LAUSR

Aims In China around 40 million children and adolescents are left behind in rural areas by parents who migrate to cities to work. This study aimed to investigate the effects of prolonged separation from parents, and different guardianship models, on engagement in risk behaviors and psychological well-being. Methods A cross–sectional study was conducted in migrant-sending areas of three counties in Zhejiang province and two in Guizhou in 2015. A self-completion questionnaire was administered among adolescents age 6 to 16 from 56 primary and middle schools, selected through random stratified sampling. Children’s demographic characteristics, family and social support, risk behaviors, and psychological wellbeing (using the Strengths and Difficulty Scale) were measured.Logistic regression was used to measure the effect of guardianship types on behavioral and psychological problems. Results There were 1447 respondents in Zhejiang, and 1773 in Guizhou. The mean age was 12 (SD 2.2). 1238 children were living with both parents, and 1977 were left behind children (LBC). Of these 1025 lived with grandparents, 838 with one-parent and 114 with ‘others’ (relatives, siblings, alone). After controlling for economic status, age and gender, LBC living with others reported higher prevalence of smoking (aOR=2.01, 95%CI:1.15-3.51), skipping class (2.28, 1,28-4.06) and cheating (2.23, 1.55-3.50) than non-LBC, but there were no significant differences in drinking, going to internet cafés, stealing, bullying and fighting. Among three types of LBC guardianship, adolescents living with one parent reported lowest level of risk behaviors, and those living with ‘others’ highest. In addition, LBC living with grandparents reported more emotional problems (1.25, 1.02-1.53), LBC living with others more hyperactivity (2.15, 1.41-3.26) and fewer peer problems (0.65, 0.43-0.98), but there were no significant differences in conduct problems. Risk factors for LBC’s behavioral and psychological problems were: living in Guizhou, poor study performance, having friends involved in risky behaviors and low social support. Conclusion Living with parents or one parent led to more favorable behavioral and psychological outcomes. Migrant parents should try to ensure that one of them stays at home to give care and guidance on a daily basis.