Communities In Wuhan Research Articles

Toward Four Basic Systems of Trauma-Informed Practice for COVID-19-Affected Communities in China: Framework Analysis from Social Workers’ Perspectives

Although its theoretical and methodological applications have been discussed since the 1970s, the theoretical framework of the four basic systems of practice has not been widely used to analyze or explain critical real-world social work practice problems. This qualitative study adopted and advanced the four basic systems of practice framework to analyze the current status and future directions of trauma-informed social work service among COVID-19-affected communities in Wuhan, China. Fourteen frontline social workers who directly served COVID-19 survivors were recruited and completed semi-structured interviews. The analysis revealed that COVID-19 survivors experienced physical and psychological posttraumatic stress from their infection and, after recovery, trauma from discrimination in their communities and on the job market. Interviewed social workers reported a lack of power and skills to provide efficient and adequate services. The roles of the acting parties in the action systems were also identified. Building on these findings, this article proposes several key objectives in the target systems that could contribute to the develop future trauma-informed systems of social service practice.

Spatial Differences in the Effect of Communities' Built Environment on Residents' Health: A Case Study in Wuhan, China.

After 40 years of reform and opening-up policies, urbanization in China has significantly improved residents’ living standards; however, simultaneously, it has caused a series of health problems among Chinese citizens. Communities’ built environment is closely related to their residents’ health. However, few studies have examined the spatial differences in the health effects of community-built environments. Based on a 2013 health survey of residents in 20 communities in Wuhan, this study uses multilevel linear models to explore the effects of the built environment on residents’ health, analyzing the differences in its health-effect within different types of communities. The results showed that there were significant differences in the self-rated health status of residents in different communities, with those in high-end communities reporting a higher self-rated health status. The effect of the built environment on the health of residents in different communities was found to be inconsistent. For instance, the effect of the built environment on low-end community residents was very significant, but it was not obvious for residents in high-end communities. There are significant community-specific differences in the health- effect of the built environment: in high-end communities, residents’ health status was mainly restricted by travel accessibility, while in low-end communities, residents’ health status was mainly restricted by the accessibility of health facilities. Therefore, this paper proposes a built-environment optimization strategy for different types of communities to provide valuable insights for healthy community planning from a policy perspective.

Conception of strategic cooperation between universities and community elderly service centers

At present, about 90% of the elderly in the country choose to live at home. For various reasons, many elderly people feel lonely, even with children around. Using the methods of questionnaire survey and indepth interviews, this paper visited the elderly service centers in 15 communities in Wuhan, and conducted a questionnaire survey on 412 elderly people over 60 years old. The results showed that 54% of the elderly often go to community elderly service centers to participate in activities, but 30% of the elderly never go; the elderly who go to the community have the highest satisfaction with community entertainment activities such as mahjong room and square dance, 50%are satisfied; elderly people with higher education level are less likely to participate in community activities; the elderly generally lack spiritual comfort; 37% of them want to use their expertise to contribute to the community but do not know how to start. To this end, this paper proposes to take advantage of Wuhan’s 83 colleges and universities to seek strategic cooperation between universities and neighboring communities, so that relatively young healthy elderly people aged 60-75 can have lifelong learning opportunities and continue their spiritual growth. At the same time, it promotes the effective combination of theoretical knowledge and social practice of teachers and students in universities. This move will enhance the social participation and well-being of the elderly and promote the construction of an elderlyfriendly society.

Determinants of Intention to Participate in Breast Cancer Screening among Urban Chinese Women: An Application of the Protection Motivation Theory.

Despite the significance of early detection of breast cancer through screening, the screening uptake in China remains relatively low. Protection motivation theory (PMT) suggested by Rogers is one of the theories concerning threat appeal. This study aimed to apply the protection motivation theory (PMT) in predicting breast cancer screening intention. In this cross-sectional study, a sample of Chinese urban women was recruited using the convenient sampling method from five communities in Wuhan. Data were collected using a self-report questionnaire that included demographic variables, knowledge about breast cancer, six PMT subconstructs, and screening intention. We used the structural equation modeling (SEM) to identify the predictor factors associated with screening intention. Of the total sample (n = 412), 86.65% had intention to participate in screening. Our data fit the hypothesized SEM model well (Goodness of fit index (GFI) = 0.91, adjusted GFI (AGFI) = 0.89, comparative fit index (CFI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, standardized root mean residual (SRMR) = 0.06, and Chi-square/df = 2.01). Three PMT subconstructs (perceived severity, response cost, and self-efficacy) were significantly associated with screening intention. Knowledge, social status, and medical history had significantly indirect associations with screening intention through the mediating effect of PMT subconstructs. Considering the utility of PMT, intervention programs might be more effective based on the subconstructs of PMT, especially to improve self-efficacy, perceived severity, and knowledge, reduce response cost, as well as targeting specific demographic groups.

