Association between micronutrient powder information dissemination and caregivers' knowledge, health beliefs, and adherence in rural western China: a propensity score-matched analysis

Background In remote rural China, a micronutrient home fortification program has been implemented to prevent childhood anemia by providing free micronutrient powders (MNP) to caregivers. Effective information dissemination is essential for improving caregivers’ knowledge, beliefs, and MNP feeding adherence. However, evidence on how different communication channels and content influence these outcomes among caregivers remains limited in rural settings. This study aimed to examine the associations between MNP information dissemination and caregivers’ knowledge, health beliefs, and adherence to recommended MNP feeding practices, providing evidence to inform future health communication strategies in nutrition interventions. Methods A cross-sectional study was conducted in 2019 among 1,229 caregivers of children aged 6–36 months in six counties in western China, selected using a multistage sampling method. Data were collected through face-to-face interviews using structured questionnaires. Propensity score matching and regression analyses were performed to examine the associations between different channels and content of MNP information dissemination and caregivers’ MNP-related knowledge, health beliefs, and adherence to recommended MNP feeding practices. Results Receiving information from a doctor was positively associated with caregivers’ MNP-related knowledge (β = 0.75, 95%CI = 0.59–0.91), health beliefs (β = 0.75, 95%CI = 0.57–1.58), and adherence to recommended MNP feeding practices (OR = 1.96, 95%CI = 1.48–2.61). Receiving information from the mass media and wider community were both positively associated with caregivers’ MNP-related knowledge (β_{mass media} = 0.46, 95%CI = 0.13–0.79; β_{wider community} = 0.25, 95%CI = 0.04–0.46) and health beliefs (β_{mass media} = 2.05, 95%CI = 0.85–3.24; β_{wider community} = 0.83, 95%CI = 0.11–1.56). For MNP content, information on the benefits of MNP and how to use them were both positively associated with caregivers’ MNP-related knowledge (β_benefits = 0.62, 95%CI = 0.47–0.77; β_{feeding method} = 0.22, 95%CI = 0.05–0.40), health beliefs (β_benefits = 1.73, 95%CI = 1.23–2.23; β_{feeding method} = 1.27, 95%CI = 0.66–1.89) and adherence (OR_benefits=1.37, 95%CI = 1.03–1.83; OR_{feeding method}=1.56, 95%CI = 1.01–2.39). Conclusions Targeted MNP dissemination strategies—especially those delivered by doctors and emphasizing key content such as the benefits of MNP and proper feeding methods—may help to promote caregivers’ MNP-related knowledge, health beliefs, and adherence to recommended MNP feeding practices, which may contribute to improved child health in low-resource settings. These findings can inform the optimization of future information dissemination strategies for the micronutrient powder program in rural western China, contributing to healthier child development in these areas.