Abstract: Objective To analyze the changing trend and influencing factors of anemia among primary and middle school students from the pilot areas of the “Nutrition Improvement Plan for Rural Compulsory Education Students” （shorten as “Program”） in Hainan Province. Methods From 2014 to 2017, primary and middle school students were selected from the key monitoring counties implementing the “Program” through stratified cluster random sampling method. The biochemical indicators such as hemoglobin were detected and questionnaire survey was carried out. Analysis of variance was used to compare the mean values of multiple groups, chi-square test was used to compare the rates, and the influencing factors of anemia were analyzed by binary Logistic regression. Results From 2014 to 2017, 2 590 students were selected, the students’ average hemoglobin levels were （138.1±12.0）, （136.4±13.4）, （138.1±12.4） and （138.1±15.4） g/L, respectively, and the differences were no statistical significance （P>0.05）. In 4 years, the anemia rates were 5.4%, 5.4%, 4.5% and 6.7%, respectively, there was no obvious change trend （P>0.05）. In 2015, the anemia rate of junior high school students was higher than the primary school students, and the difference was statistically significant （P< 0.05）. But in other years, there were no significant difference in anemia rates between primary and junior high school students, and between boys and girls （both P>0.05）. Logistic regression analysis showed that the ethnic minority students （OR=6.947） and vitamin A subclinical deficiency or deficiency students （OR=2.030） had a higher risk in anemia. Conclusion The anemia status of students from the pilot area of “Program” in Hainan Province is not significantly improved, and the ethnic minority students and vitamin A subclinical deficiency or deficiency students are the key intervention targets.

Key words: Anemia, Nutritional intervention, Changing trend, Influencing factor