Hypertension remains a major public health challenge globally, with suboptimal adherence to treatment and lifestyle modifications exacerbating cardiovascular risks. This study evaluates multidimensional adherence (medication, diet, and behavior) and its determinants among hypertensive patients in rural Northeast China. A cross‐sectional study enrolled 6352 adults aged ≥ 40 years with diagnosed and poorly controlled hypertension from rural villages across five cities (Benxi, Chaoyang, Dandong, Donggang, and Fuxin) in Liaoning Province, Northeast China, using multistage cluster sampling. Adherence was assessed via standardized questionnaires, with logistic regression analyzing sociodemographic, clinical, and behavioral predictors. Medication adherence was reported by 73.7% of participants, while dietary and behavioral adherence rates were 10.5% and 29.3%, respectively. Ethnic disparities emerged, with Han Chinese exhibiting lower medication adherence (aOR = 0.485, 95% CI: 0.377–0.624). Cohabiting with children enhanced dietary adherence (aOR = 2.184, 95% CI: 1.854–2.573), whereas widowed status reduced both dietary (aOR = 0.698, 95% CI: 0.528–0.924) and behavioral adherence (aOR = 0.726, 95% CI: 0.595–0.887). Higher hypertension knowledge scores positively influenced all adherence domains ( p < 0.05). Adherence among rural hypertensive patients is multidimensional, shaped by cultural, socioeconomic, and behavioral factors. Targeted interventions addressing dietary sodium reduction, family‐based support, and health literacy improvement are urgently needed. This study underscores the importance of integrating region‐specific strategies into hypertension management programs to mitigate cardiovascular morbidity in high‐risk populations.

Suboptimal medication adherence and unhealthy lifestyle behaviors are well‐recognized contributing factors to poor blood pressure control in hypertension patients. We evaluated the effectiveness of comprehensive health management in improving medication adherence and promoting healthy lifestyle behaviors among hypertension patients in China. A cluster randomized trial was implemented in rural areas of three provinces of China. Participants were individuals aged ≥ 40 years with uncontrolled hypertension. The intervention group received multidimensional health management measures codeveloped by healthcare organizations, village doctors, and patients, while the control group received standard care. The coprimary outcomes included the proportion of patients demonstrating good medication adherence and adherence to ≥ 3 healthy lifestyle components. Secondary outcomes comprised the proportion achieving controlled hypertension (BP < 140/90 mm Hg). From May 8th to November 28th, 2018, 9204 participants were enrolled. At 18‐month follow‐up, significantly higher medication adherence was observed in the intervention group compared with the control group, with an absolute difference of 5.0% (95% confidence interval (CI): 2.8–7.2; p < 0.001). Similarly, adherence to ≥ 3 healthy lifestyles was achieved by 45.8% in the intervention group versus 33.7% in controls, yielding a 12.1% between‐group difference (95% CI: 9.9–14.3; p < 0.001). Hypertension control rates differed significantly between groups (43.2% vs. 23.9%; absolute difference 19.2% and 95% CI: 17.2–21.3; p < 0.001). Hypertension patients receiving comprehensive health management in rural China demonstrated superior medication adherence and healthier lifestyle behaviors compared with those receiving standard care over 18 months. Further investigations are warranted to evaluate the cost‐effectiveness and generalizability of this intervention. Trial Registration: ClinicalTrials.gov identifier: NCT03527719

Objective To overview the colonoscopy adherence in cascade screening of colorectal cancer (CRC) and evaluate potential influence of the initial tests based on an ecological evaluation. Methods The performance of the initial screening tests and adherence to subsequent colonoscopy were extracted from relevant studies published up to 16 October 2020. The age-standardised incidence (ASRi) of CRC in populations in the year of screening was derived from the Cancer Statistics. Results One hundred sixty-six observational studies and 60 experimental studies were identified. Most studies applied cascade screening with faecal occult blood tests (FOBTs) as an initial test. The adherence to colonoscopy varied greatly across populations by continents, gross national income and type of initial tests, with a median (interquartile range) of 79.8% (63.1%-87.8%) in observational studies and 82.1% (66.7%-90.4%) in randomised trials. The adherence was positively correlated with the ASRi of CRC (r = 0.145, p = 0.023) and positive predictive value (PPV) of the initial tests (r = 0.206, p = 0.002) in observational studies and correlated with ASRi of CRC (r = 0.309, p = 0.002) and sensitivity of the initial tests (r = -0.704, p = 0.003) in experimental studies. Conclusions Adherence to colonoscopy varies greatly across populations and is related with performance of the initial tests, indicating the importance to select appropriate initial tests.

