Background Health impact assessment (HIA) is a procedure, method and tool for evaluating the potential health impacts of policies, plans and construction projects, as well as the distribution of these impacts on population. Majority of international studies on health impact assessment have focussed on conceptual papers or case evaluations, neglecting participants’ views on policies. Methods A semi-structured interview with 30 health impact assessment experts was employed in this study, and the Nvivo software was utilized to analyse factors that influence policy identification. Subsequently, a multi-stage stratified random sampling method was adopted to survey 655 pilot staff members involved in health impact assessment in Zhejiang Province. Descriptive statistics were used to describe the current status and identify the factors influencing policy identification. In addition, hierarchical linear regression analysis and structural equation modelling were employed to determine the relationship between policy identification and influencing factors. Results Statistically significant differences were found among participants in the level of identification of policies across three dimensions. The policy sentiment dimension had the highest score (4.137 ± 0.664), followed by policy cognition (4.075 ± 0.632) and policy evaluation (3.631 ± 0.797) dimensions. Subject trust had a positive impact on policy cognition ( β = 0.503, P < 0.001), policy sentiment ( β = 0.504, P < 0.001) and policy evaluation ( β = 0.465, P < 0.001). Procedural justice had a positive impact on policy sentiment ( β = 0.085, P < 0.01) and policy evaluation ( β = 0.084, P < 0.05), but not policy cognition ( β = 0.056, P > 0.05). Policy identification is influenced by age and average monthly salary among other factors. Conclusion These results highlight the importance of subjective trust and procedural justice in policy identification of health impact assessment. They provide valuable insights to developing interventions to overcome barriers to the implementation and enhancement of global identification of policies. Going forward, cross-sectoral synergies, enhanced international communication and training to increase participants’ trust in the policy should be optimized to improve health impact assessment. Additional measures should be taken, such as ensuring seamless communication channels, embedding health impact assessment in administrative mechanisms, and establishing strong oversight and grievance mechanisms to improve fairness and transparency in the implementation and results of health impact assessment.

Background: Limited studies have explored the relationship among cross-organizational and multidisciplinary medical staff. Aim: The present study conducted an in-depth examination and validation of the influence of complex cross-organization and multidisciplinary social networks on the job performance of team members. Method: Multi-level hierarchical regression analysis was used to assess the impact of the centrality and the characteristics of structural holes in social networks (i.e., advice network, information network, friendship network, and trust network) on job performance. Results: The in-closeness centrality of the advice network (β = 0.176, p < 0.05) and the betweenness centrality of the trust network (β = 0.126, p < 0.05) had positive effects on task performance. The in-closeness centrality of the advice network (β = 0.226, p < 0.05; β = 0.213, p < 0.05) and the CI (1 − constraint index) of the friendship network (β = 0.130, p < 0.05; β = 0.132, p < 0.05) had positive effects on contextual performance and overall job performance. Meanwhile, the out-closeness centrality of the information network (β = −0.368, p < 0.01; β = −0.334, p < 0.05) had a negative effect on contextual performance and overall job performance. Conclusions: This study investigates the relationship between healthcare professionals’ job performance and their social networks, taking into account the perspectives of cross-organizational and multidisciplinary teams. The study contributes to the effort of breaking down barriers between different disciplines and organizations, and ultimately, improving the quality of healthcare delivery.

