Association of parental level of education and child factors on length-for-age indicator among socially vulnerable children aged 6-24 months from a Brazilian state using structural equation modelling.

ABSTRACT

This cross-sectional study employs structural equation modelling (sEM) to explore both direct and indirect effects of parental level of education and child individual factors on the length-for-age outcomes in children aged 6-24 months assisted by the Bolsa Família Program in the State of Alagoas. A total of 1448 children were analysed by the sEM technique. A negative standardised direct effect (sDE) of the children's younger age (sDE -0·06; P = 0·017), the use of bottle feeding (sDE -0·11; P < 0·001) and lack of a minimum acceptable diet (sDE -0·09; P < 0·001) on the length-for-age indicator was found. Being female (SDE 0·08; P = 0·001), a higher birth weight (SDE 0·33; P < 0·001), being ever breastfed (sdE 0·07; P = 0·004) and a higher level of parental education (SDE 0·09; P < 0·001) showed a positive SDE effect on the child's length-for-age. The model also demonstrated a negative standardised indirect effect (SIE) of the sweet beverage consumption (SIE -0·08; P = 0·003) and a positive effect of being ever breastfed (SIE 0·06; P = 0·017) on the child's length-for-age through parental level of education as a mediator. This research underscores the crucial role of proper feeding practices and provides valuable insights for the development of targeted interventions, policies and programmes to improve nutritional well-being and promote adequate linear growth and development among young children facing similar challenges.