Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-05-31 Cooperative journals: 《中国全科医学》
Abstract： To provide researchers with a comprehensive understanding of the Psychology and Behavior Investigation of Chinese Residents（PBICR），this paper introduces its background and features from four aspects. In terms of design concepts，PBICR focuses on many aspects of mental health and health behaviours in the Chinese population，takes full account of timeliness and efficiency，adheres to the original intention of data openness and data sharing，builds a high-quality database with a large-sample，multi-centre，repetitive，nationwide cross-sectional design，and promotes data mining and exchange and cooperation; in terms of survey implementation，PBICR adopts a proportional to the size of the population，a combination of multilayer sampling and quota sampling，obtains data through face-to-face field surveys，and implements a rigorous sampling methodology. In terms of survey implementation，PBICR adopts a combination of population size-proportional，multistage random sampling and quota sampling sampling，and obtains data through face-to-face field surveys with strict quality control to ensure the representativeness and reliability of the samples; in terms of output，PBICR's research content is rich and updated in line with international hotspots，which can satisfy the demand for research on diversified variables and data，and the results of its past research have a higher influence in many fields such as public health，management，communication，and psychology; Looking ahead，PBICR will gradually complete the construction of databases from the general database to sub-databases，pay attention to special populations and a wide range of regions around the world，add tracking surveys and biomedical data research perspectives，and have great research potential to drive research on the mental and behavioural health of Chinese residents through the overall layout of the multi-dimensional.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-12-07 Cooperative journals: 《中国全科医学》
ZHANG, Xing
DONG, Jing
GUO, Yi
XU, Jianwei
BAI, Yamin
LIU, Min
ZHANG, Xiaochang
GUO, Xiaolei
MA, Jixiang
SUN, Xinying
Abstract： Background The prevalence of hypertension among Chinese residents is high while the control rate is low. It has been suggested by numerous epidemiologic studies that reducing salt intake could reduce blood pressure level. Therefore，it is significant for health management of residents and reducing social burden to explore determinants of salt-reduction behavior among residents. Objective To explore the predisposing，reinforcing and enabling factors of salt-reduction behavior among Shandong residents based on the PRECEDE model，and provide scientific suggestions for the subsequent salt-reduction campaign. Methods This study was a mixed methods research. A total of 114 residents were interviewed in 2016 and 2018 by using purposive sampling method. The interview guide mainly contained attitudes to salt control，difficulties encountered and assistance received during salt control. The quantitative data were obtained from the database of terminal survey of Shandong and Ministry of Health Action on Salt and Hypertension（SMASH），and the sample of eastern as well as central-southern Shandong from the database was selected into this research. The part related to hypertension among this survey was selected from the database，and a total of 6 697 research objects were finally selected. Results The results of multinomial Logistic regression showed that gender, occupation and education level have an impact on the compliance of salt reduction behavior controlling for the effect of other variables（P<0.05）. Personal taste, salt reduction knowledge and attitude towards low-salt diet have an impact on salt reduction behavior compliance while controlling for the effect of personal general conditions（P<0.05）. Physician intervention could reinforce salt-reduction behavior in residents. The health education of medical personnel could not only enhance the salt-reduction behavior and awareness of hypertensive patients，but also strengthen the supervision of family members. Through enhancing family members' salt-reduction behavior and awareness，and finally promoting salt reduction among residents. Supervision by family members in daily life can strengthen salt-reduction behavior of the residents. SMASH had formulated policies involved in the project promoting，catering industry，food industry and health education about salt-reduction，which playing very important role in creating strong salt-reduction environment. The salt-restriction spoon was the most important low-salt product in affecting residents' salt-reduction behavior，while the impact of low-salt food and low-sodium salt in reducing salt intake was weakened because of the poor accessibility. Mass media promotion was the main way for residents to obtain information on salt reduction. Television and promotion in public places were the more visible forms of mass communication currently. Conclusion Attitude towards low-salt diet and knowledge are predisposing factors of residents' salt-reduction behavior. Exhortation of doctors and reminding from family members were reinforcing factors，which can help residents to start out reducing salt intake and also reinforcing salt-reduction behavior. The salt-reduction environment was created by policies regarding salt-reduction and mass communication，products regarding salt restriction were essential tools for reducing salt intake，which are enabling factors.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-08-02 Cooperative journals: 《中国全科医学》
