Social Science Research Scholar, Center on Food Security and Environment at FSI
Postdoc, Stanford University, Social Science (2018)
Phd, Northwest University, Economics (2016)
Effect of Chinese eye exercises on change in visual acuity and eyeglasses wear among school-aged children in rural China: a propensity-score-matched cohort study.
BMC complementary medicine and therapies
2020; 20 (1): 82
BACKGROUND: Daily "eye exercises," massaging of periocular acupuncture pressure points, have been part of China's national vision care policy in schools for some 50years. However, the effect of eye exercises on myopia progression and eyeglasses wear has not been definitively investigated. This study evaluates the effectiveness of eye exercises on visual acuity and the propensity of rural children to wear eyeglasses.METHODS: Cohort study in 252 randomly-selected rural schools with baseline in September 2012 and follow up surveys 9 and 21months later. Outcomes were assessed using propensity-score matching (PSM), multivariate linear regression and logistic regression to adjust for differences between children performing and not performing eye exercises.RESULTS: Among 19,934 children randomly selected for screening, 2374 myopic (spherical equivalent refractive error≤-0.5 diopters in either eye) children (11.9%, mean age 10.5 [Standard Error 1.08] years, 48.5% boys) had VA in either eye ≤6/12 without eyeglasses correctable to >6/12 with eyeglasses. Among these who completed the 21-month follow up, 1217 (58.2%) children reported practicing eye exercises on school days and 874 (41.8%) did not. After propensity-score matching, 1652 (79%) children were matched: 826 (50%) in the Eye Exercises group and 826 (50%) in the No Exercise group. Performing eye exercises was not associated with change in LogMAR uncorrected visual acuity and wear of eyeglasses, using either logistic regression or PSM at 9 or 21months.CONCLUSIONS: We found no evidence for an effect of eye exercises on change in vision or eyeglasses wear.TRIAL REGISTRATION: The original trial (Registration site: http://isrctn.org. Registration number: ISRCTN03252665) was retrospectively registered 25/09/2012.
View details for DOI 10.1186/s12906-020-2878-9
View details for PubMedID 32164649
Can School Feeding Programs Reduce Malnutrition in Rural China?
The Journal of school health
BACKGROUND: Childhood malnutrition is commonplace among poor rural communities in China. In 2012, China launched its first nationwide school-feeding program (SFP) to address this problem. This study examines the prevalence of malnutrition before and after the SFP and identifies possible reasons for the trends observed.METHODS: Ordinary least squares regression and propensity score matching were used to analyze data from 2 cross-sectional surveys of 100 rural primary schools in northwestern China. Participants were fourth-and fifth-grade students. Outcome measures include anemia rates, hemoglobin levels, body mass index, and height for age Z scores.RESULTS: Three years after implementation of the SFP, malnutrition rates among sample students had not fallen. The SFP had no statistically significant effect on either anemia rates or BMI, but was linked to an increase in the proportion of students with below normal height for age Z scores. Meals provided to students fell far short of national recommendations that the SPF should provide 40% of the recommended daily allowance of micronutrients.CONCLUSIONS: Despite significant budgetary outlays between 2012 and 2015, China's SFP has not reduced the prevalence of malnutrition among sample students. To make the SFP more effective, funding and human resources both need to be increased.
View details for DOI 10.1111/josh.12849
View details for PubMedID 31707745
- Do Resources Matter? Effects of an In-Class Library Project on Student Independent Reading Habits in Primary Schools in Rural China READING RESEARCH QUARTERLY 2019; 54 (3): 383–411
Impact of various types of near work and time spent outdoors at different times of day on visual acuity and refractive error among Chinese school-going children.