BackgroundBoosting the individual learning passion of medical students is a novel approach to improve their academic performance. It facilitates the medical education reform, motivating both policymakers and educators to focus on the function of positive psychology in the career development of medical students. Therefore, this study aimed (1) to assess the status of two types of learning passion; (2) to clarify the relationship between self-esteem and two types of learning passion among Chinese medical students; (3) to examine the mediating role of psychological capital (PsyCap) in the relationship between self-esteem and two types of learning passion, respectively; and (4) to identify the moderating role of professional identity in the relationship between PsyCap and two types of learning passion, respectively.MethodsA cross-sectional online survey was conducted from April to June 2016 in China. A total of 1,218 valid questionnaires (effective completion rate: 67.93%) were collected from four medical schools.ResultsSelf-esteem significantly and positively influenced medical students’ PsyCap (β = 0.637, P < 0.01) and two types of learning passion, including harmonious learning passion (β = 0.589, P < 0.01) and obsessive learning passion (β = 0.436, P < 0.01). PsyCap fully mediated the relationship (β = 0.578, P < 0.01) between self-esteem and harmonious learning passion positively, whereas it suppressed the relationship (β = 0.490, P < 0.01) between self-esteem and obsessive learning passion. Further, professional identity significantly moderated the correlation between PsyCap and harmonious learning passion (β = −0.554, P < 0.05), rather than obsessive learning passion (P > 0.05).ConclusionTwo types of learning passion of medical students are positively influenced by self-esteem and PsyCap. Medical students with high-level self-esteem should possess strong PsyCap, which augments their harmonious as well as obsessive learning passion. Moreover, the positive effect of medical students’ PsyCap on harmonious learning passion is more notable among those with a lower professional identity. Finally, this study argues that strengths-based interventions of self-esteem and PsyCap are a beneficial approach for future enhancing learning passion in the domain of medical education.

Purpose: This study aims to 1) investigate inhabitants' perceptions of doctors' inconsiderate behaviors during diagnosis and treatment, 2) explore the factors influencing inhabitants' attitudes toward doctors' professional reputation, and 3) examine the status of doctors' inconsiderate behaviors and inhabitants' attitudes and behaviors toward these doctors in China. Patients and Methods: A cross-sectional online survey was conducted with 2050 participants from over 30 Chinese cities, from March to June 2018. In total, 1598 valid questionnaires were obtained (with an effective response rate of 77.95%). Data were analyzed using descriptive statistics, exploratory factor analysis, and logistic linear regression analysis. Results: We developed a questionnaire comprising of 15 items regarding doctors' inconsiderate behaviors based on inhabitants' perspectives (Cronbach's alpha was 0.944). Additionally, we identified the factors that influence the attitudes of inhabitants regarding doctors' professional reputation, such as frequency of medical consultations, medical expenses, education catalog, and type of medical insurance. A majority of the participants highly valued Chinese doctors' professional reputation (87.55%), and trusted them (86.29%). However, about 60.27% of the participants reported a pessimistic-like judgment on the current doctor-patient relationship (DPR) in China. Participants believed that Chinese doctors received a high income (20.47%), maintained a high social status (23.46%), and had a heavy workload (59.95%). Furthermore, about 54.88% of participants reported that they would not engage in aggressive behaviors against doctors during a dispute. Lastly, about 26.66% of participants reported that they would act rationally when they were dissatisfied with their doctors. Conclusion: Impassive emotions and improper actions of doctors toward patients jointly contributed to the disrepute of Chinese doctors. Although DPR was becoming tense, Chinese inhabitants held a positive evaluation of doctors' professional reputation. While an improvement in the economic situation and reputation of doctors enhanced the DPR, there remains an urgent need to improve the working environment in regard to future Chinese health reforms.

In rural China, treatment adherence of patients with hypertension remains a challenge. Although early research on patient adherence has confirmed the importance of trust in doctors, the relative contribution and influence of the two-dimensional structure of trust on adherence has not been explored. Thus, this study examined the effects of patient trust in primary care physicians' (PCPs) benevolence and ability on medication adherence, dietary management, and physical activity. The data were derived from 2,533 patients at 54 primary health institutions in China (village level) from February 2017 to May 2018. Participants were assessed using the Chinese version of the Wake Forest Physician Trust Scale and the Therapeutic Adherence Subscale for Hypertensive Patients. Other information included region, gender, age, and self-rated health status. The results of multiple linear regression and structural equation modeling confirmed that patient trust in PCPs' benevolence was positively correlated with patient adherence to medication, diet management, and physical activity. Patient trust in PCPs' ability was negatively correlated with adherence to dietary management and physical activity. We concluded that interventions aimed at increasing PCP benevolence have the greatest potential to improve patient adherence to hypertension treatment. Under the country's policy of advocating to improve PCPs' diagnoses and treatment technology, it may be important to cultivate doctors' communication skills, medical ethics, and other benevolent qualities to improve patients' adherence with drug and Non-drug treatments.

