Rural Chinese Children Research Articles

Interventions for left-behind children in Mainland China: A scoping review

BackgroundAs the discussion of Chinese left-behind children (LBC) continues, intervention programs dedicated to this population increase and diversify. While reviews have summarized intervention programs promoting LBC’s health and psychological wellbeing, there is no synthesis depicting a comprehensive picture. This scoping review systematically examines interventions tackling LBC’s various issues and identifies their design and foci. MethodWe performed a systematic literature search to extract intervention studies from four English (i.e., Web of Science, Scopus, Embase, & PsycINFO) and one Chinese (i.e., CNKI) database. The quality of the studies was assessed using the Mixed Methods Assessment Tool (MMAT). Two main rounds of deductive coding were performed on Nvivo 12 plus to identify the design and foci of the interventions. ResultsThirty-three articles were identified for our final review. Twenty-six were published in Chinese and seven in English. Existing interventions have tackled multiple psychological, social, physical, developmental, and sexual problems or needs of Chinese rural left-behind children. Among them, LBC’s psychological wellbeing has drawn the most attention. The majority of the reviewed studies performed a randomized controlled trial (N=20). Quantitative evaluation is prevalent, with only one study applying a purely qualitative evaluation. In addition, only two studies adopted validated interventions, while the others are self-designed. ConclusionsThe review results indicate several gaps in intervention studies for LBC. First, many existing interventions have considered LBC’s psychological and social wellbeing, while little effort has been paid to address their educational and intellectual development. Further, while existing interventions are concerned with LBC’s temporary needs, their long-term life planning, as well as their current self-efficacy and self-concept driving their actions towards future self, were neglected. As for the intervention design, empirically validated interventions are recommended for future studies for their verified efficacy and evidence-based standardized practice. In addition, a qualitative evaluation should be considered because it might be more powerful in eliciting realistic and viable solutions to improve the effectiveness and reliability of the interventions from the participants.

Impact of Mattering on Parental Attachment: Social Support Mediation and Self-Efficacy Moderation in Rural Chinese Children

Strong emotional relationships between parents and children are thought to be essential for developing a child's emotion of mattering, according to earlier research. Through the investigation of these relationships, the study aims to improve knowledge of the psychological and emotional elements that support normal growth in the population. To offer regulation for reinforcement of parental support networks in marginalized groups, it draws attention to the importance of these variables in determining the quality of attachment. This study explores the connection among mattering (MAT) and Parental Attachment (PA) with a focus on the dynamics that affect Social Support (SS) and Self Efficacy (SE) between rural Chinese children. Validated questionnaires assessing PA, MAT, SS, SE, and Parental Support (PS) are utilized to collect data from a sample (190) of Chinese children living in rural areas. Significantly favourable connections, especially between MAT and PA, are revealed by correlation analysis. These results reveal avenues for improving the development of rural Chinese children by underlining the significance of social networks and emotional attachments in fostering psychological well-being.

Effects of Empathy on Loneliness Among Rural Left-Behind Children in China: The Chain-Mediated Roles of Social Anxiety and Psychological Resilience.

Loneliness is a prevalent issue among rural left-behind children in China, adversely affecting their physical and mental well-being, as well as social stability. However, the influencing factors and potential mechanisms of loneliness have not yet been fully clarified. This study aims to validate the mediating roles of social anxiety and psychological resilience by examining the association between affective/cognitive empathy and loneliness among Chinese rural left-behind children. This cross-sectional survey employed a convenience sampling approach among Chinese left-behind children. A total of 540 participants aged 6 to 11 years old (Average age = 8.54, SD = 1.682) from 3 primary schools in Hunan Province completed the Children's Loneliness Scale, Social Anxiety Scale for Children, The Chinese version of Connor-Davidson Resilience Scale, and Basic Empathy Scale. Data analysis was conducted using SPSS 27.0, Origin 2020, and Mplus 8.3. Pearson correlation analyses suggested strong significant correlations among affective/cognitive empathy, loneliness, social anxiety, and psychological resilience. Path analyses indicated that the chain mediation effect size of social anxiety and psychological resilience was 0.016 between affective empathy and loneliness, while the chain mediation effect size between cognitive empathy and loneliness was -0.011. Affective empathy positively correlates with loneliness among Chinese left-behind children through social anxiety and resilience, while cognitive empathy negatively correlates with loneliness. These findings suggest that left-behind children should enhance their cognitive empathy and psychological resilience to reduce their social anxiety, thereby mitigating their loneliness.