The six dimensions of built environment on urban vitality: Fusion evidence from multi-source data

Long-standing attention has been given to urban vitality and its association with the built environment (BE). However, the multiplicity and complex impacts of BE factors that shape urban vitality patterns have not been fully explored. For this purpose, multisource data from 1025 communities in Wuhan, China, were combined to explore the BE vitality nexus. A deep learning method was explored to segment street-view images, on which a composite indicator of urban vitality was developed with social media data. Then, six dimensions of BE factors, neighbourhood attributes, urban form and function, landscape, location, and street configuration, were incorporated into a spatial regression model to systematically examine the composite influences. The results show that population density, community age, open space, the sidewalk ratio, streetlights, shopping and leisure density, integration, and proximity to transportation are positive factors that induce urban vitality, whereas the effects of road density, proximity to parks, and green space have the opposite results. This study contributes to an improved understanding of the BE nexus. Managerial implications for mediating the relationship between planning policies and urban design strategies for the optimization of resource allocation and promotion of sustainable development are discussed.

Relationship between Family Function, Anxiety, and Quality of Life for Older Adults with Hypertension in Low-Income Communities.

Background Effective functional family was beneficial for older adults' health, which may affect the quality of life (QoL) in hypertension patients. This study aimed to clarify the association between family function, anxiety, and QoL for older adults with hypertension in low-income communities. Methods A questionnaire survey was conducted on 363 older adults with hypertension in low-income communities in Wuhan from September 2019 to November 2019. The relationships among the variables were examined by Pearson's correlation analysis. Predictor effects were tested using hierarchical multiple regressions, controlling for demographic characteristics. The structural equation model (SEM) was used to test the mediation effects of anxiety on the pathway from family function to QoL. Results Family function was negatively correlated with the self-rating anxiety scale (SAS) score and positively correlated with the mental component score (MCS), but had no influence on the physical component score (PCS). Both PCS and MCS were negatively correlated with SAS. Anxiety was the negative predictor of MCS and PCS. Family function was the positive predictor of MCS, but had no influence on PCS. The path model indicated that anxiety significantly mediated the link between family function and QoL (R2 = 32.8%), but only partially. Conclusion A significant correlation between anxiety, family function, and QoL was found. Anxiety had a partial mediating effect on the relationship between family function and QoL. Further research should focus on increasing the level of family function and reducing the perceived anxiety of older adults with hypertension to improve their QoL level.

Montreal Cognitive Assessment: Seeking a Single Cutoff Score May Not Be Optimal

Background Cutoff scores of the Montreal cognitive assessment (MoCA) for screening mild cognitive impairment in older adults differ across the world and within the Chinese culture. It is argued that to seek a cutoff score is essential to classify test participants. It was unknown how taking a classifying approach might reveal the cutoff score for identifying mildly cognitively impaired older adults. Methods Participants, selected from 13 communities in Wuhan, China, were tested with the Chinese version of MoCA and rated with the Activities of Daily Living and the Clinical Dementia Rating scales. Mixture modeling was applied to the data with certain covariates and MoCA sum scores as the outcome of the latent class. Models with different numbers of classes were compared in terms of information criteria, likelihood ratio test, entropy, and interpretability. Results A 3-class model (normal, mildly impaired, and severely impaired) was found to fit the data best. The normal class averaged a MoCA score of 24, while the severely impaired class averaged a score below 18. For those cases with MoCA scores above 18 and below 24, it is not certain if they are in the normal or the severely impaired classes. Conclusion Latent variable classification modeling provides another option to identify MCI in older adults. Some categorically different cases of MCI cannot be captured with any single MoCA sum score. A range of 18–24 MoCA scores might serve as a better screening criterion of MCI. Older adults who scored within this gray zone should be monitored for potential interventions.

