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. 2025 Jun 4;25(1):2078.
doi: 10.1186/s12889-025-23268-0.

Exploring the influencing factors affecting the operational effectiveness of public health emergency response mechanism: a DEMATEL-ISM-MICMAC mixed methods study

Qunkai Wang #  1 , Nan Meng #  1 , Yunxia Ma #  1 , Yanping Wang  1 , Kexin Wang  1 , Ruiqian Zhuge  1 , Yuxuan Wang  1 , Peng Wang  1 , Huan Liu  2 , Qunhong Wu  3
Affiliations

Exploring the influencing factors affecting the operational effectiveness of public health emergency response mechanism: a DEMATEL-ISM-MICMAC mixed methods study

Qunkai Wang et al. BMC Public Health. .

Abstract

Objectives: This study aims to explore key factors and identify root factors influencing the Public Health Emergency Response Mechanism (PHERM) to ensure timely and effective responses to emerging infectious disease crises and enhance the efficiency of emergency operations.

Methods: We employed a mixed-method approach using DEMATEL-ISM-MICMAC to analyse the interrelationships among factors affecting PHERM. The DEMATEL method established the hierarchical structure of the factors, ISM determined the relational paths, and MICMAC further characterized the attributes of the factors.

Results: The analysis revealed that PHERM's influencing factors are organized into four levels, with the conscientiousness of emergency leadership action (X15) identified as the most profound and influential factor, exhibiting a strong causality with a high driving force. The decision-making and command feedback capability (X8) emerged as a significant outcome factor in the transition layer, highly influenced by other factors and with the highest node degree.

Conclusions: The proactive emergency response awareness and actions of leaders is crucial for the mechanism's smooth and efficient operation. It is essential to prioritise ideological education and simulation training to instill such awareness. Moreover, proactive preparation for factors associated with decision-making and command capabilities is necessary to mitigate potential hesitation and panic during actual epidemic prevention, thereby enhancing the operational effectiveness of PHERM.

Keywords: Health emergencies; Influencing factors; Mixed methods.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The survey in this study is anonymous and does not collect personal identity information, and does not involve sensitive topics. According to the Measures for Ethical Review of Life Sciences and Medical Research Involving Human Beings, research conducted using anonymous information data can be exempted from ethical review. The need for ethical approval was waived by the ethical review committee of Harbin Medical University. Therefore, this study does not currently require ethical review. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A model of factors influencing the operation of PHERM based on the Horn-Mitte model
Fig. 2
Fig. 2
DEMATEL-ISM-MICMAC analysis flowchart
Fig. 3
Fig. 3
DEMATEL centrality-causality diagram of PHERM influencing factors
Fig. 4
Fig. 4
PHERM influencing factors'multi-layer recursive structure model
Fig. 5
Fig. 5
Dependency-Drive graph based on MICMAC analysis
See this image and copyright information in PMC

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