Abstract： Background Health literacy is closely associated with health status，most domestic studies tend to use multidimensional and multi-item tools for assessing health literacy，lacking simple and effective assessment methods. Objective To simplify health literacy scale and conduct psychometric test within the Chinese population. Methods Adults aged 18 years and above were selected from the "China Family Health Index Survey （2021）" for this investigation. Based on inclusion and exclusion criteria，a total of 7 449 participants were selected and randomly divided into two sample sets，including 3 680 cases in sample set 1 and 3 769 cases in sample set 2. The general information questionnaire，short-form health literacy questionnaire（HLS-SF12），perception social support scale（PSSS），and family health scale short-form（FHS-SF） were administered to the respondents. Classical test theory（CTT） and the Mokken model in item response theory（IRT） were used to screen the original items，and validation analyses such as reliability and validity of the simplified scales were also conducted. Results A 9-item version （HLS-SF9） and a 4-item version（HLS-SF4） were simplified by using CTT and the Mokken model，respectively. Both the HLS-SF9 and the HLS-SF4 had no ceiling effect or floor effect，and the Cronbach's α coefficients for both were 0.913 and 0.842，with split-half reliabilities of 0.871 and 0.815，respectively. The exploratory factor analysis of HLS-SF4 revealed one common factor，accounting for 67.813% of the cumulative variance，with factor loadings exceeding 0.81 for each item. The confirmatory factor analysis of HLS-SF9 showed that χ2 /df was 10.844，goodness of fit index（GFI） was 0.985，adjusted goodness of fit index（AGFI） was 0.971，normative fit index（NFI） was 0.986，comparative fit index（CFI） was 0.987，and root mean squared error of approximation （RMSEA） was 0.051. The correlation analysis demonstrated positive correlation of HLS-SF9 and HLS-SF4 with PSSS（r=0.367，0.292，P<0.001），as well as FHS-SF（r=0.340，0.237，P<0.001），respectively. The intraclass correlation coefficients（ICC）（95%CI） for the criterion validity of HLS-SF9 against HLS-SF12 was 0.989 （0.988，0.999），while for HLS-SF4 against HLS-SF12 was 0.892（0.886，0.899）. Conclusion The simplified health literacy scales have good reliability and validity，which are reliable and effective tools for assessing the health literacy of the Chinese population. Researchers can choose the scale according to the needs of research precision（HLS-SF9） or assessment time（HLS-SF4）.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-06-16 Cooperative journals: 《中国全科医学》
CHENG Xiaoran
ZHANG Xiaotian
LI Mingyue
CHENG Haozhe
TANG Haoqing
ZHENG Huixian
ZHANG Baisong
LIU Xiaoyun
Abstract： Background Hypertension and diabetes are two major chronic diseases affecting population health，and need to be controlled through chronic diseases follow-up. However，there is currently insufficient understanding of the impact of different chronic diseases follow-up forms and contents on disease control and healthy behaviors of patients. Objective To explore the impact of the chronic diseases follow-up on health behaviors and blood pressure/glucose control of patients with hypertension and diabetes in the context of treatment-prevention integration. Methods Yiyang County in Henan Province，Xianfeng County in Hubei Province and Yangqu County in Shanxi Province were selected as study sites to collect data from the basic public health information system from 2017-01-01 to 2022-06-30. Patient survey was conducted in July 2022 to collect information on basic public health follow-up receiving, health behaviors and disease control of patients. Finally，102 769 patients with hypertension and 26 586 patients with diabetes were obtained from the basic public health information system, the data of 1 172 patients with hypertension and 456 patients with diabetes were obtained through patient surveys. Multivariate Logistic regression was used to analyze the effects of the standard-reaching frequency of follow-up，follow-up forms and contents on health behaviors and disease control of patients. Results In 2021，the standard-reaching rates of follow-up frequency of patients with hypertension and diabetes were 90.83%（67 709/74 545） and 83.35%（13 390/16 065），with frequency ≥ 4 times/year as the standard. The follow-up forms included household follow-up〔25.74%（408/1 585）〕，follow-up at institutional visits〔58.80%（932/1 585）〕，telephone or network follow-up〔15.46%（245/1 585）〕. The follow-up contents included blood pressure and blood glucose measurements〔91.15%（1 484/1 628）〕，lifestyle guidance〔74.14%（1 207/1 628）〕，disease inquiry 〔70.02%（1 140/1 628）〕，and drug use understanding〔69.29%（1 128/1 628）〕. Multivariate Logistic regression analysis showed that patients with higher standard-reaching rates of follow-up frequency had higher rates of blood pressure control（OR=1.09，P<0.05） and glucose control（OR=1.31，P<0.05），lower rates of smoking and drinking（OR=0.83，P<0.05），and higher rates of regular exercise habits（OR=1.30，P<0.05）. The proportions of smoking and