind Children in the Rural Hunan Province. Int. J. Environ. Res. Public Health 2018, 15, 525. https://doi.org/10.3390/ijerph15030525
Zhang Y, Ji M, Zou J, Yuan T, Deng J, Yang L, Li M, Qin H, Chen J, Lin Q. Effect of a Conditional Cash Transfer Program on Nutritional Knowledge and Food Practices among Caregivers of 3–5-Year-Old Left-Behind Children in the Rural Hunan Province. International Journal of Environmental Research and Public Health. 2018; 15(3):525. https://doi.org/10.3390/ijerph15030525
Chicago/Turabian StyleZhang, Yefu, Meimei Ji, Jiaojiao Zou, Tong Yuan, Jing Deng, Lina Yang, Mingzhi Li, Hong Qin, Jihua Chen, and Qian Lin. 2018. "Effect of a Conditional Cash Transfer Program on Nutritional Knowledge and Food Practices among Caregivers of 3–5-Year-Old Left-Behind Children in the Rural Hunan Province" International Journal of Environmental Research and Public Health 15, no. 3: 525. https://doi.org/10.3390/ijerph15030525