The effectiveness of a WeChat-based self-assessment with a tailored feedback report on improving complementary feeding and movement behaviour of children aged 6–20 months in rural China: a cluster randomized controlled trial

Wu, Qiong; Wang, Xiaotong; Zhang, Jian; Zhang, Yanfeng; Velthoven, Michelle Helena van

doi:10.1016/j.lanwpc.2023.100796

Cited by 6 publications

(8 citation statements)

References 31 publications

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“…We calculated our sample size based on our previous study [ 22 ], expecting the proportion of children who meet recommended physical activity time during the last 24 hours at 23.0% and a desired level of absolute precision of 2.5%. With a 5% significance and 80% power, we estimated that we required 2273 participants; considering a 30% response loss, we proposed recruiting 3247 primary caregivers of children under two years old.…”

Section: Methodsmentioning

confidence: 99%

“…We developed our survey instrument based on the WHO guidelines on physical activity, sedentary behaviour, and sleep for children under five years of age to measure children’s movement behaviour practices and caregivers’ movement behaviour knowledge, which consisted of physical activity time (PAT), outdoor time (OT), physical restraint (PR), sleep duration (SD), and screen time (ST) of children during the last 24 hours and the last two weeks. We have used the survey instrument in our previous study [ 22 ]. Furthermore, we collected information on how many times children attended ECE classes per week during the last month, the duration for each class, and caregivers’ nurturing care time spent on children every day during the last week.…”

Section: Methodsmentioning

confidence: 99%

“…In China, surveys on movement behaviours are mainly conducted among preschool children and teenagers [ 19 - 21 ], and there is limited data on movement behaviour practices for infants and young children. Data from our previous study indicated that the current status of healthy movement behaviours among children aged six to 20 months was suboptimal [ 22 ]. However, the survey was only carried out in a single county in Qinghai Province, and there is no representative national data on movement behaviours for children under two years old in urban and rural China, highlighting a need for more comprehensive data collection.…”

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confidence: 99%

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Suboptimal movement behaviours among children under two years old in early childhood education institutions in urban China: A cross-sectional study

Wang,

Huang,

Meng

et al. 2023

J Glob Health

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Background Healthy movement behaviours in early life promote better physical health and facilitate psychological development. Early childhood education (ECE) institutions provide opportunities for caregivers to improve children’s movement behaviour practices, but little is known about the current status of movement behaviours among infants and young children in urban China in this context. We aimed to investigate the movement behaviour status of children under two years of age via ECE institutions and compare movement behaviour practices and knowledge between children attending ECE classes and those not attending. Methods We conducted the cross-sectional survey from 1 March to 30 April 2023 in Gymboree Play&Music, an ECE institution covering 31 provinces in China. We developed our survey instrument based on World Health Organization (WHO) guidelines to measure children’s movement behaviour practices and caregivers’ movement behaviour knowledge. We carried out the online questionnaire survey through Sojump, the largest professional online survey platform in China. We sent a quick response (QR) code to Gymboree Play&Music centres; the QR code was linked to a questionnaire intended for caregiver members and non-members coming for experience classes and activities. Results We surveyed 3355 primary caregivers, encompassing 504, 536, and 2315 children aged 0-5 months, 6-11 months, and 12-23 months, respectively. Overall, less than half of the children met recommendations in physical activity time (PAT) (19.2%), physical restraint (PR) (45.8%), and screen time (ST) (46.4%) during the last 24 hours. PAT, outdoor time (OT), and sleep duration (SD) in children aged 0-5 months were significantly lower than in the other two age groups, while ST was significantly higher than in the other two age groups during the last 24 hours (all P < 0.001). For children attending ECE classes, PAT, OT, and SD were significantly higher than those not attending ECE during the last 24 hours and the last two weeks (all P < 0.05). All indicators in the long-nursing care time (NCT) group were significantly higher than those in the short-NCT group, while there was no statistical difference in SD between the two groups (66.6% vs 65.6%; P = 0.558). Conclusions The status of movement behaviours for children under two years old in urban China is not optimistic, especially for PAT, PR, and ST. Additionally, attending early childhood education classes and primary caregivers’ daily nurturing care time are important for infants and young children to adhere to movement guidelines. Consequently, more ECE institution-specific practical strategies and educational materials are needed to promote compliance with movement behaviour guidelines.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Suboptimal movement behaviours among children under two years old in early childhood education institutions in urban China: A cross-sectional study

