Investing in disadvantaged children for common prosperity in China

Figures & data

Table 1. Data sources.

No.	Source	Location	Sample size	No. of waves	No. of untreated observations
1	Shanghai Birth Cohort	Urban areas in Shanghai	2,145	1	2,145
		Rural areas in Shanghai (Chongming)	703	1	703
2	Birth cohorts from rural areas of Central and Western China	Rural areas of Shaanxi Province	1,801	4	5,641
		Rural areas of Shaanxi Province	2,929	3	3,996
		Rural areas of Yunnan and Hebei Provinces	449	3	815
		Rural areas of Yunnan Province	1,026	2	1,490
Total			9,053		14,807

Note. The birth cohort samples from rural areas in Central and Western China were collected in the context of cluster-randomized controlled trials. Untreated observations are the baseline and follow-up assessments of caregiver-child dyads assigned to the control group.

Table 2. Demographic characteristics of the study sample (N = 9,053).

	Shanghai (including Chongming; n = 2,848)	Rural study sites in Central and Western China (n = 6,205)	Overall (N = 9,053)	Difference between (1) and (2)
	(1)	(2)	(3)
Characteristic	n (%) or M ± SD	n (%) or M ± SD	n (%) or M ± SD	p-Value
Child
Child sex^a
Male	1,481 (51.7%)	3,232 (52.1%)	4,713 (52.0%)	.903
Female	1,384 (48.3%)	2,973 (47.9%)	4,357 (48.0%)
Preterm birth (<37 weeks of gestation)^a
No	2,644 (94.9%)	5,796 (93.4%)	8,440 (93.9%)	<.001
Yes	142 (5.1%)	409 (6.6%)	551 (6.1%)
Child is first born (n = 7,549)^a
Yes	2,093 (85.6%)	2,639 (51.7%)	4,732 (62.7%)	<.001
No	351 (14.4%)	2466 (48.3%)	2,817 (37.3%)
Household
Maternal age (n = 8,653)^b	28.7 ± 3.7	27.3 ± 5.0	27.7 ± 4.6	< 001
Maternal education level (in years) (n = 8,564)^a
Junior high school or below (≤ 9 years)	48 (1.9%)	4,909 (80.3%)	4,957 (57.9%)	<.001
Senior high school (10–12 years)	783 (32.0%)	871 (14.2%)	1654 (19.3%)
College (13–16 years)	1,304 (53.2%)	223 (3.6%)	1,527 (17.8%)
Postgraduate education (≥16 years)	316 (12.9%)	110 (1.8%)	426 (5.0%)
Self-reported socioeconomic status (n = 8,564)^a
Very well off	459 (19.4%)	0 (0%)	459 (5.4%)	<.001
Fairly well off	1,635 (69.1%)	0 (0%)	1,635 (19.1%)
Fairly poor	248 (10.5%)	1,745 (71.8%)	1,993 (23.3%)
Very poor	26 (1.1%)	4,445 (28.2%)	4,471 (52.2%)

Note. ^aMeans compared by chi-square test; ^bMeans compared by Student’s t-test.

Table 3. Rural-urban differences in ECD outcomes.

	Urban study site in Eastern China (Shanghai)		Rural study site in Eastern China (Chongming)		Rural study sites in Central and Western China
	(1)		(2)		(3)
Bayley score	n	M ± SD	n	M ± SD	n	M ± SD	Difference in means (1)–(2)	Difference in means (1)–(3)	Difference in means (2)–(3)
Bayley cognition composite score	2,145	124.6 ± 19.3	703	92.3 ± 11.8	11,942	93.3 ± 16.8	32.3***	31.3***	−1.0
Bayley language composite score	2,144	101.3 ± 15.3	703	84.5 ± 9.8	6,292	95.6 ± 13.9	16.8***	5.7***	−11.1***
Bayley motor composite score	2,144	110.7 ± 15.2	703	99.0 ± 9.5	11,909	99.2 ± 18.7	11.7***	11.5***	−0.2

* p<.10; **p<.05; ***p<.01.

Figure 1. Prevalence of delay (n = 14,807).

Figure 2. Mean ECD scores and prevalence of delay over age (in rural sample from Western China; n = 1,801).

Table 4. Differences in ECD outcomes based on child and household characteristics.

