Sean Sylvia
Datos Biográficos
| ID | 352745 |
|---|---|
| NOMBRE | Sean Sylvia |
| NOMBRES | Sean |
| APELLIDO | Sylvia |
| FIRMA | SYLVIA S |
| AFILIACIONES | University of North Carolina at Chapel Hill |
| ORCID | 0000-0002-9508-247X |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 36 |
| TOTAL DE CITAS | 65 |
| TOTAL COMO AUTOR | 36 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1994 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 5 |
Uncovering hidden patterns
Introduction: Longitudinal trends in breastfeeding (BF) are often overlooked in favor of binary or time-to-cessation measures. Characterizing these trends can inform promotion of sustained BF practices. We identified distinct BF profiles among participants of a maternal and child health program. Methods: = 949) of maternal-reported infant feeding using dynamic time warping. For each month, participants were categorized as either exclusive breastf…
Early life grandmother caregiving trajectories and child development
Grandmothers are influential caregivers for young children, yet their contributions to child development remains understudied. This study characterized trajectories of grandmother caregiving from infancy to 2 years and examined their associations with child development. Data came from a longitudinal birth cohort study in rural Pakistan ( n = 959). Grandmother caregiving behaviors were maternally reported at 3 months, 1 year, and 2 years postpartu…
The Role of Telehealth Payment Parity on Recommended Care and Emergency Department Service Utilization Among Workers With Chronic Conditions
BACKGROUND AND OBJECTIVE: State-level telehealth payment parity, requiring equal payment rates for telehealth and in-person visits, played an important role in ensuring access to telehealth services. The objective of our study is to evaluate how improved access, driven by telehealth payment parity, affected the utilization of disease-specific recommended care management services and emergency department (ED) services among insured patients with c…
Mechanisms explaining a pay-it-forward approach
Pay-it-forward is when an individual receives a gift and is offered the opportunity to donate a gift to another person. This prosocial behavior has been used to develop health interventions, including strategies to increase sexually transmitted disease (STD) testing among men who have sex with men (MSM). Although pay-it-forward has improved service uptake across several settings, the underlying mechanism is unclear. This study aims to assess the …
The medium-term impact of a micronutrient powder intervention on anemia among young children in Rural China
ISRCTN44149146 (15/04/2013)
The quality of telemedicine consultations for sexually transmitted infections in China
The burden of sexually transmitted infections (STIs) continues to increase in developing countries like China, but the access to STI care is often limited. The emergence of direct-to-consumer (DTC) telemedicine offers unique opportunities for patients to directly access health services when needed. However, the quality of STI care provided by telemedicine platforms remains unknown. After systemically identifying the universe of DTC telemedicine p…
The Impact of Multimorbidity on Labor Force Participation Among the Middle-Aged and Older Working Population in the United States
MCC significantly reduces LFP compared with non-MCC. MCC has a heterogeneous impact across occupational types. It is important to support the near-retirement-age working population with multimorbidity through effective clinical interventions and workplace wellness policies to help manage health conditions and remain active in the labor market
Pay-it-forward gonorrhea and chlamydia testing among men who have sex with men and male STD patients in China
The study with identification number NCT05723263 has been registered on clinicaltrials.gov
Parental investment, school choice, and the persistent benefits of an early childhood intervention
We present evidence from a randomised experiment testing the impacts of a six-month early childhood home-visiting program on child outcomes and parental investment behaviour at school entry. Two and a half years after completion of the program, we find large persistent effects on parental investment at home, as well as large effects on preschool enrolment. Children in treatment villages were enrolled earlier and in higher quality preschools, the …
Online Focus Group Discussions to Engage Stigmatized Populations in Qualitative Health Research
Community participation in research involving stigmatized populations has been sub-optimal, and digital tools could potentially increase participation in qualitative research. This study aims to describe the implementation of an online chat-based FGD (Focus Group Discussion) with men who have sex with men (MSM) in China as part of formative research for the PIONEER project, determine the advantages and limitations associated with the approach, an…
The Salience of Information
Besides increasing knowledge, there is another potential mechanism at work when information is delivered to a treatment group: increasing the salience of existing knowledge. We use data from a randomized controlled trial of a health information campaign to explore the relative importance of this additional mechanism in a real-world environment. The health information campaign addressed the benefits of wearing eyeglasses and provided information m…
The know-do gap in quality of health for chronic non-communicable diseases in rural China
Proper management of non-communicable diseases (NCDs) is a severe challenge to China's rural health system. This study investigates what influences the poor medical treatment of NCDs (diabetes and angina) by evaluating the “know-do gap” between provider knowledge and practice. To determine whether low levels of provider knowledge low quality of patient care is the primary constraint on the quality of NCDs diagnosis and treatment in rural China. P…
Using standardized patients to assess the quality of type 2 diabetes care among primary care providers and the health system