Objectives: To evaluate the reliability, validity, and responsiveness of the Chinese Learning Accomplishment Profile in China. Methods: 12,098 participants aged from 0 to 36 months from 30 provinces (mostly from Shanghai) in China were enrolled between 2013 and 2020. The reliability was reflected by Pearson correlation coefficients, Cronbach’s alpha coefficients and standard errors; the validity was shown by the coefficients between the dimensions, and we also evaluated the responsiveness as a supplement to the validity. Results: Reliability: in six domains among each subgroup, Pearson correlation coefficients between developmental age and chronological age ranged from 0.89 to 0.98, Cronbach’s alpha coefficients from 0.71 to 0.99, and standard errors from 0.15 to 2.76. Validity: after controlling for chronological age, the correlation coefficients between the dimensions were between 0.18 and 0.78, and most of them were below 0.70. Responsiveness: developmental age of all domains obtained via the Chinese Learning Accomplishment Profile system changed significantly (p < 0.001) with time (gap of 1–3 months), and the standardized response mean ranged from 0.66 to 2.45. Conclusions: The Chinese Learning Accomplishment Profile is suitable for assessing children’s development in Shanghai, but still needs confirmation when used in other provinces in China due to the great differences between regions in China.

Background: To save assessment time and improve the efficiency, it is necessary to find sensitive indicators from the test items of gross motor development in the C-LAP system for children aged 24~36 months and analyze the influencing factors of the passing rate of these indicators. Methods: This retrospective study was conducted among 1354 toddlers (3058 person-times) aged 24 to 36 months in Beijing, Shanghai, Guangdong between January 2013 and December 2019. A linear regression model and Cox regression model were performed to screen sensitive indicators and explore their influencing factors, respectively. Results: “Walk backwards”, “Stand from supine position” and “Hop with one foot at least twice” are the three sensitive indicators for evaluating the development of gross motor function in 24~36 month old children. The child’s physiological age at first measurement and region are the two common independent factors influencing the passing rate of the three items, while paternal age and education may influence one or two of them. Conclusions: “Walk backwards”, “Stand from supine position” and “Hop with one foot at least twice” are sensitive indicators for the effective evaluation of the development of gross motor function in 24~36 month old children, and their passing rates are influenced by some demographic variables.

Objective: To construct a simple model containing predictors derived from Chinese Learning Accomplishment Profile (C-LAP) to better the evaluation of the social–emotional development of toddlers aged 24–36 months. Method: The test results by C-LAP system and demographic information of toddlers aged 24–36 months were collected between 2013 and 2019 in Shanghai, China, whose guardians were voluntary to accept the investigation. We developed a norm with the dataset based on the study population. With the norm, stepwise regression and best subset analysis were applied to select predictors. Results: Relying on the norm established and stepwise regression and also the best subset analysis, an optimal model containing only 6 indicators was finally determined and the nomogram of the model was constructed. In the training and validation dataset, the AUCs of the optimal model were 0.95 (95% CI: 0.94–0.96) and 0.88 (95% CI: 0.85–0.90), respectively. When the cutoff point of the model was set at 0.04, its sensitivity in training and validation dataset was 0.969 and 0.949, respectively, and the specificity in training and validation dataset is 0.802 and 0.736, respectively. Conclusion: A simplified predictive model which includes only 6 items derived from C-LAP is developed to evaluate the probabilities of being at risk of developmental problem in social–emotional development for toddlers aged 24–36 months. Meanwhile, specificity and sensitivity of the model may be high enough for future fast screening.