	Bayley cognition composite score		Bayley language composite score		Bayley motor composite score
Characteristic	Shanghai (including Chongming)	Rural study sites in Central and Western China	Shanghai (including Chongming)	Rural study sites in Central and Western China	Shanghai (including Chongming)	Rural study sites in Central and Western China
Child sex
Boys	114.9 ± 22.5	87.2 ± 18.1	95.0 ± 15.6	97.6 ± 12.1	106.4 ± 14.5	104.1 ± 17.0
Girls	118.7 ± 22.4	89.8 ± 18.4	99.6 ± 15.8	101.6 ± 13.0	109.4 ± 15.1	106.0 ± 16.8
p-Value of difference in means	<.001	<.001	<.001	<.001	<.001	.002
Preterm birth (<37 weeks of gestation)
No	116.7 ± 22.4	88.8 ± 18.2	97.3 ± 15.9	99.7 ± 12.8	108.0 ± 15.0	105.3 ± 16.9
Yes	118.0 ± 23.3	84.5 ± 19.0	94.9 ± 16.3	96.2 ± 9.9	106.4 ± 15.3	101.0 ± 17.0
p-value of difference in means	.508	.001	.077	.015	.233	<.001
Maternal educational attainment
Postgraduate (≥16 years)	125.1 ± 19.8	100.5 ± 15.3	102.7 ± 15.1	109.2 ± 15.7	111.0 ± 16.1	110.1 ± 14.1
College (13–16 years)	119.7 ± 21.6	96.8 ± 15.2	99.2 ± 15.8	105.3 ± 11.1	109.0 ± 15.1	110.8 ± 16.5
Senior high school (10–12 years)	107.1 ± 22.2	94.1 ± 16.7	91.5 ± 14.8	102.4 ± 14.3	104.8 ± 14.2	107.4 ± 16.3
Junior high school or below (≤9 years)	94.8 ± 17.3	87.2 ± 18.2	81.3 ± 12.0	98.5 ± 12.1	99.5 ± 11.5	104.2 ± 17.1
p-Value of difference in means	<.001	<.001	<.001	<.001	<.001	.003
Self-reported socioeconomic status (SES)
Very well off	118.8 ± 22.5		99.9 ± 16.5		110.2 ± 15.6
Fairly well off	115.7 ± 22.5		96.7 ± 15.6		107.5 ± 14.8
Fairly poor	113.5 ± 22.7	94.7 ± 15.7	94.4 ± 16.1	102.1 ± 14.0	105.2 ± 14.7	108.2 ± 15.9
Very poor	104.2 ± 21.1	86.5 ± 18.6	87.8 ± 17.5	98.3 ± 11.9	101.8 ± 12.2	104.0 ± 17.2
p-Value of difference in means	<.001	<.001	<.001	<.001	<.001	<.001

Figure 3. Mean ECD scores over age by subgroup (in rural sample from Western China; n = 1,801).

Figure 4. Summary of regression analyses testing for treatment impacts of parental training program on ECD outcomes, parenting beliefs, and parental investment. Note. This figure presents ITT effects of cluster-randomized parenting experiments on ECD outcomes, parenting beliefs, and parental investment. The dependent variables are expressed in standardized z-scores (with a mean of 0 and SD of 1). The ITT effects are estimated using an ANCOVA specification. We control for the outcome variable of interest at baseline, control covariates, and study, cohort, and province fixed effects. Standard errors are clustered at the village-level.

Table 5. Mediation analysis of impacts of parental training programs on ECD outcomes (in rural areas of Central and Western China).

	Bayley cognition raw z-score				Bayley language raw z-score				Bayley motor raw z-score
Variable	(1)	(2)	(3)	(4)	(1)	(2)	(3)	(4)	(1)	(2)	(3)	(4)
Treatment assignment (1= treatment; 0 = control)	0.20***	0.18***	0.16***	0.15***	0.09*	0.07	0.05	0.04	0.08*	0.06	0.06	0.06
	(0.05)	(0.05)	(0.05)	(0.05)	(0.05)	(0.05)	(0.05)	(0.05)	(0.04)	(0.04)	(0.04)	(0.04)
	[0.10–0.30]	[0.08–0.27]	[0.07–0.26]	[0.06–0.25]	[−0.01–0.18]	[−0.03–0.16]	[−0.04–0.14]	[−0.05–0.13]	[−0.01–0.16]	[−0.02–0.15]	[−0.02–0.15]	[−0.03–0.14]
Parenting beliefs factor z-score		0.12***		0.09***		0.11***		0.08***		0.06***		0.05**
		(0.02)		(0.02)		(0.02)		(0.02)		(0.02)		(0.02)
		[0.07–0.16]		[0.05–0.13]		[0.08–0.15]		[0.05–0.12]		[0.02–0.10]		[0.01–0.10]
Parental investment factor z-score			0.12***	0.11***			0.15***	0.13***			0.04**	0.03*
			(0.02)	(0.02)			(0.02)	(0.02)			(0.02)	(0.02)
			[0.09–0.16]	[0.07–0.14]			[0.12–0.18]	[0.10–0.17]			[0.01–0.07]	[-0.00-–0.06]
No. of observations	2,800	2,800	2,800	2,800	2,569	2,569	2,569	2,569	2,800	2,800	2,800	2,800
Adjusted R^2	0.12	0.13	0.14	0.14	0.13	0.14	0.15	0.15	0.08	0.08	0.08	0.08
Oster’s $\delta$		3.77	8.79			5.58	8.74			9.18	6.50

Note. In all regressions, we control for children’s sex, children’s age (in months), whether the child was born prematurely, whether the mother was the primary caregiver, parental age (in months), and province, cohort, and study fixed effects. All standard errors (in brackets) are clustered at the village-level; 95% confidence intervals are reported in square brackets. Oster’s $\delta$ is reported under the condition that the treatment effect is zero. We assume $R_{\mathit{\text{max}}}=1.3R^2$, as suggested by OOster (2019).

