卫生研究

目的 了解南充偏远农村地区6～23月龄婴幼儿看护人的延迟辅食添加行为现状，从不同代际看护人视角探究其影响因素。方法 采用多阶段抽样方法，于2022年在南充市4个原国家级贫困县整群纳入6～23月龄婴幼儿及其看护人作为研究对象。通过自行设计的结构式问卷，利用平板电脑进行计算机辅助面对面访谈，共收集了800对婴幼儿及其看护人的社会人口学特征、辅食添加时间、辅食喂养知识、辅食喂养自我效能和社会支持等信息。基于WHO最新建议中婴幼儿满6月龄添加辅食是最佳时机，将延迟辅食添加行为定义为看护人在婴幼儿7月龄及以后开始添加辅食。运用二元Logistic回归模型及亚组分析，从不同代际视角深入探究婴幼儿看护人延迟辅食添加行为的影响因素。结果 最终纳入766对有效样本，婴幼儿中男婴375名(49.0%),女婴391名(51.0%);6～11月龄246名(32.1%),12～17月龄407名(51.1%),18～23月龄113名(14.8%)。看护人中201名(26.2%)为祖辈，565名(73.8%)为父辈；小学及以下文化程度243名(31.7%),初中268名(35.0%),高中及以上255名(33.3%)。222名(28.98%)看护人有延迟辅食添加行为，80名(39.8%)祖辈看护人、142名(25.13%)父辈看护人有延迟辅食添加行为。辅食喂养社会支持低(OR=2.73, 95%CI 1.13～5.24)的祖辈看护人更易发生延迟辅食添加行为，而辅食喂养知识水平低(OR=1.99, 95%CI 1.29～3.07)、辅食喂养自我效能低(OR=2.11, 95%CI 1.35～3.31)的父辈看护人更易发生延迟辅食添加行为。结论 2022年南充偏远农村地区婴幼儿祖辈看护人和父辈看护人延迟辅食添加行为的影响因素不同，辅食喂养社会支持是祖辈的影响因素，辅食喂养知识与自我效能是父辈的影响因素。

OBJECTIVE Clarify the status quo of delayed complementary food addition behavior among caregivers of infants aged 6-23 months in rural areas of Nanchong City, and explore its influencing factors from the perspective of different generations of caregivers.METHODS A multi-stage sampling method was used to enroll infants aged 6-23 months and their caregivers in four former national-level poor counties in Nanchong City, Sichuan Province in 2022. Through a self-designed structured questionnaire and computer-assisted face-to-face interview with a tablet computer, 800 pairs of infants and their caregivers were collected about their socio-demographic characteristics, caregivers' complementary food addition time, complementary food feeding knowledge, complementary food feeding self-efficacy and social support. Based on the latest WHO recommendation that the best time to add complementary foods is at the age of 6 months, this study defined the delayed addition behavior as the caregiver starting to add complementary foods at the age of 7 months and later. Binary Logistic regression model and subgroup analysis were used to explore the influencing factors of delayed complementary food addition behavior of infant caregivers from different generational perspectives.RESULTS A total of 766 pairs of infants and their caregivers were included in this study, including 375(49.0%) male infants and 391(51.0%) female infants. 246(32.1%) infants aged 6-11 months, 407(51.1%) infants aged 12-17 months, 113(14.8%) infants aged 18-23 months. 201(26.2%) infants' caregivers were grandparents and 565(73.8%) infants' caregivers were parents. 243(31.7%) of the caregivers had primary school education or below, 268(35.0%) had junior high school education, and 255(33.3%) had senior high school education or above. A total of 222(28.98%) caregivers in remote rural areas of Sichuan Province had delayed complementary food addition behavior, and 80(39.8%) caregivers had delayed complementary food addition behavior among grandparents. 142(25.13%) caregivers had delayed complementary food addition behavior among the parents. Grandparents with low social support for complementary feeding(OR= 2.73, 95%CI 1.13-5.24) were more likely to delay complementary feeding. However, parental caregivers with low complementary feeding knowledge(OR=1.99, 95%CI 1.29-3.07) and low complementary feeding self-efficacy(OR=2.11, 95%CI 1.35-3.31) were more likely to delay complementary feeding.CONCLUSION The influencing factors of delayed complementary feeding behavior of grandparents and parents in remote rural areas of Nanchong City are different. Social support for complementary food feeding is the influence factor of grandparents, and knowledge and self-efficacy of complementary food feeding is the influence factor of parents.