Relationships between gross motor skills, psychological resilience, executive function, and emotional regulation among Chinese rural preschoolers: A moderated mediation model

BackgroundEmotional regulation is a critical component of emotional intelligence, particularly during the preschool stage, a key period for children's development. Previous studies have demonstrated that executive function mediates the effect of gross motor skills on emotional understanding. However, studies specifically focusing on children from rural areas and investigating the role of psychological resilience are limited. The present study fills this knowledge gap by examining the effect of gross motor skills on emotional regulation and the roles of executive function and psychological resilience among Chinese rural preschool children. MethodsThis study included 430 children (aged 61.01 ± 6.98 months, 48.8 % boys) and their teachers from three rural preschools in China. Children's gross motor skills, including locomotor and object control skills, were assessed using the Test of Gross Motor Development-3. Executive function was measured using the Head-Toes-Knee-Shoulder task, and emotional regulation was assessed using the Emotional Regulation Checklist. Furthermore, psychological resilience was examined using the Devereux Early Childhood Assessment. Demographic information was collected, and the cross-sectional relationships between gross motor skills and emotional regulation were investigated through mediation and moderation analyses. ResultsGross motor skills, executive function, and psychological resilience were associated with emotional regulation (p < 0.05), after controlling for sex, age, and only-child status. Executive function was found to mediate the relationship between gross motor skills and emotional regulation, with a mediation effect of 0.045. Psychological resilience moderated the relationship between executive function and emotional regulation (β = 0.078, p < 0.05). Simple slope analysis, based on categorizing psychological resilience into high, medium, and low groups, revealed that preschoolers with a higher level of psychological resilience exhibited a significantly stronger predictive effect of executive function on emotional regulation (β = 0.202, p < 0.01). ConclusionsGross motor skills significantly affect emotional regulation development in rural preschoolers, with executive function acting as a mediator in this relationship. Psychological resilience was found to moderate the effect of executive function on emotional regulation. The findings suggest that enhancing gross motor skills through physical activities can benefit children by promoting the development of executive function, which is crucial for emotional regulation. On the basis of our findings, we recommend focusing on cost-effective physical activity interventions for motor skills development among rural children while also addressing the development of executive function and psychological resilience. Future efforts should include workshops to improve physical literacy of parents and teachers regarding children's gross motor skills promotion.

The impact of parental migration patterns, timing, and duration on the health of rural Chinese children.

Parent-child separation raises concerns for the well-being of 69 million left-behind children (LBC) in China. However, the effects of parental migration status, timing of migration, and migration duration on the health of children remain unclear. This study aims to explore the association between different parent-child separation experience and a range of health outcomes in rural Chinese children. A sample of 2,355 students, grades 5 to 8, from two provinces in China were recruited. Standardized self-report instruments collected data on demographics, separation status, and children's health conditions. Full data were available for 274 children with both parents currently migrating (BLBC), 638 children with one parent currently migrating (SLBC), 658 children with parents previously migrated (PLBC) and 785 children with non-migrating parents (NLBC). Regression model results showed that, compared to the NLBC group, BLBC and PLBC exhibited lower self-rated health (p < 0.05), higher depression (p < 0.05), and higher rates of non-suicidal self-injury behaviors (p < 0.05) and suicidal ideation (p < 0.05). Children who experienced parental separation before the age of three were at a higher risk for four health indicators. Additionally, children left behind by parents for more than 7 years had significantly worse health outcomes. Children who have experienced both current and previous parental migration, as well as earlier parental migration age and longer migration duration, are at a disadvantage in terms of health. These findings highlight the need for targeted interventions focusing on the most vulnerable children.

