Impact of a national educational intervention on academic burden and health-related behaviours among children and adolescents in China: a repeated cross-sectional study
Repeated cross-sectional study finds temporary drops in academic burden and sedentary time among students, suggesting policy impacts fade without systemic reform.
Key Points
To evaluate longitudinal changes in academic burden and health-related behaviours among school-aged children before and after the implementation of China's "Double Reduction" policy.
Conducted a repeated cross-sectional study from 2019 to 2025 using data from the Guangzhou Student Common Diseases and Health Influencing Factors Surveillance Program.
Sampled Year 4 to Year 12 students across 66 schools in Guangzhou, China.
Analyzed self-reported daily homework, weekly tutoring, sedentary time, moderate-to-vigorous physical activity (MVPA), and sleep duration using mixed-effects models stratified by education stage, sex, and location.
Daily homework time decreased from 2019 to 2022 (β = -0.10, 95% CI: -0.11 to -0.09) but rebounded from 2022 to 2025 (β = 0.05, 95% CI: 0.04 to 0.06).
Weekly tutoring time declined between 2019 and 2022 (β = -0.19, 95% CI: -0.20 to -0.18) and rebounded from 2022 to 2025 (β = 0.06, 95% CI: 0.05 to 0.07), with sedentary time mirroring this U-shaped trajectory and sleep duration declining post-2022.
Compliance with MVPA guidelines increased steadily across the entire 2019–2025 study period.