Evaluation of Subjective Feelings of Outdoor Thermal Comfort in Residential Areas: A Case Study of Wuhan

Outdoor thermal comfort in urban residential areas is closely related to the daily lives of their residents. Nine residential communities in Wuhan, a typical city in central China, were selected as the research object. A questionnaire survey, meteorological parameter measurements, and data analyses were used to investigate the influences of factors such as the characteristics of the spatial environments and the types of outdoor activities undertaken by the residents on the levels of comfort. This investigation was expected to provide a reference for improving these levels. The results show that the level of satisfaction of those in areas with building heights of more than 15 stories reached 51%. Wind speeds were higher in medium-density areas while comfort was the highest in residential areas with densities between 22% and 30%. High-quality areas, which benefitted mainly from higher sensations of wind speed, had the highest levels of comfort but the strongest sensations of heat. A positive correlation exists between green areas and comfort. Where the green coverage rate exceeded 70.0%, temperature satisfaction increased to 33.3–66.7%. Areas with impervious paving are negatively correlated to temperature sensations. Areas of 400–625 m2 had levels of temperature satisfaction lower than 21.5%.

Visualizing the Effect of Built Environment on COVID-19 Transmission: A Community-Level Study in Wuhan, China

With the outbreak of a novel respiratory coronavirus disease (COVID-19) over the world, restriction of human mobility plays an important role to reduce the potential for the spread of virus. People are restricted for limited activities in local communities where the built environment in communities serve as a mediated pathway for the virus transmission. Our study aims to examine to what extent built environment factors explain COVID-19 transmission at the community level. Drawing on primary data collected from 648 communities in Wuhan, China, we employed a geographically weighted regression and a 3D mapping approach to examine the relationship between COVID-19 confirmed cases and three built environment factors including green coverage, property price, and underground parking. We find that green coverage and property price explain COVID-19 transmission better in communities with a larger amount of confirmed cases

Identification of the high-risk residence communities and possible risk factors of COVID-19 in Wuhan, China

The coronavirus disease 2019 (COVID-19) has become a public health emergency of international concern. It is important to identify high-risk residence communities and the risk factors for decision making on targeted prevention and control measures. In this paper, the number of confirmed and suspected cases of COVID-19 in the residence communities in Wuhan, China was collected together with the characteristic variables of the residence communities and the distances between the residence communities and nearby crowded places. The correlation analysis was conducted between the number of confirmed cases and the characteristic/distance variables. Concerning the characteristic variables, there are significant positive correlations between the number of COVID-19 confirmed cases and the construction area, covered area, total number of houses, total number of buildings, volume ratio, property charge, and number of second-hand houses in the residence communities in Wuhan, while minor or no correlation is observed for the average price of houses, construction year, greening ratio, or number of sold houses. Concerning the distance variables, there are significant negative correlations between the number of confirmed cases and the distances from the residence communities to the nearest universities, business clusters, and railway stations, while minor or no correlation is observed for the Huanan Seafood Wholesale Market, kindergartens, primary schools, middle schools, shopping malls, cinemas, subway stations, bus stops, inter-city bus stations, airport, general hospitals, or appointed hospitals for COVID-19 pandemic. Therefore, the residence communities which are newly-built, where the volume ratio or property charge is high or the construction area, covered area, or total number of houses, buildings, second-hand houses, or sold houses is large, or which are close to universities, business clusters, subway stations, or railway stations are the high-risk ones where strict measures should be taken. This study provides the authorities with a valuable reference for precise disease prevention and control on the residence community level in similar cities in the world.

The impact of individual lifestyle and status on the acquisition of COVID-19: A case-Control study.

BackgroundCoronavirus disease 2019 (COVID-19) has spread to the world. Whether there is an association between lifestyle behaviors and the acquisition of COVID-19 remains unclear.MethodsIn this case-control study, we recruited 105 patients with SARS-CoV-2 infection as a case group from the Wuhan Tongji Hospital (Wuhan, China). For each case two control subjects were recruited. Participants were randomly selected from communities in Wuhan and matched for sex, age (± 2yrs), and pre-existing comorbidities (hypertension and diabetes).ResultsA total of 105 patients diagnosed with COVID-19 and 210 controls were included. Compared with control group, the case group had higher proportions of lack of sleep (30.5% vs. 14.8%, P = 0.001) and increased physical activities (56.2% vs. 32.9%, P < 0.001). And patients in the case group were more likely to have alopecia (28.6% vs. 10.0%, P < 0.001) than people from the control group. Overall, we found that lack of sleep [adjusted odds ratio (OR) 1.56, 95% confidence interval (CI) 1.03–2.39)], physical activities (≥ 5 times a week) (adjusted OR 2.05, 95%CI 1.39–3.02) and alopecia (adjusted OR 1.73, 95%CI 1.13–2.66) were independent risk factors for COVID-19 infection. Conversely, low-dose alcohol intake (<100g alcohol per week), hand hygiene, and fruits intake (daily) were significantly associated with a decrease in morbidity.ConclusionsIndividual lifestyle behaviors and health status can affect the occurrence of COVID-19.