Background: Improving type 2 diabetes (T2D) care is key to managing and reducing disease burden due to the growing prevalence of diabetes worldwide, but research on this topic, specifically from rural areas, is limited. This study uses standardized patients (SPs) to assess T2D care quality among primary care providers to access the healthcare system in rural China. Methods: Using multi-stage random sampling, health facilities, providers, and hous…
Parenting centers and caregiver mental health
This study conducts an exploratory analysis of the impacts of a center-based early childhood development intervention on the mental health of caregivers, using data from a cluster-randomized controlled trial of 1664 caregivers (Mage = 36.87 years old) of 6- to 24-month-old children in 100 villages in rural China. Caregivers and children in 50 villages received individual parenting training, group activities and open play space in village parentin…
Depressive and Anxiety Symptoms among Children and Adolescents in Rural China
Although children living in low- and middle-income countries (LMICs) account for 90% of the global population of children, depression, and anxiety among children in LMICs have been understudied. This study examines the prevalence of depression and anxiety and their associations with biological and psychosocial factors among children across China, with a focus on rural areas. We conducted a large-scale epidemiological study of depression and anxie…
Explaining the declining utilization of village clinics in rural China over time
Early childhood development and parental training interventions in rural China
Comparing the Quality of Primary Care between Public and Private Providers in Urban China
Previous studies have been limited by not directly comparing the quality of public and private CHCs using a standardized patient method (SP). This study aims to evaluate and compare the quality of the primary care provided by public and private CHCs using a standardized patient method in urban China. We recruited 12 standardized patients from the local community presenting fixed cases (unstable angina and asthma), including 492 interactions betwe…
Early Childhood Reading in Rural China and Obstacles to Caregiver Investment in Young Children
Studies have shown that nearly half of rural toddlers in China have cognitive delays due to an absence of stimulating parenting practices, such as early childhood reading, during the critical first three years of life. However, few studies have examined the reasons behind these low levels of stimulating parenting, and no studies have sought to identify the factors that limit caregivers from providing effective early childhood reading practices (E…
Tracking the effects of Covid-19 in rural China over time
By examining the economic and social effects of the COVID-19 restrictions in rural communities, this study will help to guide other middle- and low-income countries in their containment and restorative processes. Without consideration for economically vulnerable populations, economic hardships and poverty will likely continue to have a negative impact on the most susceptible communities
Passive versus active service delivery
We present the results of a cluster-randomized controlled trial that evaluates the effects of a free, center-based parenting intervention on early cognitive development and parenting practices in 100 rural villages in China. We then compare these effects to a previous trial of a home-based intervention conducted in the same region, using the same parenting curriculum and public service system, accounting for potential differences between the stud…
Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (Covid-19) during the early outbreak period
The impact of pay-for-percentile incentive on low-achieving students in rural China
Impact of substandard and falsified antimalarials in Zambia
Eliminating substandard and falsified antimalarials is an important step towards a malaria-free Zambia. Beyond the dissemination of insecticide-treated bed nets, indoor residual spraying, and other malaria control measures, attention must also be paid to assure the quality of antimalarial treatments
Parental Migration and Early Childhood Development in Rural China
Nearly one-quarter of all children under age 2 in China are left behind in the countryside as parents migrate to urban areas for work. We use a four-wave longitudinal survey following young children from 6 to 30 months of age to provide first evidence on the effects of parental migration on development, health, and nutritional outcomes in the critical first stages of life. We find that maternal migration has a negative effect on cognitive develop…
Parental Migration and Early Childhood Development in Rural China
Nearly one-quarter of all children under age 2 in China are left behind in the countryside as parents migrate to urban areas for work. We use a four-wave longitudinal survey following young children from 6 to 30 months of age to provide first evidence on the effects of parental migration on development, health, and nutritional outcomes in the critical first stages of life. We find that maternal migration has a negative effect on cognitive develop…
From Quantity to Quality
A key challenge in developing countries interested in providing early childhood development (ECD) programmes at scale is whether these programmes can be effectively delivered through existing public service infrastructures. We present the results of a randomised experiment evaluating the effects of a home-based parenting programme delivered by cadres in China’s Family Planning Commission (FPC)—the former enforcers of the one-child policy. We find…
The Han-Minority Achievement Gap, Language, and Returns to Schools in Rural China
Although access to quality education in rural China has expanded dramatically over the past 3 decades, significant disparities persist between ethnic minorities and the Han majority. This article compares the academic achievement and determinants of achievement of minority and Han students in rural western China. In a survey of nearly 21,000 primary school students, we find that minority students score significantly lower than their Han peers on …
Survey using incognito standardized patients shows poor quality care in China’s rural clinics
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…
