RESEARCH

Keywords

Child Development, Parenting, Nutrition, Mental Health, Health Policy, Evidence-based, Implementation Science

Field Work

Research lives in the field, where questions meet people, and data tells lived stories. Our field experience spans China, Brazil, the United States, Tanzania, Kenya, and Uganda, where I have worked on projects ranging from early childhood interventions to maternal health, reproductive health service delivery, and health systems strengthening. These experiences inform our commitment to evidence-based, community-informed, and policy-driven approaches to population health research.

Zhengzhou, China: Parental Stimulation Center-based Intervention among Rural-to-Urban Migrant Population

China has the largest rural-to-urban internal migrant population in the world, with over 290 million migrants as of 2020, approximately 20% of the national population. Among them are 22 million children under the age of two, whose families face compounded challenges due to China's household registration system, hukou. This system restricts access to high-quality education, healthcare, and public services, leaving migrant families vulnerable to adverse social determinants of health. Migrant children, consequently, often lag behind their rural and urban peers in developmental outcomes, facing systemic inequalities from birth. 

On the Foxconn Science Park, the world’s largest Apple production supplier, which hosts about 150 thousand migrant workers in Zhengzhou, China, our team established an early childhood development center for local communities, engaging 300 migrant families with children under the age of three who are employed at Foxconn’s Zhengzhou campus. The intervention is comprised of weekly one-on-one parental training sessions for primary caregivers and their children on interactive parenting practices, with curriculum adapted from Reach Up and Learn.

As a field coordinator, I designed a process evaluation and monitoring database to streamline the implementation of the stepped wedge trial, which significantly reduced the attrition rate. During the evaluation phase, I managed a team of evaluators from local colleges to conduct interviews with caregivers to understand their experiences and parenting practices, and we administered the Bayley Scales of Infant Development to assess children’s developmental stages. To ensure a standardized evaluation, I prepared interview protocols and training materials, focusing on effective communication and the consistent use of tools. 

Manaus, Brazil: Youth-led Nutrition Education Program for two Amazon riverine communities (Santa Helena do Inglês and Tumbira)

During the Harvard-Brazil Collaborative Public Health Field Course, we worked in collaboration with Foundation for Amazon Sustainability (FAS), a non-profit civil society organization that works on the sustainable development of the Amazon through infrastructure, education, health, research and innovation, entrepreneurship, and income generation programs. Our project focuses on addressing nutrition and food security in two riverine communities in the state of Amazonas, Santa Helena do Inglês and Tumbira. Primary data were collected on-site through nutrition and food intake surveys and used to inform a two-step strategy to improve child and adolescent nutrition. The proposal focuses on improving school meals provided through PNAE by creating a hub to connect local producers to the program and a youth extension program to promote agriculture activities throughout generations and to teach business and management skills. The proposal was submitted for a federal grant. 

I filmed a video documenting the development of the course and the lived experience of local people and communities in Manaus, Brazil in January, 2024. 

China: Oxford COVID-19 Government Response Tracker under Global Pandemic

Served as a Global Data Contributor and recognized as Contributor of the Month among over 2,000 participants, I was involved in developing the comprehensive China COVID-19 Policy portfolio in a team of 30 data collectors to map the political landscape influencing COVID-19 policies across all provinces. I supported the development of the OxCGRT China Working Paper, especially given my expertise in data analysis and visualization. Additionally, I conducted in-depth quantitative and qualitative syntheses of global health policies, co-authoring policy briefs featured in the International Public Policy Observatory’s global policy scans.

The following are publications that I contributed to the tracker:

Tanzania: Multi-stakeholder Qualitative Study on China-Tanzania Malaria Control Project

Tanzania is among the countries with the highest malaria cases and deaths worldwide, where vulnerable populations have been severely affected due to poverty and weakness in health system and infrastructure. The China-Tanzania Malaria Control Project (the Project) was a two-phase global health intervention project implemented between 2015 and 2021 that aimed to transfer project-designated intervention experience in malaria elimination to the Tanzanian health system. This study aims to identify the barriers and facilitators encountered during the Project and to improve our understanding of the emerging phenomenon of South-South global health collaboration.

We conducted a thematic analysis of qualitative data collected from a purposive sample of 14 participants from multiple stakeholders, including the project management office, the project implementation agency, funding partners, and external evaluators of the Project. A conceptual framework was developed to construct the interview guides. The interviews were transcribed verbatim, cross-checked, translated into English, and analyzed with NVivo 12.0. We conducted the open coding followed by the axial coding based on the Grounded Theory to generate themes and subthemes, and identified key influencing factors that aided or hindered malaria control in Tanzania.

The findings suggested that malaria control strategies should largely be tailored due to varied socioeconomic contexts. The perceived enablers in practice include project-designated intervention experiences and technologies, professional and self-learning capabilities of the implementation team, sustainable financial assistance, and support from the international partners. The barriers include the shortage of global health talents, existing gaps to meet international standards, defects in internal communication mechanisms, inadequacy of intergovernmental dialogue, and limitations in logistical arrangements. A checklist and policy implications for China's future engagement in malaria control in resource-limited settings have been proposed.

Selected Publications

Peer-reviewed Journal Articles

Ramponi, F., Zhou, H., Gosliner, W., …, Verguet, S., Cohen, J. (2025). Universal free school meal policies and participation in the U.S. National School Lunch and Breakfast Programs. JAMA Pediatrics [Preprint]

Zhou, H., Zhang, H., Xiao, A.Y., Tang, K., Yu, L. (2024). Effects of an Animation-based Comprehensive Sexuality Education Package: A Two-year Repeated Intervention Study. Health Education & Behavior, 51(5), 733-747.

Sun, Z., Zhou, H., Chen, F., …, & Zhang, X. (2023). Understanding the China-Tanzania Malaria Control Project: Lessons Learned from a Multi-Stakeholder Qualitative Study. Frontiers in Public Health, 11, p.1229675.

Gu, X., Zhou, H., Zhang, L.(2022). Spatial Accessibility Assessment of Healthcare Services and Governance Optimization in New Urban Areas of Mega City: the Case of Five New Towns in Shanghai (in Chinese), Urban Development Studies, 11.

Working Papers

Zhou, H., Castro, M. C., Machado, M. M. T. (2025). Trajectories of maternal mental health and early child development at 3 years of age: a prospective cohort study in Fortaleza, Brazil. Child Development. [Under Review]

Zhou, H., Tiemeier, H. (2025). Clinical trials for digital health interventions: an umbrella review of developer effect and study independence. PLOS Digital Health. [Under Review]

Ramponi, F., Zhou, H., Verguet, S., Cohen, J. (2025). Effects of universal free school meal policies on educational outcomes in the U.S. [In Preparation]

Zhou, H., Mak, B. (2025). The path to reducing maternal mortality in India: an extended cost-effectiveness analysis of Janani Suraksha Yojana. [In Preparation]

Zha, H., Zhang, Y., Zhou, H., Wang, L., Zhang, Z., Tan, Z., ... & Hale, T. (2022). Chinese provincial government responses to COVID-19. Version 2. Working Paper, Blavatnik School of Government, Oxford University, Oxford.

Book Chapters

Zhou, H., Huang, A., Kun, T. (2025). Multilateral cooperation in global health governance: a case study from China-UK Global Health Support Programme. Casebook on the Chinese Global Health Practice and Governance. [Under Review]