Wang,

Huang,

Meng

et al. 2023

J Glob Health

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“…the frequency of seven groups of complementary food during the last month and caregivers' feeding knowledge and information sources. We translated and adapted the standard survey instruments to make it appropriate for the Chinese context and we have been using the questionnaires in our previous studies during the past decade [21][22][23][24][25].…”

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confidence: 99%

Complementary feeding practices for children aged 6–23 months in early childhood education institutions in urban China: A cross-sectional study

Wu,

Meng,

Wang

et al. 2024

J Glob Health

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Background Appropriate infant and young child feeding (IYCF) plays a crucial role in promoting the healthy growth of children. Currently, many Chinese urban parents are seeking care of children from the early childhood education (ECE) institutions, however, little is known about the feeding practices of infants and young children in ECE institutions. This study aims to investigate the complementary feeding practices for Chinese urban children aged 6-23 months in ECE institutions and explore potential factors influencing their feeding practices.Methods This cross-sectional study was conducted among primary caregivers of children aged 6-23 months in ECE institutions across 31 provinces in China from 1 March to 30 April 2023. Convenience sampling was used to recruit caregivers from centres of Gymboree Play & Music (an ECE institution). Self-administered questionnaires were designed using the online survey tool Sojump and distributed through WeChat platform, which collected information on 1) children's complementary feeding practices; 2) food frequency of seven food groups; 3) caregivers' feeding knowledge and practices; 4) frequency of children attended ECE classes and the primary caregivers' daily nurturing care time; 5) source of information on complementary feeding. ResultsA total of 2731 children and their caregivers were surveyed, with 416 children aged 6-11 months and 2315 children aged 12-23 months. The prevalence of minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) was 59.4, 60.6, and 39.2%, respectively. Only 17.3% caregivers believed that continued breastfeeding should be at two years or above, and 29.5% children were continuously breastfed at 12-23 months (CBF). The proportion of non-responsive feeding practices among caregivers ranged from 28 to 64%. Except for CBF, the prevalence of other key complementary feeding practices was higher among children who attending ECE classes than those not attending ECE classes (all P < 0.05). Moreover, children aged 12-23 months who received long-nursing care time (≥4h/d) had significantly higher MMF and MAD prevalence than those in short-nursing care time group (MMF = 66.2 vs. 58.8%, P = 0.0003; MAD = 44.2 vs. 38.3%, P = 0.0047). ConclusionsThe complementary feeding practices of children aged 6-23 months in ECE institutions in urban China remained suboptimal, and non-responsive feeding practices among caregivers were common. The attendance of ECE classes and the caregivers' daily nurturing care time could be beneficial in ensuring children to comply with complementary feeding recommendations.

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“…Early childhood represents a critical period for optimal growth and development [ 1 ], with the promotion of healthy feeding practices and movement behaviours playing a crucial role in optimising the nutritional status and motor development of infants and young children, ultimately influencing their long-term health outcomes [ 2 ]. In 2002, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) jointly issued the Global Strategy on Infant and Young Child Feeding to advocate for best feeding practices.…”

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confidence: 99%

Leveraging nursery and early childhood education institutions for improving feeding and movement behaviours of infants and young children in China

Huang,

Li,

Zhao

et al. 2024

J Glob Health

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The effectiveness of a WeChat-based self-assessment with a tailored feedback report on improving complementary feeding and movement behaviour of children aged 6–20 months in rural China: a cluster randomized controlled trial

Cited by 6 publications

References 31 publications

Suboptimal movement behaviours among children under two years old in early childhood education institutions in urban China: A cross-sectional study

Suboptimal movement behaviours among children under two years old in early childhood education institutions in urban China: A cross-sectional study

Complementary feeding practices for children aged 6–23 months in early childhood education institutions in urban China: A cross-sectional study

Leveraging nursery and early childhood education institutions for improving feeding and movement behaviours of infants and young children in China

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