[Influencing factors of delayed complementary food addition behavior among caregivers of infants aged 6 to 23 months in rural areas of Nanchong City: Based on the intergenerational perspective of caregivers].

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.