To investigate the influence of the home environment, defined as family socioeconomic status (SES) (parent education level, household income), student resource-mediated SES (access to nutritional resources and cognitively stimulating experiences), reading ability, and difficulty with homework on quality of life in children and adolescents residing in urban and suburban areas in Hangzhou City, Zhejiang Province, China. This study included 3200 Grade 3–6 students from 8 elementary schools in Hangzhou City. Assessments included questionnaires that evaluated student quality of life, family SES, resource-mediated SES (dietary behavior and the home literacy environment), reading ability, and difficulty with homework. The effects of the home environment on student quality of life were analyzed by univariate analysis, multiple linear regression analysis, and structural equation modeling. Overall, 80.6% of students had a medium or better quality of life. Young age (Grade 3 or 4), female sex, household income of 10000–15000 RMB, high breakfast consumption, daily intake of fruit, a balanced diet, and good reading habits were positively correlated with student quality of life ( P < 0.05), while overuse of electronic devices was negatively correlated with quality of life ( P < 0.05). Dietary behaviors, home literacy environment, and student reading ability and difficulty with homework directly affected quality of life. Family SES indirectly affected student quality of life. Children and adolescents in China should have access to good nutrition and cognitively stimulating experiences to enhance their well-being and provide them with social and academic advantages.

Based on a sufficient analysis of the theoretical framework of " transformation learning collaboration" ( TLC ) and " people-centered and integrated health care " ( PCIC ) mode, this article introduced the main practices and achievements of " Hangzhou characteristics" countywide medical alliances, centering on TLC mode.Hangzhou takes the countywide medical alliance construction as a pilot, refers to the TLC model, and takes growth-oriented collaboration as the guidance, to promote responsibility sharing, benefit sharing, service integration and management collaboration.Guided by the PCIC model proposed by the World Health Organization, the city has established an integrated service model of hierarchical medical system-prevention-rehabilitation-aging care.The countywide medical alliance system framework features " 5 fields, unified leadership, unified culture, 6 supports, 3 tasks and TLC teams " , which may provide references for the coordinated and integrated development of such alliances.

Objective To build a social evaluation index system of public hospitals,for their social evaluation to be carried out timely and provide the theory basis for governance practices.Methods Comprehensive literature analysis method,focus group discussion and individual in-depth interviews were used to collect the initial index system.The Delphi method was used to screen the evaluation index system and to calculate the index weight.Results Based on the theory of public hospitals′social evaluation model,an index system was built comprising 3 level-1 indexes,10 level-2 indexes,and 32 level-3 indexes.Conclusions In view of social systems,establishment of an evaluation index system highlighting public hospitals′social responsibility is in line with the social collaborative governance strategy,which can help with exploration and enriching the social evaluation theory and practice of public hospitals.

Objective To survey the cognitive attitude and participation intention for stakeholders of public hospitals,in order to provide basis for public hospitals social evaluation.Methods 621 stakeholders of public hospitals were subject to the questionnaire survey.Results 76.7%(475/619) stakeholders held it as necessary to independently launch the public hospitals social evaluation,and held that the evaluation subjects selection should be professional(83.8%),independent(67.7%),authoritative (55.6%),and proactive(46.1%).The survey also recommended that social evaluation of public hospitals should have such indexes as government investment (80.2%),social supervision (76.0%),and information disclosure system(7 1.1%).The overall willingness rate of stakeholders to participate in the public hospital social evaluation was 7 1.6%.Conclusions Development of the social evaluation index system of public hospitals and diversified evaluation subj ects are key to developing the theory and practice system of public hospitals social evaluation.

Objective To identify appropriate subjects for public hospitals social evaluation which fit and match the public hospital social evaluation index system.Methods The methods of literature review,expert consulting and comprehensive evaluation were used.SWOT analysis,appropriateness ranking and classification were made to such six evaluation subj ects as civil servants,medical workers, professional organizations,patients and their family,the public at large and mass media representatives. Results For the support dimension,the top three appropriate evaluation subj ects are professional social organizations,the public at large and medical workers in turn.For the process dimension,the top three subj ects are social professional organizations,civil servants and the public at large.For the result dimension,the top three are professional organizations,the public at large and civil servants.Conclusions Diversified evaluation subj ects independently represented and guided by non-government third-party professional organizations seem a better solution for China′s present specifics.Such a mechanism is authorized by the government,involving patients and their family,the public and social observers,and mass media representatives,supported and coordinated by government departments and public hospitals.

