[Evolution and Application of Disease Control Priorities]. / ç–¾ç— æŽ§åˆ¶ä¼˜å ˆçš„æ¼”è¿›åŠåº”ç”¨.

Disease control priority (DCP) is an important public health intervention strategy. Diseases that should be prioritized for prevention and control are first screened with a series of criteria, including the severity of the disease burden, the effectiveness of disease control technologies, the prevention and control capacity of the existing health system, etc. Then, the prevention and control technologies for these diseases undergo qualitative evaluation (eg, face-to-face interviews, expert consultation, workshops, etc) and quantitative evaluation (eg, cost-benefit analysis, multi-criteria decision analysis, etc). Finally, the public health initiatives that should be prioritized are identified. From the conception of the idea, to the formal proposition of the concept, to guidance for practice, DCP has gone through more than 70 years of development. Through DCP, significant contributions has been made to improving the efficiency of health care service systems and promoting the health of populations in developing countries. Herein, we systematically reviewed the background, development history, realization method, and practical applications of DCP, focusing on exploring the application potential of DCP in health governance and providing technical support and decision-making reference for the comprehensive promotion of the Healthy China Initiative.

The development and application of a two-step surveillance process for Healthy China Initiative based on wide coverage interagency data.

BACKGROUND: Healthy China is a nationwide health strategy aiming at improving health from diverse dimensions, and strengthening high-quality assessment is essential for its stimulation. However, there is limited evidence in the surveillance of the actual performance of the initiative at regional levels. This study innovatively proposes a two-step surveillance process which comprehensively monitors Healthy China Initiative based on regional realities, thus provides guidance for policymaking. METHODS: A flexible indicator system was firstly developed basing on Delphi survey and focus group discussions. And then the Analysis Hierarchical Process and the TOPSIS method were used to determine the weights of indicators and calculate comprehensive indexes as the surveillance outcomes. A pilot study was conducted in a typical area in China to verify the applicability of the process. RESULTS: Following the surveillance process and basing on the implementation of Healthy China Initiative in the target region, an indicator system comprised of 5 domains and 23 indicators with weights was first developed specifically for the pilot area. Then 1848 interagency data of the study area were collected from 8 provincial institutions/departments to calculate the indexes and ranks of the five domains which were health level, healthy living, disease prevention and control, health service, and healthy environment. The outcomes showed that Healthy China Initiative in the pilot area had been constantly improved since the strategy proposed, while there were still issues to be tackled such as the deficient monitoring mechanisms and unevenly development progress. CONCLUSIONS: This study proposed a pragmatic surveillance process with indicators which could be tailored for specific context of target regions and produce meaningful surveillance outcomes to inform decision-making for policymakers, and also provided a theoretical foundation as well as empirical evidence for further health strategies and plannings assessment studies.

Geographic, Demographic, and Socioeconomic Disparities and Factors Associated With Cancer Literacy in China: National Cross-sectional Study.

BACKGROUND: Cancer literacy is associated with several health-related behaviors and outcomes. However, there is still a lack of nationwide surveys for cancer literacy in China. OBJECTIVE: This study aims to evaluate cancer literacy in China, explore disparities, and provide scientific evidence for policy makers. METHODS: A cross-sectional survey was conducted in mainland China in 2021 using the multistage probability proportional to the size sampling method. Both the reliability and validity of the questionnaire were evaluated. The awareness levels were adjusted by sampling weights and nonrepresentativeness weights to match the actual population distributions. The Rao-Scott adjusted chi-square test was applied to test geographic, demographic, and socioeconomic disparities. A generalized linear model was used to explore potential factors. RESULTS: A total of 80,281 participants aged 15-74 years were finally enrolled from 21 provinces, with an overall response rate of 89.32%. The national rate of cancer literacy was 70.05% (95% CI 69.52%-70.58%). The rates were highest regarding knowledge of cancer management (74.96%, 95% CI 74.36%-75.56%) but were lowest regarding basic knowledge of cancer (66.77%, 95% CI 66.22%-67.33%). Cancer literacy was highest in East China (72.65%, 95% CI 71.82%-73.49%), Central China (71.73%, 95% CI 70.65%-72.81%), and North China (70.73%, 95% CI 68.68%-72.78%), followed by Northeast (65.38%, 95% CI 64.54%-66.22%) and South China (63.21%, 95% CI 61.84%-64.58%), whereas Southwest (59.00%, 95% CI 58.11%-59.89%) and Northwest China (57.09%, 95% CI 55.79%-58.38%) showed a need for improvement. Demographic and socioeconomic disparities were also observed. Urban dwellers, the Han ethnic group, and population with higher education level or household income were associated with prior knowledge. The questionnaire showed generally good internal and external reliability and validity. CONCLUSIONS: It remains important for China to regularly monitor levels of cancer literacy, narrow disparities, and strengthen health education for dimensions with poor performance and for individuals with limited knowledge to move closer to the goal of Healthy China 2030.