Enhancing Cooperation in 5-6-Year-Old Rural Chinese Children through Cooperative Constructive Play Based on Anji Play: A Quasi-Experimental Study.

Cooperation plays a crucial role in children's social development and adaptation. This study designed a cooperative constructive play (CCP) intervention based on the Anji Play teaching model and evaluated its effectiveness in a quasi-experimental design involving 60 rural Chinese children aged 5-6 years. Participants were divided into an experimental group, which engaged in 12 weeks of CCP, and a control group, which continued with regular teaching activities. The cooperation data were collected through a truck racing task using pre-, mid-, post-, and follow-up tests, while the cooperation levels and strategies were evaluated by video observations of role-playing games before and after the tests. The results indicated significant improvements in cooperation scores in both the truck racing task and role-playing games in the experimental group compared to the baseline, with no similar enhancements observed in the control group. Furthermore, cooperation scores in the follow-up were higher than pre- and post-test scores, demonstrating the CCP's effectiveness in fostering child cooperation, transferability to other contexts, and sustainability. These findings suggest that CCP intervention based on Anji Play can significantly enhance cooperation in children, offering a valuable tool for educational practices.

Prevalence and the interrelationship between depression and anxiety, and its association with problem behaviors among the sample of Chinese rural school-aged children: a symptom network analysis

Prevalence and the interrelationship between depression and anxiety, and its association with problem behaviors among the sample of Chinese rural school-aged children: a symptom network analysis

Hidden curriculum: Voices of Chinese rural migrant children

AbstractUnited Nations Sustainable Development Goal 10 emphasises the need to ‘reduce inequality within and among countries.’ In line with this goal, this study focuses on the educational experiences of five rural migrant children from an urban village in China. Using the concept of hidden curriculum (HC), the study explores whether these children have encountered social exclusion in their schools. Through interviews and observations, the study shows that the HC is not easily discernible but subtly influences students, teachers, and parents, resulting in a certain degree of social exclusion within various educational facets. Reducing inequalities through education presents significant challenges, requiring sustained efforts.

Spatial and emotional distances in parent-child relationships: Impacts on human capital development in rural Chinese boarding children

BackgroundThe policy of merging remote rural elementary schools into centralized villages has led to the emergence of boarding schools as an essential means of providing compulsory education in rural areas of China. As boarding children reside in schools for extended periods, parents' influence on their human capital development is inevitably specificity. The development of rural boarding children is a serious social issue in China, and parent–child distance plays a crucial role in affecting the development of children's human capital. ObjectiveWhile previous studies have focused on the relationship between parental absence and the development of human capital in rural boarding children, this study examines the effects of both spatial and emotional distance between parents and children on the human capital of rural boarding children. Participants and settingA stratified, multi-stage probabilities proportional to size (PPS) sampling method was used, and self-report questionnaires were completed by 2397 rural boarding children (54.2 % males; ages 12 to 18, M = 14.66, SD = 1.30). MethodsChildren's background, family, and school and teacher characteristics were used as control variables. An OLS regression model was used to assess the effects of parent–child spatial and emotional distance on the human capital of rural boarding children, and a CMP–OLS regression model was used to address endogeneity using parents' self-assessed family economic conditions as instrumental variables. ResultsParent–child spatial distance had a significant positive effect (p < 0.05, p < 0.05), and emotional distance had a significant negative effect (p < 0.05, p < 0.01) on the cognitive and non-cognitive abilities development of rural boarding children. Living with grandparents heightened the negative effect on non-cognitive abilities development. ConclusionsThe findings of this study strengthen the link between parent–child distance and rural boarding children and the moderating impact of living with grandparents on the effect of parent–child distance on rural boarding children's human capital providing new insights for promoting the development of rural boarding children. It also highlights the detrimental effects of emotional neglect on rural boarding children's development. This is important for realizing China's rural revitalization strategy and the healthy development of disadvantaged children in rural areas.

