Effects of Boarding on Physical Growth and Nutrition Health of Disadvantaged Preschool Children

• In Event: Poster Session 10
  In Poster Session: PS 10 Topic - Health, Growth, Injury

Abstract

Background
Boarding school is one type of institutional childcare. Children under institutional childcare run the risk of being structurally neglected, especially when the institution is lack of resources (van IJzendoorn et al., 2011). While rarely noted in other countries, boarding preschools are not uncommon in China (Sun & Li, 2013). Children aged as young as 3 years typically arrive at school on Sunday evenings, stay at the school throughout the weekdays, and return home on Friday afternoons. Early institutionalized experience in children’s first year of life was related to delay in physical growth (van IJzendoorn, Bakermans-Kranenburg, & Juffer, 2007). Whereas research on rural school-age children in China found that boarding was related to malnutrition and retarded development (Chen, Pei, & Zhao, 2018; Luo, Shi, Zhang, Liu, Rozelle, & Sharbono, 2009; Wang, Medina, Luo, Shi, & Yue, 2016), little evidence was noted on the effect of boarding on preschoolers. Through comparing the physical development of boarding and non-boarding students longitudinally, the current study aimed to examine the effect of boarding on physical growth and nutrition health of rural preschoolers in China.

Research Questions
The study explored (1) How was boarding related to preschoolers’ physical growth outcomes? (2) What was the prevalence of malnutrition in the boarding and non-boarding population? (3) Was boarding related to the risk of malnutrition? (4) Did age, sex and food intake need moderate the relation between boarding and child outcomes?

Method
A total of 265 rural pre-school children (136 boarders and 129 non-boarders) and their parents were recruited from Yunan, China and were followed up twice (Time 1 [T1], Time 2 [T2]) with one-year gap in between. The average age of the pre-schoolers was 50.85 months (SD =6.41) at T1. Their height, weight and head circumference were measured by trained research assistants at both T1 and T2. Z-scores for heights, weight, head circumference and body mass index (BMI) were calculated with reference to WHO norm-for-age, and cases of malnutrition were identified using cutoffs suggested by WHO (WHO, 2008). Demographics and food intake need of the children (Luo et al., 2009) were based on parent report.

Results
Boarding was associated with more extreme values in all the measure except head circumference-for-age (CAZ) (see Table 1). Moreover, boarding was associated with lower height-for-age (HAZ) and higher BMI-for-age (BAZ). The prevalence of malnutrition for boarders was higher (see Table 2). Malnutrition was 5.276 (95%CI [2.259, 12.324]) times more likely to happen for boarders as compared to non-boarders at T2 after controlling for baseline and demographics. Sex difference was only noted for weight-for-age (WAZ), with boarding associated with lower WAZ for boys but not for girls. The negative impact of boarding on HAZ was larger for children with more food intake needs. No moderating effect of age was noted.

Conclusion
Boarding was associated with delayed growth, obesity, and increased risk of malnutrition for rural pre-schoolers in China. Differences in food-intake patterns between boarding school and home contexts might partially explaining the divergence.

Keywords: boarding preschool; physical growth, nutrition health; rural China

Authors

• Nan XIAO, Ohio State University
  Presenting Author

• Xiao Zhang, The University of Hong Kong
  Non-Presenting Author