Community satisfaction, sense of community, and social well-being in China

Social well-being in communities has received little research attention, particularly regarding the impact of community satisfaction on social well-being. Thus, we examined the link between community satisfaction and social well-being in the Chinese cultural context, and investigated whether sense of community mediates this relationship. We collected survey data from 572 residents living in various communities in Wuhan, Hubei Province, China, and used regression analysis to test the hypotheses. Results reveal that community satisfaction was positively related to social well-being, and sense of community played a mediating role in this relationship. Our findings provide a culture- and location-specific perspective of community satisfaction and social well-being in China and highlight the importance of social well-being in community studies.

The Prevalence and Negative Effects of Thoracic Hyperkyphosis on Chinese Community-Dwelling Older Adults in Wuhan, Hubei Province, China.

Globally, 20% to 50% older adults have been found to have thoracic hyperkyphosis. Negative effects on physical performance have been reported. However, there has been a lack of research on the prevalence and negative effects of thoracic hyperkyphosis among Chinese community-dwelling elderly. A cross-sectional study. The communities in Wuhan, China. Three hundred and ninety-five Chinese community-dwelling older adults with thoracic hyperkyphosis. Chinese community-dwelling older adults aged 60 or above lived in Wuhan, China from August to December 2018 were recruited for spine and physical performance assessments. The primary outcome was the prevalence of thoracic hyperkyphosis estimated according to the angle of kyphosis which was measured by manual inclinometers. The secondary outcomes were the effects of thoracic hyperkyphosis on physical performance measured by One-leg Standing Test (OLS), Timed Up AND Go Test (TUG), Chest Expansion Test (CE), Six Minutes Walking Test (6MWT), and Farsi Version of Functional Gait Assessment (FGA). The socio-demographic and health-related information were collected by a questionnaire. Among 395 participants, the mean angle of kyphosis was 49.0° ± 10.5°, 75.2% of participants had the angle of kyphosis >40° (i.e., having thoracic kyperkyphosis). Compared with older adults having no thoracic hyperkyphosis, older adults with thoracic hyperkyphosis had increased risks performing impaired in OLS (OR=4.55, 95% CI 2.18-9.53, p<0.001), TUG (OR=6.08, 95% CI 2.57-14.40, p<0.001), CE (OR=3.23, 95% CI 1.63-6.38, p=0.001), 6MWT (OR=4.64, 95% CI 1.98-10.86, p<0.001), and FGA (OR=5.18, 95% CI 2.25-11.89, p<0.001) after controlling socio-demographic and health-related factors. The thoracic hyperkyphosis had high prevalence and associated with impaired performance in balance, gait, and cardiopulmonary function tests among Chinese community-dwelling older adults, which calls for the future intervention.

Residents’ Attention and Awareness of Urban Edible Landscapes: A Case Study of Wuhan, China

More and more urban residents in China have suffered from food insecurity and failed to meet the national recommendation of daily fruit and vegetable consumption due to rapid urbanization in recent years. Introducing edible landscapes to urban greening systems represents an opportunity for improving urban food supply and security. However, residents’ opinion on urban edible landscapes has rarely been discussed. In this study, questionnaire surveys were performed in eight sample communities in Wuhan, China, to collect the information on residents’ attention and awareness of urban edible landscapes. Results indicated that nearly one-third of the respondents were unaware of edible landscapes before the interview. Most residents thought that an edible landscape could promote efficient land use (57.26%) and express special ornamental effects (54.64%), but quite a few didn’t believe that growing edible plants in urban public spaces could increase food output (37.10%) and improve food quality (40.12%). Overall, 45.65% and 32.73% of the growers performed their cultivation behavior in private and semiprivate spaces, respectively. Lack of public areas for agriculture use was regarded as the main barrier restricting the development of urban horticulture by 55.86% of growers and 59.51% of non-growers. The residents were also worried about their property manager’s opposition, possible conflicts, and complex relationships with their neighbors. Food policies and infrastructure support from local governments and official institutions were needed to ensure the successful implementation of edible landscapes in urban areas.