2019; 14 (4): e0215827
Various types of near work have been suggested to promote the incidence and progression of myopia, while outdoor activity appears to prevent or retard myopia. However, there is a lack of consensus on how to interpret these results and translate them into effective intervention strategies. This study examined the association between visual acuity and time allocated to various activities among school-going children.Population-based survey of 19,934 students in grade 4 and 5 from 252 randomly selected rural primary schools in Northwest China in September 2012. This survey measured visual acuity and collected self-reported data on time spent outdoors and time spent doing various types of near activities.Prolonged (>60 minutes/day) computer usage (-0.025 LogMAR units, P = .011) and smartphone usage (-0.041 LogMAR units, P = .001) were significantly associated with greater refractive error, while television viewing and after-school study were not. For time spent outdoors, only time around midday was significantly associated with better uncorrected visual acuity. Compared to children who reported no midday time outdoors, those who spent time outdoors at midday for 31-60 minutes or more than 60 minutes had better uncorrected visual acuity by 0.016 LogMAR units (P = .014) and 0.016 units (P = .042), respectively.Use of smart phones and computers were associated with declines in children's vision, while television viewing was not. Statistically significant associations between outdoor time at midday and reduced myopia may support the hypothesis that light intensity plays a role in the protective effects of outdoor time.
View details for PubMedID 31026279
- Can reading programs improve reading skills and academic performance in rural China? CHINA ECONOMIC REVIEW 2018; 52: 111–25
- Assessing college critical thinking: preliminary results from the Chinese HEIghten (R) Critical Thinking assessment HIGHER EDUCATION RESEARCH & DEVELOPMENT 2018; 37 (5): 999–1014
- Can Social-Emotional Learning Reduce School Dropout in Developing Countries? JOURNAL OF POLICY ANALYSIS AND MANAGEMENT 2016; 35 (4): 818-?
- Developing instruments to assess and compare the quality of engineering education: the case of China and Russia ASSESSMENT & EVALUATION IN HIGHER EDUCATION 2016; 41 (5): 770-786
Survey using incognito standardized patients shows poor quality care in China's rural clinics.
Health policy and planning
2015; 30 (3): 322-333
Over the past decade, China has implemented reforms designed to expand access to health care in rural areas. Little objective evidence exists, however, on the quality of that care. This study reports results from a standardized patient study designed to assess the quality of care delivered by village clinicians in rural China. To measure quality, we recruited individuals from the local community to serve as undercover patients and trained them to present consistent symptoms of two common illnesses (dysentery and angina). Based on 82 covert interactions between the standardized patients and local clinicians, we find that the quality of care is low as measured by adherence to clinical checklists and the rates of correct diagnoses and treatments. Further analysis suggests that quality is most strongly correlated with provider qualifications. Our results highlight the need for policy action to address the low quality of care delivered by grassroots providers.
View details for DOI 10.1093/heapol/czu014
View details for PubMedID 24653216
- Mental health and dropout behavior: A cross-sectional study of junior high students in northwest rural China INTERNATIONAL JOURNAL OF EDUCATIONAL DEVELOPMENT 2015; 41: 1-12
- The Han-Minority Achievement Gap, Language, and Returns to Schools in Rural China ECONOMIC DEVELOPMENT AND CULTURAL CHANGE 2015; 63 (2): 319-359
- The impact of pay-for-percentile incentive on low-achieving students in rural China ECONOMICS OF EDUCATION REVIEW 2020; 75
Effect of Chinese Eye Exercises on Change in Visual Acuity and Eyeglasses Wear Among School-aged Children in Rural China
ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2019
View details for Web of Science ID 000488800701084
- The cost-effectiveness of alternative vision screening models among preschool children in rural China ACTA OPHTHALMOLOGICA 2019; 97 (3): E419–E425
- Impact of various types of near work and time spent outdoors at different times of day on visual acuity and refractive error among Chinese school-going children PLOS ONE 2019; 14 (4)
The Effect of Providing Free Eyeglasses on Children's Mental Health Outcomes in China: A Cluster-Randomized Controlled Trial.
