Anxiety among Chinese primary school teachers under the “double reduction” policy: prevalence and associated factors

Objectives: The implementation of the "Double Reduction" Policy in China has raised concerns about increased anxiety levels among primary school teachers. However, the prevalence of anxiety symptoms and the factors associated with them remain unclear. This study aims to investigate the prevalence and correlates of anxiety among primary school teachers under this policy. Methods: A cross-sectional survey was conducted from September to October 2022 among primary school teachers in 15 cities across China. Participants completed a series of questionnaires administered via WeChat to assess anxiety symptoms and potential related factors, including perceived stress, sociodemographic characteristics, and job-related variables. Anxiety and perceived stress were measured using the Generalized Anxiety Disorder-7 (GAD-7) and 10-item Perceived Stress Scale (PSS-10), respectively. Results: Overall, 44.5% (1,423/3,199) of teachers reported at least mild anxiety symptoms. Among them, 56.43%, 25.30% and 18.27% had mild, moderate, and severe anxiety, respectively. In the final logistic regression model, five variables remained independently associated with anxiety: education level (master's degree or above: OR = 2.781, 95% CI: 1.858-4.163), income dissatisfaction (OR = 1.487, 95% CI: 1.205-1.834), intermediate professional title (OR = 1.372, 95% CI: 1.084-1.738), younger age (OR = 0.979, 95% CI: 0.966-0.993), and perceived stress (OR = 1.489, 95% CI: 1.443-1.538). Conclusion: Anxiety was prevalent among primary school teachers during the implementation of the "Double Reduction" Policy. Higher education level, income dissatisfaction, intermediate professional title, younger age, and elevated perceived stress were significant risk factors for anxiety. Therefore, interventions focusing on stress management and occupational support may help improve teachers' mental well-being.