Prevalence and risk factors of diabetic peripheral neuropathy in Chinese communities

Objective: To investigate the prevalence and risk factors of diabetic peripheral neuropathy in type 2 diabetic patients under community management programs. Methods: A cross-sectional study was conducted on T2DM patients in eight communities in Wuhan and Changshu cities. Data would included questionnaire, body measurement, blood testing and clinical examination. The criterion of diabetic peripheral neuropathy was under the combination of symptoms with five physical examinations. Binary logistic regression model was used to analyze the influential factors. Results: The overall prevalence of peripheral neuropathy was 71.2% among the diabetic patients who were managed in primary care health services in the two cities. The binary logistic regression method identified older age (≥60 years, OR=2.39, 95%CI:1.95-2.94), longer diabetic duration (≥10 years, OR=1.25, 95%CI: 1.02-1.54), and worse postprandial glucose control (2 h postprandial plasma glucose >10.0 mmol/L: OR=1.65, 95%CI:1.33-2.04) (all P<0.05) as risk factors for the presence of diabetic peripheral neuropathy, while higher education level was protective factor (compared to patients with education levels of primary school or below, OR=0.52, 95%CI: 0.41-0.66; OR=0.59, 95%CI: 0.44-0.79; OR=0.64, 95%CI: 0.44-0.94 for those with education levels of junior high school, senior high school, and college, respectively). Conclusions: High rates of diabetic peripheral neuropathy among T2DM patients suggested the urgent need for early screening and standardized management at the community levels. It is necessary to promote appropriate screening techniques and methods to identify the peripheral neuropathy, in the primary health service institutions.

1661. Using Social Media to Enhance an STI Screening Program in Wuhan, China

Background357 million people between the ages of 19 and 49 are infected each year with a sexually transmitted infection (STI). Wuhan, China is a unique setting for STI intervention as it has over 900,000 college students, a population at high risk for contracting HIV. Cultural attitudes toward premarital sex and homosexuality and poor sexual education are barriers to lowering STI rates. Additionally, 90% of Chinese healthcare is provided at large public hospitals with minimal privacy. Anonymous STI screening outside of the public hospital setting is highly desired by young adults and MSM populations.MethodsStudy investigators partnered with dating app Blued to advertise a nontraditional testing site where high-risk individuals were offered anonymous STI/HIV screening. With the assistance of the regional CDC and a community-based organization (CBO), rapid STI results were provided in a convenient and nonjudgmental setting. Information on sexual behavior and knowledge of STIs was surveyed for future public health interventions.ResultsOf 200 individuals screened for HIV, syphilis, gonorrhea, and chlamydia, 51 (25.5%) had a positive test result. Over 10% of rectal and pharyngeal tests were positive, compared with 1% of urine tests. 3/200 (1.5%) of had positive rapid HIV test results; all were connected to treatment. Among 41 (20.5%) who learned about the study through Blued, STI prevalence was higher (31.7% vs. 23.9%, P = 0.3), compared with participants recruited through advertisement by the CBO. Most (67.5%) identified as MSM. Survey data confirmed low underlying knowledge of STI transmission and risk factors, especially regarding pre-exposure prophylaxis (PrEP).ConclusionA discreet screening service at a nontraditional site, facilitated through dating application and social media advertisement, was well received by young adult and MSM communities in Wuhan, China. Triple-site STI screening found a significant number of infections among this population and should be routinely offered by public health services. The use of real-time, convenient diagnostic testing presents an opportunity to lower HIV incidence in Wuhan, a city with a large at-risk population.Disclosures All authors: No reported disclosures.

