Since 2019, three types of HPV vaccine have been approved for use in mainland China. High quality messages are crucial for vaccine acceptance, but little is known about the online information quality concerning HPV vaccine in China. "HPV vaccine" and "cervical cancer vaccine" in the form of Chinese were used as keywords through search engines from personal computer (PC), portable mobile device (PMD), and WeChat Public Accounts in 2019. Readability, information content, as well as DISCERN scores were evaluated for each message included. Characteristics associated with quality indicators of the messages were also analyzed. A total of 294 messages from PC engines (104, 35%), PMD engines (128, 43%) and WeChat (62, 21%) were assessed. Most (269, 91%) messages required at least undergraduate readability level. The most frequently reported theme was HPV vaccine and its function (273, 93%), while the least was information regarding quality, safety and side effects (129, 44%). The frequency of messages with at least one error was 132 (45%). The median of sum DISCERN scores was 42 (IQR = 14), and only one (< 1%) message showed good DISCERN quality. Messages retrieved from PC engines and those with pictures were of better overall quality. The overall quality of HPV vaccine-related online messages in Chinese websites was not optimal. Government and health professionals should promote information quality construction to improve the status of HPV vaccination messages online.

Some studies have found associations between the peer network and childhood obesity. The present study aimed to analyze the association of the peer network with obesity-related cognition, behaviors and adiposity indicators, and explore whether peer network influences the effect of a childhood-obesity intervention. Based on DECIDE-Children, 1392 children’s friendship nominations within the class were collected and peer network indicators including the network size, network density, and in- and out-degree centrality were calculated. The linear mixed model was used to analyze the association between peer network indicators and children’s cognition, behaviors and adiposity indicators (body mass index (BMI), BMI z score, the prevalence of overweight and obesity). Children with a higher in-degree centrality had 34.4% (95%CI: 17.4% to 48.1%) lower risk of overweight or obesity. The baseline degree centrality was inversely associated with the BMI and BMI z score at the end of the trial. For each unit increase in in-degree centrality at baseline, the BMI at the end of the trial decreased by 0.047 (95%CI: 0.015 to 0.080), and the BMI z score decreased by 0.015 (95%CI: 0.003 to 0.028). Children’s popularity reflected by centrality in their peer network was associated with cognition, behaviors, and adiposity indicators. Future childhood-obesity intervention research could pay more attention to socially inactive children.

Some studies have found associations between dietary quality and obesity and their concurrent changes were observed in a few interventions. The present study aimed to assess the effect of a multifaceted intervention for childhood obesity on dietary quality and examine the mediating effect of dietary quality between the intervention and changes in adiposity indicators. Based on the social ecological model, the cluster randomized controlled trial included five components (three targeted children and two targeted their environment). In total, 1176 children from three cities in China participated in a baseline (2018) and end-of-trial (2019) examination, including 605 children in the intervention group and 571 in the control group. Self-reported behavior and anthropometric measures were collected at both time points. The Diet Balance Index Revision (DBI-07) was calculated to assess dietary quality. Generalized linear mixed models were used to estimate the intervention effect on dietary quality and its mediating effects were examined. Compared to the controls, the proportion of sugar-sweetened beverage (SSB) intake (OR = 0.27, p < 0.001, corrected p < 0.001) decreased in the intervention group. Higher bound scores (HBS) of the DBI-07 indicating over-intake decreased in the intervention group compared to the controls (mean difference = −1.52, p = 0.005, corrected p = 0.015). Changes in the HBS partially mediated the associations between the intervention and changes in body mass index, waist circumference, and body fat percentage. Future intervention should promote knowledge, attitudes, and behaviors related to dietary quality.

Early identification of children with neurodevelopmental abnormality is a major challenge, which is crucial for improving symptoms and preventing further decline in children with neurodevelopmental abnormality. This study focuses on developing a predictive model with maternal sociodemographic, behavioral, and medication-usage information during pregnancy to identify infants with abnormal neurodevelopment before the age of one. In addition, an interpretable machine-learning approach was utilized to assess the importance of the variables in the model. In this study, artificial neural network models were developed for the neurodevelopment of five areas of infants during the first year of life and achieved good predictive efficacy in the areas of fine motor and problem solving, with median AUC = 0.670 (IQR: 0.594, 0.764) and median AUC = 0.643 (IQR: 0.550, 0.731), respectively. The final model for neurodevelopmental abnormalities in any energy region of one-year-old children also achieved good prediction performance. The sensitivity is 0.700 (IQR: 0.597, 0.797), the AUC is 0.821 (IQR: 0.716, 0.833), the accuracy is 0.721 (IQR: 0.696, 0.739), and the specificity is 0.742 (IQR: 0.680, 0.748). In addition, interpretable machine-learning methods suggest that maternal exposure to drugs such as acetaminophen, ferrous succinate, and midazolam during pregnancy affects the development of specific areas of the offspring during the first year of life. This study established predictive models of neurodevelopmental abnormality in infants under one year and underscored the prediction value of medication exposure during pregnancy for the neurodevelopmental outcomes of the offspring.

