Abstract: ObjectiveTo examine health-related knowledge,attitude and behavior among guardians of left-behind and unleft-behind preschool children and to provide a basis for conduction health intervention among rural left-behind children.MethodsUsing random cluster sampling,we selected 735 guardians of preschool children in Gaotang county of Shandong province for a questionnaire survey on health literacy.ResultsTotally 269 guardians(36.6%)of left-behind children and 466(63.4%)of unleft-behind children were involved in this survey.The ratio of the guardians knowing the necessity of annual health examination was 57.7% and there were 76.2% of the guardians not knowing that health food could not be used as a medicine,58.5% not knowing dietary status of their children during a recent period,whereas there were 28.0% of the guardians giving nutritional supplementations to their children,78.6% concerning about nutrional diet for their children,and 43.8% concerning about nutrition and hygienic status when buying food for their children.Compared with the guardians of unleft-behind children,the guandians of left-behind children had a lower level of health literacy.There were significant differences between the guardians of left-behind and unleft-behind children in knowledge about health life style,no substitution of medicine with health food,low salt in diet,prevention of overweight and obesity,avoidance of uncooked food,seperation of cooked food from uncooked food,vaccination of the newborn,annual health examination,nutrition collocation of diet,and concerns of nutrition and hygienic status when buying food(P<0.05 for all).ConclusionThe health knowledge,attitude and behavior of guardians of left-behind children are not as good as those of guardians of unleft-behind children and need to be improved.