基于扎根理论的执行突发公共卫生事件社区防控政策的影响因素研究

目的 探讨执行突发公共卫生事件社区防控政策的影响因素及其作用机制,并提出相应对策.方法 于2020年2-9月按照目的、理论和滚雪球抽样结合扎根理论研究方法对我国7个省(市)的122名社区管理人员、基层医疗机构医务人员、志愿者和社区居民进行半结构化访谈,经开放编码、主轴编码和选择性编码构建执行突发公共卫生事件社区防控政策...

Influencing factors of the implementation of community-based public health emergency prevention and control policies:based on Grounded Theory

Objective To investigate the influencing factors,mechanisms,and countermeasures of the implementation of public health emergency prevention and control policies in communities.Methods Semi-structured interviews were conducted with 122 community managers,medical staff at primary care institutions,volunteers,and community residents in seven provinces(municipalities)in China from February 2020 to September 2020 with a Grounded Theory(GT)approach(including the use of snowball sampling).The influencing factors of community-based implementation of public health emergency prevention and control policies and their mechanisms of action were analyzed by using the three data analysis steps in the GT method:open coding,axial coding,and selective coding.Results After the three-level coding,146 concepts,22 categories,5 primary categories and 1 core category related to the implementation of public health emergency prevention and control policies were identified,which yielded that the main influencing factors for the implementation of community prevention and control policies for public health emergencies were policy attributes,internal management,external support,and residents'cooperation and participation.Conclusions In the implementation of communitybased prevention and control policies for public health emergencies,“policy attributes”is an antecedent to policy implementation,“internal management”plays a gravitational role,“external support”has a supportive role,and“residents'cooperation and participation”plays a“thrust”role.All of these factors ultimately produce different implementation behaviors such as normal and deviant policy implementation.Therefore,it is important to improve the performance incentive mechanism and quality improvement mechanism of community workers,optimize the supervision of policy implementation,and innovate the ways of policy publicity to create a good environment for policy implementation.