General Practitioners’ Perceptions of their Practice of Evidence-based Chronic Disease Prevention Interventions: A Quantitative Study in Shanghai, China

Abstract

Background Despite increasing calls internationally for the inclusion of evidence-based decision-making (EBDM) processes in chronic disease prevention and control programming and policymaking, there is relatively sparse research assessing the current capacity of physicians and the factors influencing that capacity in China.Method A total of 892 physicians were collected from community healthcare centers (CHCs) in Shanghai, China. The experience-based chronic disease prevention (EBCDP) evaluation tool assessed physicians’ awareness, adoption, implementation and maintenance of EBCDP based on the RE-AIM framework. Linear regression analysis was used to assess associations between each EBCDP process and personal characteristics or organizational factors. Result Physicians from CHCs perceived their awareness (mean=4.90, SD=1.02) and maintenance (mean=4.71, SD=1.07) of EBCDP to be relatively low. Physicians with lower titles and monthly incomes >9,000 RMB per month tended to have relatively higher scores for the awareness, adoption, and implementation of EBCDP (P<0.05). Those who participated in one program were less likely to adopt (b=-0.284, P=0.007), implement (b=-0.292, P=0.004), and maintain (b=-0.225, P=0.025) EBCDP than those who participated in more programs. Physicians in general practice (Western medicine) had a lower level of awareness of EBCDP than those in other departments (P<0.0001). Those who were from the suburbs had lower scores regarding awareness (b=-0.150, P=0.047), implementation (b=-0.171, P=0.029), and maintenance (b=-0.237, P=0.002) compared with those from urban areas. Physicians in CHCs affiliated with universities had higher scores on all four EBCDP processes compared with those in CHCs not affiliated with a university. Conclusions This study provides evidence quantitatively illustrating the practice of EBCDP among physicians in CHCs with various personal and organizational characteristics. More solutions should be provided to increase their awareness of EBCDP to stimulate the use of EBCDP for chronic disease prevention and other public health priorities.