Research On The Process And Optimization Of Community Health Education Service Based On Grounded Theory

ObjectiveCommunity health education is the crucial project of the national health education system,and optimizing the process of community health education services has a fundamental role in strengthening the grassroots public health system.This research used qualitative research based on grounded theory as methodological guidance,to construct a model of the urban community health education service process,and analyze the dilemmas and causes of each link of the community health education service in the main urban areas of Chongqing,in order to optimize the community health education service process for reference.MethodsIn this research,the literature research method was used to sort out the current research status of the community health education service process,and build a community health education service process analysis framework based on the complex adaptive system and co-production theory.After that,20 community health service centers in the main urban areas of Chongqing were selected as sample communities to collect their annual health education plans,summaries,and health education activity records.In addition,semi-structured interviews were conducted with health education professionals(part-time)on related issues.Finally,the above content was sorted and classified into 20 sets of case materials,and the case materials were coded in three-level theory using Nvivo23.0 software.Results and ConclusionsBasic situation: In the first half of 2020,on average,each community health service center held 7.44±3.90 health education lectures,carried out6.56± 2.89 health education publicity activities,distributed 13,558.83±7547.50 health education publicity materials,The 11.83±4.42 period of health education publicity column was updated,1387.78±561.07 hours of health education audio and video materials were broadcast,and 23881.71±13809.33 person-times of personalized health education were carried out.Coding result: In the open coding,108 initial concepts were obtained,which were classified into 66 categories.In the main axis coding,a total of16 main categories are extracted,including management subject,policy and system construction,design subject,service purpose,service object,service form,service content,service requirement,provider,concept and skills,system guarantee,and collaboration and innovation,facilities and places,assessment subject,assessment content,assessment system.In the selective coding,a total of 4 core categories were extracted,including co-management,co-design,co-provide,and co-evaluation.Based on this,a community health education service process model was constructed.The story line was sorted out that community health education services were based on the interaction of the main body in order to realize common interests,and the main body interaction existed in all links of joint production.Meanwhile,the essence of the health education service process is the co-production process of the service.The realization path includes co-design,co-provide,co-evaluation,and co-management throughout the first three links.Based on the above results,we analyzed the service process of community health education in the main urban areas of Chongqing,and pointed out that there are five difficulties in the process.First,the policy and institutional system need to be improved urgently,and there was no common value goal between the subjects.Second,dislocation of supply and demand was widespread,and service planning lacks adaptability.Third,there were difficulties in financial support,personnel guarantee,guidance and training.Fourth,the service process focused on vertical linkage and ignored horizontal collaboration.Fifth,there were deviations in the evaluation index system,and the assessment mechanism did not fully play an incentive role.SuggestionsThe first is to improve the implementation rules and supporting policies under the existing legal framework,and balance the interests of all parties to achieve value symbiosis.The second is to optimize the service supply structure,accurately assess demand,and innovate service methods.The third is to improve the funding compensation mechanism,strengthen the construction of the personnel team,strengthen technical assistance and systematic training,and continue to optimize the allocation of resources to break through the bottleneck of service capabilities.The fourth is to strengthen horizontal coordination and build a new model of multi-community cooperative governance,including strengthening the public health function construction of public hospitals,building institutional coordination between community neighborhood committees and primary medical institutions,and guiding the collaborative participation of social organizations.The fifth is to take into account economic and social benefits,and optimize the evaluation and assessment framework.