Social evaluation governance strategy was introduced to study the social management path for public hospitals.On the basis of definition of social governance and social evaluation theory, clarification of the concepts and relationship logic of public hospital′s social evaluation,and analysis of the context analysis of their social evaluation policy,the paper discussed the establishment of social evaluation and governance theory logic framework of public hospitals.In terms of such realization paths as the purposes,indexes,entities,and methods of the evaluation,as well as result release and application of the evaluation,recommendations were made.

Objective To analyze the impact of performance-based contract management mode purchased by government on the equity and efficiency of public health services in rural areas.Methods Randomized controlled method,agency investigation and questionnaire survey on public health services recipients were used.Results The utilization of residents health records management services,child health management services,health care management of patients with hypertension and type 2 diabetes in pilot counties was higher quality absolutely fair.Gini＜0.2,CI≈0.The overall effectiveness,technical validity and effectiveness of scale of the townships in pilot counties were better than that in non-pilot county.Conclusion This management mode helps to improve the equity of public health services and service efficiency.

When performance-based contract of public health services was implemented in rural areas,some difficult issues need to be considered.Some suggestions are proposed that specific public health services managed by performance-based contract should be measurable.Specific public health services have been proven to be effective.The strategies of increasing the service providers' competition should be taken.In different districts,the rural public health service performance-based contract entering into different areas,and the different strategies should be used to promote competition.And the price for public health services paid to public providers by government should be different from that paid to private providers by government.

The performance-related pay of public health services is described in the way of definition,characteristics and application.Taking pay program of hypertension management in Wuzhi,Henan as an example,through combining with the request of the characteristics and requirements of performance-based contract management,the main problems have been analyzed,and operational suggestions on strengthening performance-related pay public health services have been raised.

Objective:To understand implementation of performance-based contract for rural public health services purchased by government launched in the project Ⅺ pilot counties in Henan Province.To find the problems that may exist and to provide the basis to promote the policy for further improvement.Methods:Using questionnaires,interviews,institution investigation,and other methods to evaluate the implementation direction,design,efficiency,fairness,and degree of response of the policy,etc.Results:Public health services have been improved in the pilot areas.Public health service utilization of residents has been significantly improved.Conclusion:Performance-based contract for rural public health services purchased by government have advanced smoothly.The effective motivation mechanism of rural public health services delivery has been established.

Through applying sociological evaluation method,the operation of performance-based contract for rural public health services purchased by government in pilot trial counties is investigated and analyzed.Management mechanism of performance-based contract of rural public health services contract purchased by government includes the following six aspects,financing mechanism,institutional admittance mechanism,the collaboration among township hospitals and village clinics,service selection mechanism,supervision and evaluation mechanisms,and payment mechanism.And the feasibility of performance-based contract for rural public health services purchased by government is analyzed.

随着社会竞争的加剧,人们越来越认识到:社会的压力、习惯的改变、不良的生活方式、人口的迁移都会造成疾病的增加和传播.健商概念的提出,为缓解这种应激状态提供了一些有效的保健方法[1].医院是进行健商文化宣传教育的主阵地之一,护士则是实施教育的主力军.本研究旨在了解目前护士的健商状况,分析影响其健商的主要原因,进而强化护士履行普及健商义务的意识,加强健康教育的能力,从而提高护理服务质量.

Recent years, the commands about public health more and more step into the life of Chinese people, and the focus turns to the government gradually from public health itself, and turns to the responsibility and even the credit that the government should undertake. The lack of governmental responsibility in public health is because of the indifferent sense of responsibility. But it is also important to the indistinctness and disorder of responsibility. We must give full scope to the regulations of safeguard and constraint, especially the regulations of investigate responsibility, in order to realize the governmental responsibility.