Chen Kaiyue, Zhao Qian, Xia Jingwei, Feng Yuheng, Xia Qinghua, Zheng Jicui, Lu Jun, Li Xiaohong
Department of Health Policy and Management, Fudan University School of Public Health, Shanghai, China.
China Research Center on Disability, Fudan University, Shanghai, China.
BMJ Open. 2024 Dec 5;14(12):e084414. doi: 10.1136/bmjopen-2024-084414.
Unintentional injuries are a major threat to children's health. Community-based health management services, which include the prevention of unintentional injuries among children aged 0-6 years, are important basic national public health services. However, deficiencies exist at this stage, such as community childcare doctors not being motivated to provide guidance. Previous studies have explored the impact of the underlying reasons; however, few studies have considered the supporting factors from a social perspective. This study explored the elements supporting community childcare doctors in conducting parental health education and sought to generate a framework capable of providing recommendations.
A qualitative study was conducted to analyse data collected through semistructured interviews and used the grounded theory method.
Interviews were conducted at eight health institutions, health management departments, hospital and universities in four regions of eastern China (Shanghai, Zhejiang, Anhui and Liaoning) and recorded on audio. Interviews were conducted face to face or online.
Key informant interviews were conducted with 39 adults (15 parents of children, 11 direct providers of child healthcare and 13 health department managers or experts). The information obtained through interviews included the current situation and difficulties faced by community childcare doctors providing parental health education, the attitudes and perceptions of parents regarding receiving health education and the degree of service acceptance. The independent transcription of interview results was performed by two coders.
A total of 39 interview transcripts from healthcare service providers, managers and demanders were analysed. Many factors affect the provision of parental health education by community childcare doctors, including the macrodimension and microdimension. Supplier, demander, direct support and indirect support were summarised and reported as both facilitators and barriers to active provision of health services, including 18 subdomains under these four main domains.
A theoretical model of parental health education based on community childcare doctors was constructed to explain the factors influencing the implementation of education by community childcare doctors. These include individual and socialised behaviours requiring cooperation among individuals, families, governments, the general public and all workers in the healthcare sector. For demanders, it is essential to evoke their beliefs, and for suppliers, it is necessary to improve their skills and stimulate their motivation, both of which cannot be separated from macrolevel support. This model can be used to guide intervention designs aimed at enhancing the enthusiasm of community childcare doctors and further enhancing parental literacy, ultimately achieving the goal of improving children's health.
意外伤害是儿童健康的重大威胁。基于社区的健康管理服务，包括预防0至6岁儿童的意外伤害，是重要的国家基本公共卫生服务。然而，现阶段存在不足，如社区儿童保健医生缺乏提供指导的积极性。以往的研究探讨了潜在原因的影响；然而，很少有研究从社会角度考虑支持因素。本研究探讨了支持社区儿童保健医生开展家长健康教育的因素，并试图构建一个能够提供建议的框架。
进行了一项定性研究，以分析通过半结构化访谈收集的数据，并采用扎根理论方法。
在中国东部四个地区（上海、浙江、安徽和辽宁）的八家卫生机构、健康管理部门、医院和大学进行访谈，并进行录音。访谈通过面对面或在线方式进行。
对39名成年人进行了关键信息访谈（15名儿童家长、11名儿童保健直接提供者以及13名卫生部门经理或专家）。通过访谈获得的信息包括社区儿童保健医生在提供家长健康教育方面面临的现状和困难、家长对接受健康教育的态度和看法以及服务接受程度。访谈结果由两名编码员独立转录。
共分析了来自医疗服务提供者、管理者和需求者的39份访谈记录。许多因素影响社区儿童保健医生提供家长健康教育，包括宏观层面和微观层面。总结并报告了供应方、需求方、直接支持和间接支持，它们既是积极提供健康服务的促进因素，也是障碍因素，在这四个主要领域下包括18个子领域。
构建了基于社区儿童保健医生的家长健康教育理论模型，以解释影响社区儿童保健医生实施教育的因素。这些因素包括需要个人、家庭、政府、公众和医疗保健部门所有工作人员合作的个人和社会化行为。对于需求者来说，唤起他们的信念至关重要，对于供应方来说，提高他们的技能并激发他们的积极性是必要的，这两者都离不开宏观层面的支持。该模型可用于指导旨在提高社区儿童保健医生积极性并进一步提高家长素养的干预设计，最终实现改善儿童健康的目标。
