Public satisfaction with Healthy China Action Plan implementation: a web-based cross-sectional survey in southwest China

Abstract

Objective: The Healthy China (Guangxi) Action Plan has been in effect for approximately 4 years, with its primary goals being to improve public health and prevent diseases. However, there is limited information available on the community-level public satisfaction with the outcomes of its implementation. Therefore, we intend to conduct an assessment based in southwest China.

Design: A population-based, cross-sectional survey was performed between 1 June 2023 and 31 July 2023.

Setting: Community members of all 14 prefecture-level cities within Guangxi, China, during June 2023 to July 2023.

Participants: A total of 62 4016 participants were included for analysis based on exclusion criteria, with 44.4% aged 18-35 and a male to female ratio of 3:2.

Primary outcome measure: 'Public satisfaction with the Healthy China (Guangxi) Action Plan implementation' was measured by the combination of 'Willingness to join health promotion' and 'Satisfaction to overall medical implementation measures and services' using a structural equation model with a multiple-indicator, multiple-cause approach in R software.

Results: The study proposed a comprehensive five-factor model to evaluate the public satisfaction with Healthy China (Guangxi) Action Plan implementation. With the mediator of 'awareness of Healthy China (Guangxi) Action Plan', health education/promotion demonstrated important effect on overall public satisfaction with Healthy China (Guangxi) Action Plan implementation. Mental health had small but positive effect on the outcomes. High socio-characteristic variables showed negative effects on all latent variables except for the mental health status. All of the effects were statistically significant.

Conclusions: Understanding the impact of background variables on public satisfaction with Healthy China (Guangxi) Action Plan implementation was crucial, along with considering the sociodemographic traits of participants. This knowledge helped policymakers to develop tailored interventions and strategies.

Keywords: Awareness; Health policy; PUBLIC HEALTH; Patient Satisfaction.

Figure 1. Theoretical model of public satisfaction with Healthy China (Guangxi) Action Plan implementation based on hypotheses proposed. Mental health refers to mental health status. Hospital publicity refers to health education and promotion provided by medical personnel. Awareness of Healthy China (GX) refers to awareness of the Healthy China (Guangxi) Action Plan. SAT to health services refers to satisfaction to overall health services.

Figure 2. Multiple-indicator, multiple-cause model examining the impact of covariates on the public satisfaction with Healthy China (Guangxi) Action Plan implementation. Mental health refers to mental health status. Awareness of Healthy China refers to awareness of the Healthy China (Guangxi) Action Plan. Satisfaction to health services refers to satisfaction to overall health services. Anxiety refers to experience anxiety symptoms in the past 3 months. Depression refers to experience symptoms of depression in the past 3 months. To outpatients refers to doctor’s education on disease prevention during outpatient visits. To inpatients refers to hospital staff’s provision of disease prevention information during hospitalisation. Join health activity refers to be interested in joining health education events and receiving health information. Disseminate health info. refers to be willing to actively promote health knowledge to their family and friends. Sat. 1 refers to satisfaction to current government health action implementation. Sat. 2 refers to satisfaction to medical service provided by local medical institutions. Sat. 3 refers to satisfaction to public health services provided by local Center for Disease Control and Prevention. Parameter estimates are standardised. All parameters are significant associates (p<0.05).