Research on the concept of hospital health literacy based on proceduralised grounded theory / 中华医院管理杂志

Objective:To construct the concept and its conceptual framework of hospital health literacy(HHL) for exploring the HHL promotion mechanism in the country.Methods:Based on the proceduralised grounded theory, twelve middle or senior managers of hospitals were selected for in-depth interviews and three hospitals were selected for field research from July 2021 to February 2022. Open coding, axial coding, and selective coding were used in data analysis, establishing the concept of HHL and its conceptual framework in China.Results:The conceptual framework of HHL was composed of an internal driver mechanism(hospitals improve their health literacy promotion management system, staff-led health literacy promotion, health literacy promoting physical environment construction), and an external driver mechanism(cooperate with external organizations and institutions to conduct health literacy promotion). The concept of HHL in China was derived as follows: the combination of supportive environments and human resources that health care organizations have in place can improve access and understandability of health information and simplify healthcare services to help patients of different health literacy levels more easily obtain, process, and understand health information as well as to make the most of medical services.Conclusions:Hospital health literacy promotion mechanism in China is a synergy between internal and external driver mechanisms.

Chinese adults′ cognition of respiratory diseases in Healthy China Initiative (2019—>2030) / 中华健康管理学杂志

Objective:To investigate the cognition of Chinese adults on respiratory health in the Healthy China Initiative (2019—2030).Methods:From January 2022 to February 2022, the electronic questionnaire was distributed by using the two-dimensional code on the Wechat platform. The questionnaire involving the respiratory health part of the Healthy China Initiative (2019—2030) was conducted among people aged ≥18 years (except pregnant and postpartum women) in 32 provincial administrative regions in China. A total of 5 892 questionnaires were distributed, 4 754 valid questionnaires were recovered. Chi square test was used to analyze the basic situation of the survey subjects, the cognition of people in different regions to the content, the correlation between physical activity and age stratification, the correlation between smoking cessation and disease, and the common cognitive misunderstanding of chronic obstructive pulmonary disease.Results:Of the 4 754 subjects in this study, 3 462 were from urban area and 1 292 were from rural area. In terms of active participation in lung cancer screening, regular physical examination, no awareness of reducing risk factors exposure, isolation of pulmonary tuberculosis patients, reduction of travel of pulmonary tuberculosis patients, wearing masks when contact with pulmonary tuberculosis patients, active learning of medical and health care knowledge, and timely medical treatment in case of health problems, the cognition status of people in the city was better than people in the rural areas (all P<0.05). The compliance rates of moderate intensity physical activity and high intensity physical activity were 72.7% and 83.8%, respectively, among the population aged 18—64 years old; the compliance rates of moderate intensity physical activity and high intensity physical activity were 82.3% and 85.7%, respectively, among the population aged≥65 years old; the proportions of light intensity physical activity in people aged 18—64 and ≥65 years old were 65.2% and 87.6%, respectively. There was a correlation between whether the patients had respiratory diseases and whether they were troubled by respiratory diseases for a long time and their determination to quit smoking (all P<0.05); the rate of common misconceptions about chronic obstructive pulmonary disease among Chinese adults was between 13.0% and 38.0%, and the rate of misconceptions among people with college education or above who believed that even if the cognition of chronic obstructive pulmonary disease was improved and the diagnosis and treatment were standardized, the treatment of the disease was still ineffective was as high as 30.3%; in addition, the rate of two cognitive misunderstandings (when the symptoms of chronic obstructive pulmonary disease were mild, no intervention was needed; the medication can be discontinued when the symptoms were relieved) of people with college education or above were 24.2% and 25.8%, respectively, which were higher than those with primary school education and junior high school education (all P<0.05). Conclusions:The cognition of Chinese adults on early screening of respiratory diseases, reduction of exposure to risk factors, prevention and control of tuberculosis, and acquisition of scientific knowledge in the Healthy China Initiative (2019—2030) is generally poor. The participation of people <65 years old in high-intensity physical activities is insufficient, and the cognition of people with high education level does not show advantages.

Construction of health literate health care organizations and its enlightenment to China / 中华医院管理杂志

Health literacy serves as the foundation of health for all. Hence the authors introduced the connotation and extension of health literate health care organization(HLHO) and related concepts. On such basis, the paper presented the construction method of HLHO from the perspective of health policy, healthcare organizations and inter-institutional cooperation, in order to improve the health literacy of the Chinese people and implement the Healthy China initiative(2019—2030).