Multicomponent intervention increases nutrition knowledge scores in rural China

Improving residents' nutrition knowledge (NK) is crucial for enhancing dietary health. However, rural areas in China face significant challenges in accessing effective nutrition education. This study aimed to design and evaluate the effectiveness and feasibility of a multicomponent nutrition education intervention strategy suitable for resource-limited rural areas. This study was conducted in five administrative villages in Chengdu, with a total population of approximately 20,000. Through focus group discussion, a multicomponent nutrition education intervention was designed and implemented over a four-week period. The intervention's effectiveness was assessed using two independent cross-sectional surveys (pre-intervention n = 275; post-intervention n = 280, adjusted to n = 275 for analysis to match the baseline). A validated questionnaire was used to evaluate changes in NK levels. The priority of strategies was ultimately determined based on coverage, feasibility, and cost. Six intervention channels were identified through focus group discussion. Post-intervention, the median NK score among villagers increased significantly from 60.0 to 70.0 (an increase of 10 points, p < 0.001). NK levels improved significantly across all demographic subgroups (p < 0.05), with subgroups having lower baseline NK levels (e.g., males, older adults, less-educated individuals, non-health/wellness workers and non-chronic disease patients) showing greater improvement, indicating a "catch-up effect" that reduces knowledge inequality. Based on effectiveness and feasibility assessments, the prioritized order of intervention strategies was: loudspeaker broadcasts > WeChat group videos > posters > leaflets > Child-Teaching-Family (CTF) program > prize quizzes. Multicomponent nutrition education interventions can effectively and equitably improve the NK of rural residents in China. The combination of "loudspeaker broadcasts + WeChat group videos" was confirmed as the core strategy, with its low-cost and wide-coverage characteristics being suitable for promotion in resource-limited areas. It is recommended to institutionalize such models by integrating them into primary public health services and clarifying the leading role of local governments in resource integration and sustainable promotion, thereby contributing to the goals of "Healthy China".