Using community health workers to deliver a scalable integrated parenting program in rural China
Parental investment, school choice, and the persistent benefits of an early childhood intervention
We present evidence from a randomised experiment testing the impacts of a six-month early childhood home-visiting program on child outcomes and parental investment behaviour at school entry. Two and a half years after completion of the program, we find large persistent effects on parental investment at home, as well as large effects on preschool enrolment. Children in treatment villages were enrolled earlier and in higher quality preschools, the …
Explaining the declining utilization of village clinics in rural China over time
Seeing Is Believing
We present results of a randomized trial testing the impact on academic outcomes of providing free eyeglasses to junior high school students in a poor rural area of western China. We find that providing free prescription eyeglasses approximately halves dropout rates over a school year among students who did not own eyeglasses at baseline. Effects on dropout are mirrored by improvements in student performance on standardized exams in math and aspi…
Online Focus Group Discussions to Engage Stigmatized Populations in Qualitative Health Research
Community participation in research involving stigmatized populations has been sub-optimal, and digital tools could potentially increase participation in qualitative research. This study aims to describe the implementation of an online chat-based FGD (Focus Group Discussion) with men who have sex with men (MSM) in China as part of formative research for the PIONEER project, determine the advantages and limitations associated with the approach, an…
Passive versus active service delivery
We present the results of a cluster-randomized controlled trial that evaluates the effects of a free, center-based parenting intervention on early cognitive development and parenting practices in 100 rural villages in China. We then compare these effects to a previous trial of a home-based intervention conducted in the same region, using the same parenting curriculum and public service system, accounting for potential differences between the stud…
At three years of age, we can see the future
BACKGROUND: While the Chinese education system has seen massive improvements over the past few decades, there still exists large academic achievement gaps between rural and urban areas, which threaten China's long-term development. Additionally, recent literature has underscored the importance of early childhood development (ECD) in later-life human capital development. OBJECTIVES: We analyze the lifecycle of cognitive development and learning ou…
Quality of life among patients post-myocardial infarction at baseline in the Survival and Ventricular Enlargement (Save) trial
China’s Left-Behind Children
China's rapid development and urbanization have induced large numbers of rural residents to migrate from their homes to urban areas in search of better job opportunities. Parents typically leave their children behind with a caregiver, creating a new, potentially vulnerable subpopulation of left-behind children in rural areas. A growing number of policies and nongovernmental organization efforts target these children. The primary objective of this…
Survey using incognito standardized patients shows poor quality care in China’s rural clinics
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…
The Han-Minority Achievement Gap, Language, and Returns to Schools in Rural China
Although access to quality education in rural China has expanded dramatically over the past 3 decades, significant disparities persist between ethnic minorities and the Han majority. This article compares the academic achievement and determinants of achievement of minority and Han students in rural western China. In a survey of nearly 21,000 primary school students, we find that minority students score significantly lower than their Han peers on …
Impact of Text Message Reminders on Caregivers’ Adherence to a Home Fortification Program Against Child Anemia in Rural Western China
Objectives. To test whether text message reminders sent to caregivers improve the effectiveness of a home micronutrient fortification program in western China. Methods. We carried out a cluster-randomized controlled trial in 351 villages (clusters) in Shaanxi Province in 2013 and 2014, enrolling children aged 6 to 12 months. We randomly assigned each village to 1 of 3 groups: free delivery group, text messaging group, or control group. We collect…
The effect of a micronutrient powder home fortification program on anemia and cognitive outcomes among young children in rural China
ISRCTN44149146 ; prospectively registered on 15th April 2013
The Quality of Tuberculosis Care in Urban Migrant Clinics in China
Large and increasing numbers of rural-to-urban migrants provided new challenges for tuberculosis control in large cities in China and increased the need for high quality tuberculosis care delivered by clinics in urban migrant communities. Based on a household survey in migrant communities, we selected and separated clinics into those that mainly serve migrants and those that mainly serve local residents. Using standardized patients, this study pr…
Using community health workers to deliver a scalable integrated parenting program in rural China
Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (Covid-19) during the early outbreak period
The impact of pay-for-percentile incentive on low-achieving students in rural China
Impact of substandard and falsified antimalarials in Zambia
Eliminating substandard and falsified antimalarials is an important step towards a malaria-free Zambia. Beyond the dissemination of insecticide-treated bed nets, indoor residual spraying, and other malaria control measures, attention must also be paid to assure the quality of antimalarial treatments
Parental Migration and Early Childhood Development in Rural China