* p<.10; **p<.05; ***p<.01

Table 6. Breakdown of total program impacts on ECD outcomes.

		Bayley cognition z-score	Bayley language z-score	Bayley motor z-score
Effect	Notation	(1)	(2)	(3)
Total mediated ITT effect	${\mu }_{\mathit{\text{ITT}}}$	0.044	0.045	0.017
		[0.029–0.062]	[0.030–0.062]	[0.006–0.029]
ITT effect mediated through parenting beliefs		0.016	0.014	0.01
		[0.007–0.027]	[0.007–0.026]	[0.003–0.020]
ITT effect mediated through parental investment		0.024	0.026	0.007
		[0.014–0.036]	[0.015-0.040]	[-0.001–0.015]
ITT effect mediated through parenting beliefs and parental investment		0.004	0.005	0.001
		[0.002–0.007]	[0.003–0.008]	[-0.000–0.003]
Unmediated ITT effect	${\upsilon }_{\mathit{\text{ITT}}}$	0.151	0.04	0.057
		[0.079–0.221]	[-0.032–0.118]	[-0.007–0.132]
Total ITT effect	${\tau }_{\mathit{\text{ITT}}}$	0.195	0.085	0.075
		[0.123–0.266]	[0.012–0.163]	[0.008–0.146]
% Of ${\tau }_{\mathit{\text{ITT}}}$ mediated		22.3%	53.0%	23.2%
		[20.8–23.9%]	[51.0–54.9%]	[21.6–24.8%]
% Of ${\tau }_{\mathit{\text{ITT}}}$ mediated through parenting beliefs		8.2%	16.5%	12.7%
		[7.2–9.3%]	[15.1–18.0%]	[11.5–14.0%]
% Of ${\tau }_{\mathit{\text{ITT}}}$ mediated through parental investment		12.1%	30.8%	9.0%
		[10.9–13.3%]	[29.0–32.7%]	[7.9–10.1%]
% Of ${\tau }_{\mathit{\text{ITT}}}$ mediated through parenting beliefs and parental investment		2.0%	5.7%	1.5%
		[1.5–2.6%]	[4.8–6.6%]	[1.1–2.1%]
No. of observations		2,800	2,569	2,800

Figure A.1. Scree plots of the eigenvalues of the principal components of parenting beliefs and parental investment.

Table A.1. Exploratory factor analysis to determine the number of latent factors.

Variable	Cattell’s scree plot	Horn’s parallel analysis
Parenting beliefs	1	1
Parental investment	1	1

Table A.2. Estimated factor loadings and communality.

Factor	Factor loading	Signal-to-noise ratio
Parenting beliefs factor
Acknowledges importance of play for child development	1	0.21
Knows how to play with child	1.30	0.35
Acknowledges importance of reading for child development	1.13	0.27
Knows how to read books to child	1.27	0.37
Acknowledges importance of stimulative home environment	0.58	0.12
Parental investment factor
Uses toys to play with child on a daily frequency	1	0.10
Tells stories to child on a daily frequency	1.88	0.64
Sings songs to child on a daily frequency	1.10	0.13
Reads books to child on a daily frequency	1.40	0.55
No. of picture books for children at home	7.28	0.08

Note. We normalize the factor loading of the first measure for each factor to 1. The signal-to-noise ratio is the extent to which the variance in each of the outcome measures is driven by signal relative to noise.

Figure B.1. Trial profiles of the three intervention studies. Note: In the home visitation program in Shaanxi Province, 79 caregiver-child dyads in treatment group villages were randomly assigned to control at the individual level. As shown in Sylvia et al. (2021), no evidence was detected of spillover effects of the parenting intervention on child development or parenting outcomes of the untreated households in treatment group villages. In addition, in the study in Panel A, the Griffith Mental Development Scales were administered instead of the Bayley scales to assess ECD outcomes of n = 300 children. This subsample is excluded from the evaluation sample.

Table B.1. Baseline characteristics by study arm.