Perceived discrimination and self‐esteem of left‐behind children: The mediating effect of grit

AbstractAlthough perceived discrimination has been found to diminish self‐esteem, the mechanism of such effect and potential protective factors demands further study. Grit has been suggested to moderate the effect of risk factors affecting Chinese left‐behind children, but few studies have considered that being left behind might diminish the family and social conditions needed for nurturing grit, and therefore grit might mediate the effect of being left behind and perceived discrimination upon self‐esteem. With the questionnaire data collected from 974 Chinese rural children among whom 517 were left‐behind children, the present study shows that perseverance of effort mediates the effect of being left behind upon self‐esteem. Moreover, within the subsample of left‐behind children, perceived discrimination was found to mediate the effect of time length of being left behind on self‐esteem, while a chain mediation effect was found where perceived discrimination and consistency of interest mediated the effect of the time length of being left behind on self‐esteem. Findings suggest that for left‐behind children, while the adverse social conditions reflected by perceived discrimination affects self‐esteem by diminishing consistency of interest, the absence of adequate parental regulation more directly affects perseverance of effort and therefore affects self‐esteem. Further research directions about practices and interventions targeting at protecting self‐esteem through fostering grit are discussed.

The longitudinal relationship between loneliness and both social anxiety and mobile phone addiction among rural left-behind children: A cross-lagged panel analysis.

Left-behind children are a special group that needs urgent attention. Due to enduring separation from their parents, loneliness is considered the most common and prevalent developmental hurdle in the experiences of left-behind children. This longitudinal cross-lagged study examined the direction of the association between loneliness and both internalizing and externalizing symptoms, with considering gender and left-behind status differences. A total of 1175 rural Chinese children (48.3% boys, 39.9% left-behind children, Mage = 14.54 ± 1.18 at baseline) completed self-reported loneliness, social anxiety, and mobile phone addiction at two-time points with 6 months intervals. Descriptive statistics, cross-lagged panel analysis, and multiple group analysis were estimated in the present study. Loneliness exacerbated social anxiety and mobile phone addiction, and vice versa. In addition, gender and left-behind status moderated these relationships, with boys more likely to be mobile phone addicted due to loneliness and girls more likely to be lonely due to mobile phone addiction. More importantly, left-behind children with loneliness are more prone to social anxiety and mobile phone addiction, and vice versa, compared with non-left-behind children. The targeted interventions should be carried out for different genders and left-behind statuses. Particularly for left-behind children, neglecting to address both the symptoms of loneliness and both social anxiety and mobile phone addiction could significantly undermine the efficacy of intervention programs that solely target either one of these afflictions.

Supporting cognitive catch-up: The effects of cluster-randomized psychosocial stimulation interventions on preterm low birthweight children in rural China.

Improved survival of preterm low birthweight (LBW) infants due to advances in neonatal care has brought issues such as postnatal development trajectories to the foreground. This study pools evidence from three cluster-randomized experiments evaluating community-based psychosocial stimulation programs conducted from 2014 to 2017 that included 3571 rural Chinese children aged 6-24 months (51.1% male, 96.2% Han Chinese). The risk of severe cognitive delay was found to be 26.5 percentage points higher for preterm LBW children than for their peers at age 2.5, with a prevalence rate of 48.3%. Results show that psychosocial stimulation interventions can improve child cognitive development at scale, with beneficial impacts on child cognition disproportionately larger for preterm LBW children, helping them to catch up developmentally.

Father's involvement associated with rural children's depression and anxiety: A large-scale analysis based on data from seven provinces in China.