Nearly one-quarter of all children under age 2 in China are left behind in the countryside as parents migrate to urban areas for work. We use a four-wave longitudinal survey following young children from 6 to 30 months of age to provide first evidence on the effects of parental migration on development, health, and nutritional outcomes in the critical first stages of life. We find that maternal migration has a negative effect on cognitive develop…
From Quantity to Quality
A key challenge in developing countries interested in providing early childhood development (ECD) programmes at scale is whether these programmes can be effectively delivered through existing public service infrastructures. We present the results of a randomised experiment evaluating the effects of a home-based parenting programme delivered by cadres in China’s Family Planning Commission (FPC)—the former enforcers of the one-child policy. We find…
Seeing Is Believing
We present results of a randomized trial testing the impact on academic outcomes of providing free eyeglasses to junior high school students in a poor rural area of western China. We find that providing free prescription eyeglasses approximately halves dropout rates over a school year among students who did not own eyeglasses at baseline. Effects on dropout are mirrored by improvements in student performance on standardized exams in math and aspi…
At three years of age, we can see the future
BACKGROUND: While the Chinese education system has seen massive improvements over the past few decades, there still exists large academic achievement gaps between rural and urban areas, which threaten China's long-term development. Additionally, recent literature has underscored the importance of early childhood development (ECD) in later-life human capital development. OBJECTIVES: We analyze the lifecycle of cognitive development and learning ou…
Early childhood development and parental training interventions in rural China
Comparing the Quality of Primary Care between Public and Private Providers in Urban China
Previous studies have been limited by not directly comparing the quality of public and private CHCs using a standardized patient method (SP). This study aims to evaluate and compare the quality of the primary care provided by public and private CHCs using a standardized patient method in urban China. We recruited 12 standardized patients from the local community presenting fixed cases (unstable angina and asthma), including 492 interactions betwe…
Early Childhood Reading in Rural China and Obstacles to Caregiver Investment in Young Children
Studies have shown that nearly half of rural toddlers in China have cognitive delays due to an absence of stimulating parenting practices, such as early childhood reading, during the critical first three years of life. However, few studies have examined the reasons behind these low levels of stimulating parenting, and no studies have sought to identify the factors that limit caregivers from providing effective early childhood reading practices (E…
Tracking the effects of Covid-19 in rural China over time
By examining the economic and social effects of the COVID-19 restrictions in rural communities, this study will help to guide other middle- and low-income countries in their containment and restorative processes. Without consideration for economically vulnerable populations, economic hardships and poverty will likely continue to have a negative impact on the most susceptible communities
Passive versus active service delivery
We present the results of a cluster-randomized controlled trial that evaluates the effects of a free, center-based parenting intervention on early cognitive development and parenting practices in 100 rural villages in China. We then compare these effects to a previous trial of a home-based intervention conducted in the same region, using the same parenting curriculum and public service system, accounting for potential differences between the stud…
The know-do gap in quality of health for chronic non-communicable diseases in rural China
Proper management of non-communicable diseases (NCDs) is a severe challenge to China's rural health system. This study investigates what influences the poor medical treatment of NCDs (diabetes and angina) by evaluating the “know-do gap” between provider knowledge and practice. To determine whether low levels of provider knowledge low quality of patient care is the primary constraint on the quality of NCDs diagnosis and treatment in rural China. P…
Using standardized patients to assess the quality of type 2 diabetes care among primary care providers and the health system
Background: Improving type 2 diabetes (T2D) care is key to managing and reducing disease burden due to the growing prevalence of diabetes worldwide, but research on this topic, specifically from rural areas, is limited. This study uses standardized patients (SPs) to assess T2D care quality among primary care providers to access the healthcare system in rural China. Methods: Using multi-stage random sampling, health facilities, providers, and hous…
Parenting centers and caregiver mental health
This study conducts an exploratory analysis of the impacts of a center-based early childhood development intervention on the mental health of caregivers, using data from a cluster-randomized controlled trial of 1664 caregivers (Mage = 36.87 years old) of 6- to 24-month-old children in 100 villages in rural China. Caregivers and children in 50 villages received individual parenting training, group activities and open play space in village parentin…
Depressive and Anxiety Symptoms among Children and Adolescents in Rural China
Although children living in low- and middle-income countries (LMICs) account for 90% of the global population of children, depression, and anxiety among children in LMICs have been understudied. This study examines the prevalence of depression and anxiety and their associations with biological and psychosocial factors among children across China, with a focus on rural areas. We conducted a large-scale epidemiological study of depression and anxie…
Explaining the declining utilization of village clinics in rural China over time
Medicine (27 obras) · China (18 obras) · Psychology (18 obras) · Environmental health (14 obras) · Family medicine (13 obras) · Political science (13 obras) · Geography (11 obras) · Nursing (10 obras) · Economic growth (9 obras) · Health care (9 obras)