	Full sample	Control	Treatment	(2) vs. (3), p-Value
	(1)	(2)	(3)
Panel A: Child characteristics
Child is male (1 = yes; 0 = no)	0.516	0.527	0.505	.133
	(0.008)	(0.012)	(0.009)
Age (in months)	14.029	14.173	13.897	.700
	(0.127)	(0.203)	(0.153)
Child belongs to ethnic minority (1 = yes; 0 = no)	0.038	0.034	0.041	.753
	(0.009)	(0.012)	(0.014)
Child is firstborn (1 = yes; 0 = no)	0.475	0.470	0.480	.491
	(0.011)	(0.016)	(0.014)
Prematurely born (1 = yes; 0 = no)	0.053	0.049	0.056	.312
	(0.004)	(0.005)	(0.005)
Birthweight <2.5 kg (1 = yes; 0 = no)	0.044	0.044	0.044	.959
	(0.004)	(0.006)	(0.005)
Bayley cognition raw z-score	−0.023	−0.019	−0.026	.731
	(0.026)	(0.035)	(0.039)
Bayley language raw z-score	0.000	−0.017	0.016	.632
	(0.028)	(0.035)	(0.042)
Bayley motor raw z-score	−0.002	0.018	−0.020	.451
	(0.030)	(0.038)	(0.045)
Panel B: Household characteristics
Mother at home (1 = yes; 0 = no)	0.794	0.803	0.786	.321
	(0.009)	(0.013)	(0.013)
Maternal age (in years)	27.882	27.833	27.927	.920
	(0.122)	(0.175)	(0.170)
Maternal education (in years)	9.350	9.341	9.357	.884
	(0.079)	(0.117)	(0.106)
Household SES score	2.866	2.751	2.972	.322
	(0.093)	(0.137)	(0.126)
Recipient of social security support packages (‘dibao’; 1 = yes; 0 = no)	0.111	0.111	0.112	.692
	(0.007)	(0.009)	(0.010)
No. of observations	3,456	1,658	1,798

Notes: p-Values account for clustering at the village level and for stratification at the cohort level. An omnibus test across all baseline covariates shows that the two groups are well balanced at baseline. We test this by regressing the indicator of treatment assignment on the complete set of baseline characteristics and testing whether the coefficients are jointly equal to zero (p-value = .482).

Table B.2. Baseline characteristics of stayers by study arm.

	Full sample	Control	Treatment	(2) vs. (3), p-Value
	(1)	(2)	(3)
Panel A: Child characteristics
Child is male (1 = yes; 0 = no)	0.506	0.523	0.492	.076
	(0.009)	(0.014)	(0.012)
Age (in months)	14.205	14.361	14.067	.733
	(0.139)	(0.229)	(0.162)
Child belongs to ethnic minority (1 = yes; 0 = no)	0.042	0.042	0.042	.945
	(0.010)	(0.015)	(0.014)
Child is firstborn (1 = yes; 0 = no)	0.461	0.459	0.463	.703
	(0.012)	(0.018)	(0.015)
Prematurely born (1 = yes; 0 = no)	0.053	0.052	0.054	.702
	(0.004)	(0.007)	(0.006)
Birthweight <2.5 kg (1 = yes; 0 = no)	0.044	0.045	0.044	.922
	(0.004)	(0.006)	(0.006)
Bayley cognition raw z-score	−0.023	−0.016	−0.029	.605
	(0.026)	(0.037)	(0.036)
Bayley language raw z-score	0.018	0.008	0.027	.851
	(0.029)	(0.037)	(0.043)
Bayley motor raw z-score	0.003	0.018	−0.010	.570
	(0.030)	(0.042)	(0.043)
Panel B: Household characteristics
Mother at home (1 = yes; 0 = no)	0.806	0.822	0.792	.101
	(0.009)	(0.012)	(0.014)
Maternal age (in years)	27.990	27.915	28.055	.838
	(0.133)	(0.187)	(0.188)
Maternal education (in years)	9.284	9.267	9.298	.922
	(0.082)	(0.123)	(0.110)
Household SES score	2.851	2.737	2.951	.420
	(0.094)	(0.139)	(0.126)
Recipient of social security support packages (‘dibao’; 1 = yes; 0 = no)	0.113	0.115	0.112	.839
	(0.007)	(0.010)	(0.010)
No. of observations	2,800	1,312	1,488

Notes: p-Values account for clustering at the village level and for stratification at the cohort level. An omnibus test across all baseline covariates shows that the two groups are well balanced at baseline. We test this by regressing the indicator of treatment assignment on the complete set of baseline characteristics and testing whether the coefficients are jointly equal to zero (p-value = .585).

Sylvia, Sean, Nele Warrinnier, Renfu Luo,  Ai Yue, Orazio Attanasio, Alexis Medina, and Scott Rozelle. 2021. “From  Quantity  to   Quality:  Delivering  a Home-Based  Parenting  Intervention  through  China’s  Family Planning Cadres.” The Economic Journal 131 (635): 1365–1400. https://doi.org/10.1093/ej/ueaa114

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