alcohol cessation （OR=2.38，P<0.05） and regular exercise habits（OR=1.62，P<0.05） were higher in the patients followed up at institutional visits were higher than those followed up by telephone or network. The proportions of smoking and alcohol cessation（OR=2.33，P<0.05） and regular exercise habits（OR=2.54，P<0.05） of patients received household follow up were higher than those followed up by telephone or network. Patients who received lifestyle guidance，disease inquiry，and drug use understanding had higher rates of blood pressure control（OR=1.61，1.34，and 1.62，respectively；P<0.05），smoking and alcohol cessation （OR=3.59，3.54，and 2.91，respectively；P<0.05） and regular exercise habits（OR=3.16，2.15，2.45，respectively；P<0.05）. Conclusion Receiving chronic diseases follow-up at least 4 times per year，with follow-up at institutional visits and household follow-up as the forms，provided with blood pressure and blood glucose measurements，lifestyle guidance，disease inquiry and drug use understanding as the contents in patients were positive correlated with blood pressure/glucose control，smoking and alcohol cessation, and regular exercise habits.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-04-24 Cooperative journals: 《中国全科医学》
ZHANG， Baisong
WANG， Ziyue
HU， Dan
LI， Mingyue
WANG， Huijuan
WEI， Tiantian
CHENG， Xiaoran
CHENG， Haozhe
LIU， Xiaoyun
Abstract： Background The free training for rural order-oriented medical students has trained a large number of primary health personnel for the central and western regions of China. By the summer of 2021，the first order-oriented medical graduates had completed their compulsory service and face the choice of staying or leaving. The income is an important influencing factor of their choices, however，there are still few studies on the income of order-oriented medical graduates. Objective The panel data of order-oriented medical graduate cohort study was used to compare and analyze the change trend of the income of order-oriented medical graduates and general clinical graduates in the early career，and to explore the influencing factors of the change of income. Methods Qinghai University，Guangxi Medical University，Jiujiang Medical University and Gannan Medical University were selected to establish the order-oriented medical graduate cohort every year from 2015 to 2019，matching the general clinical graduates of the same grade as controls. The baseline survey was conducted，including basic information and family information. A total of four follow-up surveys were conducted in 2016，2017，2018 and 2020，including the status of standardized resident training（hereinafter referred to as "standardized training"），passing of medical licensing examination，working conditions and other information. Fixed effects model was used to explore the factors influencing the income of order-oriented medical graduates and general clinical graduates，and propensity score matching（PSM） was used to test the stability of the results. Results In the first two years after graduation，the income of order-oriented medical graduates was higher than general clinical graduates，and the difference was statistically significant （P<0.05）. Two years after graduation，the income of order-oriented graduates was lower than general clinical graduates，and the difference was statistically significant（P<0.05）. The results of the fixed effects model showed that completion of standardized training，passing of the medical licensing examination，working position，and year of graduation were factors influencing the income of order-oriented graduates（P<0.05）. The income of order-oriented graduates who completed the standardized training decreased by 47%，and the income of the graduates who passed the medical licensing examination and promoted increased by 16% and 10%，respectively；The income of the graduates in the third，fourth and fifth years after graduation increased by 7%，16% and 34%，respectively，compared with the first year of graduation. Job change and graduation years were the factors influencing the income of general clinical graduates（P<0.05）；Job change increased the income of general clinical graduates by 15%，and the income of graduates in the third，fourth and fifth year after graduation increased by 27%，83% and 101%，respectively，compared with the first year. The regression results of two-way fixed effects model showed that the completion of standardized training，passing of the medical licensing examination，job change，staffing and graduation years had different effects on the income of order-oriented graduates and general clinical graduates（P<0.05）. The regression results of two-way fixed effects model using the data after PSM showed similar to the results of the original sample with good consistency. Conclusion The starting point of income of order-oriented graduates is higher，but the growth rate is significantly lower than general clinical graduates，the income gap between them has been increasing year by year. The main reasons include the loss of training allowance after the standardized training of order-oriented graduates and the income difference caused by different working institutions. At the same time，the income of order-oriented graduates decreases with the increase of graduation time，which will seriously affect their performance and willingness of primary care.
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