To investigate the relationship between father involvement in parenting and mental health problems among children and adolescents in rural China. The Rural Children's Mental Health dataset includes mental health information from 2,489 children and adolescents aged 5-16 in seven provinces in China. The relationship between father involvement in children and adolescents depression risk and anxiety was analyzed by Spearman's correlation analysis, logistic regression analysis, and restricted cubic spline. Father involvement was significantly and negatively associated with depression scores (r = -0.38, P<0.001) and anxiety scores (r = -0.18, P<0.001) in rural Chinese children and adolescents. Both multivariate models indicate that the highest level of father involvement has a protective effect on the risk of depression among children and adolescents (OR = 0.268 and 0.303, 95% CI: 0.149~0.483 and 0.144~0.636), while the association with anxiety risk is only significant in the multivariate model 1 (OR = 0.570, 95% CI: 0.363~0.896). Father involvement is a protective factor for the risk of depression among children and adolescents in rural China. The level of father involvement should be increased, and active participation should be encouraged to reduce the risk of depression in their children and to further promote the mental health of children and adolescents in China.

Identification of central symptoms of children depression and development of two short version of Children's Depression Inventory: Based on network analysis and machine learning

BackgroundUsing network analysis to study the central symptoms is important for understanding the mechanism of depression symptoms and selecting items for the short version depression screening scale. This study aimed to identify the central symptoms of depression and develop the short and effective depression screening tools for Chinese rural children. MethodsFirstly, the 2458 individuals (Mage = 10.74; SDage = 1.64; 51.2 % were female) were recruited from the rural children's mental health database. Children's Depression Inventory (CDI) was used to assess depression symptoms. Then, network analysis was used to identify the central symptoms of depression. The accuracy, stability, and gender invariance of the depression symptoms network were tested. Finally, a short version of CDI with central symptoms (CDI-SC) and a new CDI-10 (CDI-10-N) were developed by network analysis and feature selection techniques to optimize the existing CDI-10. Their performances in screening depression symptoms were validated by the cutoff threshold and machine learning. ResultsThe central symptoms of Chinese rural children's depression were sadness, self-hatred, loneliness and self-deprecation. This result was accurate and stable and depression symptoms network has gender invariance. The AUC values of CDI-10-N and CDI-SC are over 0.9. The CDI-10-N has a higher AUC than CDI-10. The optimal cutoff thresholds for CDI-10-N and CDI-SC are 6 and 1. The performance of machine learning on AUC generally outperforms those of cutoff threshold. ConclusionsThe central symptoms identified in this study should be highlighted in screening depression symptoms, and CDI-10-N and CDI-SC are effective tools for screening depression symptoms in Chinese rural children.

Children's interpretations of parental responses to children's negative emotions in Chinese urban and rural communities

AbstractChildren's interpretations of parenting behaviors offer valuable insights into cultural meanings of parenting. This study examined how Chinese urban and rural children interpreted six different types of parental responses to children's negative emotions (PRCNE), which have traditionally been identified as supportive (e.g., emotion‐focused responses, problem‐focused responses, and expressive encouragement) versus nonsupportive ones (e.g., minimization, parental distress, punitive responses) in Western cultures. Based on surveyed samples of 976 children, demographically matched samples of 102 urban (Mage = 14.23 years) and 100 rural (Mage = 14.38 years) children were generated for analysis, using propensity score matching (PSM). Results revealed that compared with rural children, urban children rated problem‐focused responses as more normative, whereas parental distress and punitive responses as less normative. Additionally, urban children evaluated emotion‐focused responses, problem‐focused responses, expressive encouragement, and minimization as less negative, and parental distress as less positive than rural children. In urban communities, emotion‐focused responses, problem‐focused responses, and encouragement were evaluated most positively and least negatively, followed by minimization, and lastly parental distress and punitive responses. In rural communities, emotion‐focused responses and problem‐focused responses were evaluated most positively and least negatively, followed by encouragement and minimization, and lastly parental distress and punitive responses. The findings highlight the diverse interpretations children have towards PRCNE across different cultural contexts.

The practice of social protection policies in China: a systematic review on how left-behind children's mental health can be optimised.