Besides genetic factors and energy-related behaviors, psycho-cultural factors are also important in obesity etiology. Previous studies have suggested that improving body image might be an effective method for managing body weight. Thus, this study aimed to evaluate the effects of a multifaceted intervention on the body image of children and explore whether body image played a mediating role in changes in adiposity indicators. This study was embedded in a cluster randomized controlled trial, involving 1287 children from 24 primary schools in three cities in China (Beijing, Changzhi and Urumqi). The 9-month multifaceted intervention on childhood obesity included five components (three targeted children and two targeted environments), and randomization was performed by an independent person who was blinded to the schools. Two indicators (body size perception and body size expectation) were chosen to characterize body image and were measured by Ma figural stimuli at baseline and the end of the trial. Changes in body image indicators were classified as conducive to weight loss or not. Other anthropometric measures and self-reported behaviors were also collected at both time points. Generalized linear mixed models were used in the analyses. Compared to the controls (n = 648), the proportion of body size perception conducive to weight loss increased in the intervention group (n = 639), with an odds ratio of 2.42 (95%CI: 1.70~3.45, p < 0.001). The proportion of body size expectation conducive to weight loss also increased more in the intervention group than in the controls (OR = 1.74, 95%CI: 1.14~2.66, p = 0.010). In children whose baseline nutritional status was “normal weight with higher BMI” or “overweight/obese”, the improvements in body size perception and body size expectation partly mediated the association between the intervention and changes in BMI, BMI Z score, waist circumference and body fat percentage (p < 0.05). This multifaceted study effectively improved the body image of children, which, in turn, led to beneficial changes in adiposity indicators. For the first time, body size perception and body size expectation have been confirmed to be important factors associated with the beneficial effect of a childhood obesity intervention, suggesting that body image components should be generalized in the future.

Background/Objectives: Identifying the factors influencing compliance is essential to improve the effectiveness of interventions. However, no study has examined factors that influence the longitudinal patterns of obesity intervention compliance. We aim to identify the longitudinal trajectories of parental and child compliance using group-based trajectory modeling (GBTM) and assess the influencing factors. Methods: The Diet, ExerCIse, and CarDiovascular hEalth Children (DECIDE-Children) was a 9-month app-assisted obesity prevention intervention targeted 8–10-year-old children. Altogether, 684 child–parent pairs from the intervention group were included. Parents were required to use the mobile app to learn health knowledge, monitor children’s diet and exercise behaviors, manage children’s weight, and received the assessment results. Parental compliance was assessed as the monthly usage times and duration of the mobile app. For child compliance, we used data recorded by parents in the “behavior monitoring” module. We employed group-based trajectory modeling (GBTM) to identify distinct trajectories of parental and child compliance and examined their associations with childhood obesity outcomes. Univariate and multivariate logistic regressions were performed to identify the influencing factors associated with the identified compliance groups. Results: Distinct trajectory groups of parental and child compliance were identified. The compliance trajectories of parents and children are related to the extent of changes in the child’s obesity-related outcomes (waist circumference, waist-to-hip ratio, and body fat percentage. p < 0.05). A majority of parents were classified into the “relatively low compliance” group. Parents in this group was associated with having a daughter (OR: 1.95, 95% CI: 1.17, 3.31) and the father having a higher education level (OR: 1.65, 95% CI: 1.05, 2.60). For children, 20.2% were assigned to the “decreasing compliance” group. Children in this group were more likely to have a younger mother (OR: 1.05, 95% CI: 1.01, 1.10) and parents with poorer compliance (OR: 2.36, 95% CI: 1.16, 5.47). Conclusions: Both student and parental compliance were shown to influence the effectiveness of childhood obesity interventions, highlighting the need to prioritize the assessment and promotion of compliance in such interventions. Child sex, paternal educational level, and maternal age were identified as significant factors associated with compliance, while the level of family involvement was found to play a pivotal role in fostering healthy behaviors in children. These findings suggest that future intervention strategies should place greater emphasis on engaging families and providing targeted supervision and support for populations at risk of lower compliance in order to enhance intervention outcomes.