上海市社区全科医生实施主动健康管理知信行现状及其影响因素OA

Background With evolving health concepts and changing disease spectra,the importance of proactive health management in disease prevention and health promotion has become increasingly prominent.As the cornerstone of primary health care at the community level,general practitioners play a pivotal role in implementing proactive health management.However,evidence on the current status of community general practitioners'knowledge,attitude,and behaviors regarding proactive health management,as well as the factors influencing these domains,remains limited.Objective This study aims to assess the current status of knowledge,attitude,and behaviors related to proactive health management among community general practitioners in Shanghai,to analyze the major influencing factors,and to propose targeted strategies for improvement.Methods From February to May 2023,a questionnaire survey was conducted in two community health service centers in each of the 16 administrative districts of Shanghai,and a total of 691 community general practitioners were enrolled.A self-developed Community General Practitioners'Proactive Health Management Knowledge,Attitude,and Behaviors Questionnaire was used,comprising three dimensions(knowledge,attitude,and behaviors)and demonstrating acceptable reliability and validity.Independent-samples t tests,one-way analysis of variance,and multiple linear regression analyses were performed to examine differences across subgroups and to identify associated influencing factors.Results Overall,community general practitioners reported positive beliefs regarding proactive health management(score rate 84.12%),a moderately high level of knowledge(75.90%),and comparatively lower levels of related behaviors(71.98%).Multiple linear regression analysis showed that educational level,professional title,serving as a team leader,and practice region were significant predictors of knowledge scores(P<0.05);educational level,years of working in general practice,and serving as a team leader were significant predictors of attitude scores(P<0.05);and educational level,years of working in general practice,professional title,serving as a team leader,and practice region were significant predictors of behavior scores(P<0.05).The main perceived barriers to implementing proactive,health-oriented management among community general practitioners included lack of policy support(n=473,68.45%),heavy clinical workload(n=469,67.87%),insufficient health awareness among residents(n=410,59.33%),and limited institutional resources(n=383,55.43%).Conclusion Community general practitioners in Shanghai demonstrate generally positive attitudes toward proactive health management;however,their knowledge remains insufficiently systematic and their behaviors are not fully translated into practice.Educational level,professional title,years of general practice experience,team leadership roles,and practice region significantly influence their levels of knowledge,beliefs,and behaviors.Stratified training,optimized policy support,strengthened allocation of digital resources,and enhanced health education for community residents are warranted to promote the effective translation from"knowing"and"believing"to"doing"in proactive health management,thereby improving the quality and effectiveness of proactive health management at the primary care level.