By discussing the mental health challenges faced by left-behind children, this article recommends or comments on existing social protection policies that can affect left-behind children's mental health at the micro-, meso- and macro-levels to holistically understand how a range of parties can jointly socially include left-behind children, a process which is conducive to the latter's mental health development. J.H. carried out a systematic review by searching through the English bibliographical databases Google Scholar, Web of Science and Scopus, in addition to Chinese bibliographic databases CNKI, Wanfang Data and VIP Chinese Science and Technology Periodicals. Here J.H. searched for the words ('social protection' OR 'socially protected') AND ('mental health' OR 'psychological wellbeing' OR 'mental problems' OR 'psychological problems') AND ('left-behind children' OR 'LBC' OR 'leftover children') AND ('China' OR 'Chinese'). Publication dates of the search results were limited to between 2010 and 2022. One of the primary problems encountered by left-behind children is their inadequate home supervision. A further study indicates that parental migration serves as a crucial risk factor for child depression. State-level provision of insurance programmes helps curtail these children's encounters of mental health challenges. Moreover, an improvement in family and school protection is essential when optimising the protection system for left-behind rural Chinese children from poor villages. It is necessary for upper-level government units to re-structure their lower-level counterparts to improve the local administration. This allows lower-level government units to exploit preferential policies, refine relevant regulations and policies on child protection, and facilitate the establishment of social organisations where local policies can be successfully implemented to socially include and protect left-behind children in villages. At the meso-level, community environment construction should be emphasised. At macro- and meso-levels, government authorities and social organisations should encourage the marketisation of hiring professional surrogate parents. At the micro-level, migrant parents should proactively take an initiative to contact their left-behind children via telecommunications.

Immediate and longer-term changes in mental health of children with parent–child separation experiences during the COVID-19 pandemic

BackgroundThe psychological impact of the COVID-19 pandemic has been understudied among vulnerable populations. This study aimed to examine the immediate and longer-term changes in the mental health of children with parent–child separation experiences during the COVID-19 pandemic, and identify potential buffering opportunities for mental health.MethodsThis longitudinal cohort study used data from 723 rural Chinese children who provided data before (Oct. 2019) the COVID-19 pandemic and during the following 2 years. Changes in the probability of depressive symptoms, anxiety symptoms, non-suicide self-injurious (NSSI), suicidal ideation, suicide plan, and suicide attempt were tested across four waves using generalized estimating models (GEE).ResultsCompared with children who never experienced parent–child separation, children persistently separated from parents since birth experienced greater deterioration in all mental health in the 2-year follow-up (average change: depressive symptoms: β = 0.59, 95% CI [0.26, 0.93]; anxiety symptoms: β = 0.45, 95% CI [0.10, 0.81]; NSSI: β = 0.66, 95% CI [0.31, 1.01]; suicide ideation: β = 0.67, 95% CI [0.38, 0.96]; suicide plan: β = 0.77, 95% CI [0.38, 1.15]; suicide attempt: β = 1.12, 95% CI [0.63, 1.62]). However, children with childhood separation from their parents but reunited with them during the transition to adolescence showed similar even lower changes to counterparts who never experienced parent–child separation (all ps > 0.05).ConclusionThese results indicating improvements in supportiveness of the caregiving environment during the transition to adolescence may provide the opportunity to buffer the adverse impact of COVID-19 on mental health. Translating such knowledge to inform intervention and prevention strategies for youths exposed to adversity is a critical goal for the field.

Enhancing 3–4-year-old rural Chinese children’s theory of mind: a randomized control trial to evaluate a parent-involved school-based dialogic reading intervention programme

ABSTRACT This study examined the effect of dialogic reading intervention on improving the theory of mind of rural Chinese children. A 12-week-randomized controlled trial design with two intervention groups, i.e. school practice intervention (SPI), parent-involved intervention (PII), and one control group with traditional reading intervention (TRI) that provided data at pre-, mid-, post-test, and follow-up tests, was adopted. Seventy-five children participated in the study, with twenty-five participants in each group. Results indicated the gain scores of ToM score from pre to mid-tests and pre- to post-tests of the two intervention groups were higher than the control group. The PII group showed higher gain scores in the mid- and post-test than the SPI group. The intervention effects were well maintained in the SPI and PII groups during the two-month follow-up assessment. The findings indicated school-based dialogic reading can effectively promote ToM development and has a maintenance effect, especially when parents are engaged.

