Targeting Children or Caregivers? Educational Interventions and Information Spilloversin Children's Sugar-Sweetened Beverage Choices

Nutrition information interventions are widely used to improve children’s dietary choices, yet it remains unclear whether they should target children or caregivers. We study this question in a randomized field experiment with 574 child-caregiver pairs in a rural elementary school in China using an incentivized sugar-sweetened beverage (SSB) choice experiment. We compare two student-targeted nutrition education interventions and one caregiver-targeted intervention, and measure both students’ own beverage choices and caregivers’ proxy choices immediately after the intervention and one month later. The student-targeted intervention reinforced with visual cues improves students’ SSB-related knowledge but does not generate robust behavioral change. By contrast, the student-targeted intervention reinforced with peer incentives produces the largest and most persistent improvements in students’ own SSB choices and also generates child-to-caregiver spillovers in caregivers’ proxy choices. The caregiver-targeted intervention improves caregivers’ proxy choices both immediately and one month later, and generates delayed caregiver-to-child spillovers. Spillovers are therefore bidirectional but asymmetric. Heterogeneity analyses show that peer-based effects are stronger among children with greater purchasing autonomy and social ability, whereas caregiver-side responses are stronger in households with greater caregiver engagement and communication. Overall, nutrition education is more effective when it is reinforced by peers on the student side and by changes in household food provision on the caregiver side, highlighting the importance of school-home collaboration.