International journal of environmental research and public health
2018; 15 (12)
If children with common vision problems receive and use eyeglasses, their educational performance rises. Without proper treatment, visually impaired children may not achieve educational gains and could suffer from poor mental health. We use a randomized controlled trial to study the impact of an eyeglasses promotion program in rural China on the mental health of myopic primary school students. Three measures of mental health are used: learning anxiety, physical anxiety, and scores on the Mental Health Test (MHT). Our empirical analysis showed that on average, the treatment has small and insignificant for learning anxiety and MHT, and a small but significant reduction in physical anxiety. However, subgroup analysis reveals that myopic students who study more intensively see their learning anxiety and physical anxiety reduced after being provided with eyeglasses. In contrast, students with the lower study intensity suffer a rise in learning anxiety after receiving eyeglasses. A potential mechanism for the differing impacts is the increase in teasing reported among low study-intensity students that does not occur for high study-intensity students. Care should be taken to maximize the benefits and minimize the costs of in-school vision programs.
View details for PubMedID 30563118
- The Effect of Providing Free Eyeglasses on Children's Mental Health Outcomes in China: A Cluster-Randomized Controlled Trial INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15 (12)
The cost-effectiveness of alternative vision screening models among preschool children in rural China.
PURPOSE: To explore the accuracy and cost-effectiveness of three vision screening models among preschool children in rural China.METHODS: Vision screening was carried out among children aged 4-5years in 65 preschools in two counties in Northwest China, using Crowded Single Lea Symbols to test visual acuity. Children were assigned randomly by school to one of three screening models: screening by teachers (15 schools, 1835 children), local optometrists (30 schools, 1718 children) or volunteers (20 schools, 2183 children). Children identifying ≥2 symbols incorrectly in either eye failed screening. Accuracy of screening was compared with screenings executed by experienced optometrists among 141 children selected randomly from the three screening models. Direct and indirect costs for each model were assessed. Costs to detect a true case failed screening were estimated.RESULTS: The sensitivity for three models ranged from 76.9% to 87.5%, specificity from 84.9% to 86.7% and standardized positive predictive value from 83.7% to 85.7%. None differed significantly between models. The costs per case detected were $37.53, $59.14 and $52.19 for the teachers, local optometrists and volunteers. In producing the cost estimates for teacher screening and local optometrist screening models, we used a salary payment that was identical for both models (with the salary being equal to that of the optometrist). The teacher screening model was the most cost-effective.CONCLUSION: Accuracy of screening by teachers, local optometrists and volunteers was the same in this setting, but the use of teachers was most cost-effective, reducing the cost per case detected by almost 40%.
View details for PubMedID 30345728
Health Seeking Behavior among Rural Left-Behind Children: Evidence from Shaanxi and Gansu Provinces in China
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
2018; 15 (5)
More than 60 million children in rural China are “left-behind”—both parents live and work far from their rural homes and leave their children behind. This paper explores differences in how left-behind and non-left-behind children seek health remediation in China’s vast but understudied rural areas. This study examines this question in the context of a program to provide vision health care to myopic rural students. The data come from a randomized controlled trial of 13,100 students in Gansu and Shaanxi provinces in China. The results show that without a subsidy, uptake of health care services is low, even if individuals are provided with evidence of a potential problem (an eyeglasses prescription). Uptake rises two to three times when this information is paired with a subsidy voucher redeemable for a free pair of prescription eyeglasses. In fact, left-behind children who receive an eyeglasses voucher are not only more likely to redeem it, but also more likely to use the eyeglasses both in the short term and long term. In other words, in terms of uptake of care and compliance with treatment, the voucher program benefitted left-behind students more than non-left-behind students. The results provide a scientific understanding of differential impacts for guiding effective implementation of health policy to all groups in need in developing countries.
View details for PubMedID 29710797
The Han-Minority Achievement Gap, Language, and Returns to Schools in Rural China.
Economic development and cultural change
2015; 63 (2): 319–59
View details for PubMedID 25635143
- Dormitory management and boarding students in China's rural primary schools CHINA AGRICULTURAL ECONOMIC REVIEW 2014; 6 (3): 523-550