Reciprocal relationship between interpersonal communication and depressive symptoms and the mediating role of resilience across two years: Three-wave cross-lagged panel model

BackgroundDepression among children has been a growing public health concern. It is generally recognized that individuals with depression are likely to have interpersonal malfunctioning. However, there remains a limited scientific understanding of the reciprocal relationship between interpersonal communication and depressive symptoms among rural Chinese children in a longitudinal approach. MethodsTherefore, guided by the interpersonal model of depression and the developmental cascade model, the present study conducted a cross-lagged panel analysis study to explore the bidirectional relationship between interpersonal communication and depressive symptoms across three waves among 2188 elementary school students in rural areas of one county of Gansu Province, China. We also examined the mediating effect of resilience and sex differences of the models. ResultsOur results showed that depressive symptoms negatively predicted interpersonal communication from T1 to T2 and T2 to T3. Interpersonal communication negatively predicted depressive symptoms from T1 to T2, but not T2 to T3. Furthermore, resilience showed significant partial mediating effects in the reciprocal relationship between interpersonal communication and depressive symptoms. In terms of sex differences, the significant relationship between depressive symptoms at T1 and interpersonal communication at T2 was found to be significant among male students and marginally significant among female students. The full mediating effect of resilience at T1 was found only among male students, whereas resilience at T2 functioned as a full mediator between depressive symptoms at T2 and interpersonal communication at T3 only among female students. LimitationsFirst, the present sample consisted of only third and fourth grade (i.e., in T1) students from one county in rural China. Second, the present study examined depressive symptoms instead of depression as a clinical diagnosis. Third, the third wave of the data was collected during COVID-19. The impact of the COVID-19 pandemic could unexpectedly pose on child mental health. ConclusionsThe finding underlined the importance of providing comprehensive depression prevention and intervention from fostering children's inner resilience and promoting their ability to navigate interpersonal resources.

School-based Psychosocial interventions on mental health among Chinese rural children with traumatic experiences: a protocol using cluster randomized controlled trial

BackgroundThe first aim of this study is to test the effectiveness of school-based psychosocial interventions for improving mental health in rural Chinese children with traumatic experiences. The second aim is to examine which individual, family and school related factors could explain the effectiveness of school-based psychosocial interventions. Third, we will investigate whether individual, family, and school related conditions play a moderator role on the effectiveness of school-based psychosocial interventions.MethodsThis study will conduct a cluster randomized controlled trial (RCT) in a large sample of Chinese rural children. Four rural counties in Shandong (Central China), Henan (Central China), Inner Mongolia (Northern China), and Xinjiang (Western China) will be selected as study settings from which schools will be sampled. Each sampled school will be randomly allocated either the intervention groups or a control group. Randomization will be performed by the research member who is not involved in the intervention stage. In each school students in grade 5 or higher will be recruited to ensure that approximately 50 children aged 10 to 18 years will be included. In each county, one high school, one middle school, and one primary school will be randomly chosen as the intervention group, and the other three similar schools will be chosen as control (waiting list) groups. A standardized and uniform research protocol will be applied in all intervention schools. All school social workers and psychological teachers would receive one week of in-person training following procedures. School-based psychosocial interventions included 14 group sessions for 14 consecutive weeks.DiscussionThis study would develop school-based mental health promotion policy recommendations to improve Chinese rural children’s mental health. This study can provide solid evidence for the promotion of school-based intervention in general.Trial registrationChiCTR2300069405, Registered on 15 March 2023.