Survey of Chinese persons managing depressive symptoms: Help-seeking behaviours and their influencing factors

ObjectivesTo explore help-seeking behaviours of Chinese persons managing depressive symptoms and factors that influence these behaviours. MethodsA survey of residents living in communities in Wuhan, China was conducted using stratified random sampling. The Patient Health Questionnaire (PHQ-2), the Actual Help-Seeking Questionnaire (AHSQ) and a socio-demographic questionnaire were completed by participants. Descriptive statistics were analyzed. A multiple linear regression model was used to explore factors associated with help-seeking behaviours. ResultsOf the 1785 respondents, 672 (37.6%) reported that they experienced depressive symptoms during the past year, and of these respondents, 517 (76.9%) indicated that they sought assistance. Among help-seeking sources utilized by participants, informal help was sought most frequently (72.9%), followed by hotline/Internet assistance (14.3%), mental health professionals (MHPs) (7.9%) and general physicians (GPs) (3.7%). The results of multilinear regression analysis showed that participants who were adults (aged 25–64 years), attended junior and high school (7–12 years education), and lived in urban areas were more likely to seek additional assistance for their depressive symptoms. ConclusionMental health promotion and education efforts are needed to improve the public’s mental health literacy and to promote appropriate utilization of informal sources of assistance in managing depressive symptoms such as a hotline or the Internet. Further interventions need to be considered to reinforce use of social supports and mental health professionals, especially in rural areas.

Healthy aging with parks: Association between park accessibility and the health status of older adults in urban China

Accessibility is a crucial element reflecting the potential availability of parks. By conducting a cross-sectional study of 700 older adults sampled from 30 communities in Wuhan, China, we examine the association between the accessibility of parks and the health status of older adults. A varying two-step floating catchment area model was developed to measure the accessibility of parks for older adults that simultaneously considered the physical environment and sociopersonal context. Based on the results of a logistic regression analysis, older adults with the greatest access to parks experience significantly lower odds of cardio-cerebral vascular diseases, joint diseases and endocrine diseases than their counterparts with the least access to parks. The effects of the physical environment and sociopersonal context on the accessibility of parks and health status are also discussed. In general, these two factors jointly influence the potential alternatives to parks and participation in park-based activities among older adults and in turn affect the health benefits for older adults. This study provides empirical support for the role of parks in supporting healthy aging. It also emphasizes the need for more comprehensive economic planning strategies to improve park accessibility and promote healthy aging in transitional cities.

Chinese women's experiences, emotions and expectations of breast-feeding in public: a qualitative study.

To explore Chinese mothers' experiences, emotions and expectations of breast-feeding in public places. Exploratory qualitative study. Purposive sampling was used to recruit participants and face-to-face interviews were conducted. Themes were identified by content analysis. Two different geographical communities in Wuhan, Hubei Province, central China, March-May 2016. A total of twenty-seven mothers aged 23-33 years, who had one child under 3 years of age and had experience of breast-feeding in public places. Seven themes emerged from the interviews: struggling to balance infant's needs and personal feelings; embarrassed or natural emotion regarding breast-feeding in public places; effect of cultural and social norms; internalized concerns going beyond actual social reaction; measures to make breast-feeding in public places easier; desire for more public facilities; and expecting emotional support from society members. More positive social support, favourable policies and necessary facilities were desired to enable mothers to breast-feed in an appropriate public location. Women expected increased public acceptance of breast-feeding practices and support from government health officials to ensure women's success in breast-feeding in public settings.

A survey on difficulties and desires of breast-feeding women in Wuhan, China

Objectivesexclusive breast feeding in China is relatively low and no research has been conducted to explore the difficulties and desires of Chinese lactating mothers. Currently, Chinese women turn to massage therapists to increase breastmilk volume, implying that many breast-feeding women faced problems but had few support mechanisms.This study aimed to explore the difficulties and desires of Chinese breast-feeding women and to propose strategies for increasing the rate of exclusive breast feeding. Methodsthree hundred and seventy-five primiparous women were recruited from two randomized cluster communities in Wuhan following ethical approval. Face-to-face semistructured interviews were conducted with 76 of the participants to collect data on their infants' feeding status, duration of exclusive breast feeding, reasons for stopping, difficulties encountered, and sources of support for lactation. Resultsthe breast feeding initiation rate was 93.6%, but exclusive breast feeding was only 6.2% at six months. The most frequently cited reason for giving up exclusive breast feeding was perceived breastmilk insufficiency. Women cited a desire for professional and individualised instruction from following resources: (1) lactation consultants in hospital and communities; (2) Qualified cuirushi; (3) breast feeding website;(4) Relatives, friends and peers;(5) Telephone hotline. Conclusionsto improve the rate and duration of exclusive breast feeding in China, effective and available resources must be available. Timely,professional and face-to-face lactation counselling such as lactation consultant, qualified cuirushin is needed.