Sun Xiaojie, Zhang Nan, Liu Kun, Li Wen, Oksanen Tuula, Shi Lizheng
Center for Health Management and Policy of Shandong University (key Lab of Health Economics and Policy, National Health and Planning Commission), Jinan, Shandong, China.
Health Bureau of Jinan, Jinan, Shandong, China.
PLoS One. 2014 Dec 11;9(12):e114924. doi: 10.1371/journal.pone.0114924. eCollection 2014.
To examine whether workplace social capital improved after implementing a workplace social capital intervention in community health centers in China.
This study was conducted in 20 community health centers of similar size in Jinan of China during 2012-2013. Using the stratified site randomization, 10 centers were randomized into the intervention group; one center was excluded due to leadership change in final analyses. The baseline survey including 447 staff (response rate: 93.1%) was conducted in 2012, and followed by a six-month workplace social capital intervention, including team building courses for directors of community health centers, voluntarily public services, group psychological consultation, and outdoor training. The follow-up survey in July 2013 was responded to by 390 staff members (response rate: 86.9%). Workplace social capital was assessed with the translated and culturally adapted scale, divided into vertical and horizontal dimensions. The facility-level intervention effects were based on all baseline (n = 427) and follow-up (n = 377) respondents, except for Weibei respondents. We conducted a bivariate Difference-in-Difference analysis to estimate the facility-level intervention effects.
No statistically significant intervention effects were observed at the center level; the intervention increased the facility-level workplace social capital, and its horizontal and vertical dimensions by 1.0 (p = 0.24), 0.4 (p = 0.46) and 0.8 (p = 0.16), respectively.
The comprehensive intervention seemed to slightly improve workplace social capital in community health centers of urban China at the center level. High attrition rate limits any causal interpretation of the results. Further studies are warranted to test these findings.
探讨在中国社区卫生中心实施工作场所社会资本干预措施后,工作场所社会资本是否得到改善。
2012 - 2013年期间,在中国济南选取了20家规模相似的社区卫生中心进行本研究。采用分层整群随机抽样法,将10家中心随机分为干预组;最终分析时,有1家中心因领导层变动被排除。2012年对447名工作人员进行了基线调查(应答率:93.1%),随后进行了为期6个月的工作场所社会资本干预,包括为社区卫生中心主任举办团队建设课程、自愿公益服务、团体心理咨询和户外培训。2013年7月的随访调查有390名工作人员应答(应答率:86.9%)。采用经过翻译和文化调适的量表评估工作场所社会资本,分为纵向和横向维度。除了潍北的应答者外,设施层面的干预效果基于所有基线(n = 427)和随访(n = 377)应答者。我们进行了双变量差分分析以估计设施层面的干预效果。
在中心层面未观察到具有统计学意义的干预效果;干预使设施层面的工作场所社会资本及其横向和纵向维度分别增加了1.0(p = 0.24)、0.4(p = 0.46)和0.8(p = 0.16)。
综合干预似乎在中国城市社区卫生中心的中心层面略微改善了工作场所社会资本。高损耗率限制了对结果的任何因果解释。有必要进一步开展研究以验证这些发现。