The Social Ecological Model: A Framework for Understanding COVID-19 Vaccine Uptake among Healthcare Workers—A Scoping Review

Background Primary care has been identified as a key factor in facilitating timely diagnosis and effective management of congestive chronic heart failure (CHF) in older patients. Understanding the current status of CHF management in community health care can therefore be effective in reducing the disease burden of CHF. Objectives The aim of this study was to evaluate the existing state of CHF services offered by healthcare facilities and to identify the primary obstacles faced by community medical personnel in China. Methods In this interpretive study, the social ecological model (SEM) was employed to facilitate interviews conducted using a semi-structured interview guide. Each participant underwent an interview lasting between 45 and 60 minutes. Thematic analysis was utilized for data analysis. Results This study incorporated a cohort of 30 participants. Facilitators and barriers were identified within the five domains of the SEM. (1) individual level: medical staff lack knowledge and experience in CHF management while patients’ weak health awareness. (2) interpersonal level: insufficient support from the patients’ family and lack of trust in community hospitals and health workers. (3) organizational level: inadequate medical knowledge and training programs for medical staff, shortage of medical staff and weak teamwork and few health promotion channels. (4) community level: Lack of regular screening and follow-up, medical equipment and an information technology-assisted monitoring system. (5) public policy level: lack of policy support, funding subsidies, national guidelines adapted to the local context and low medical insurance reimbursement rate. Conclusion There are many impediments to chronic disease management in the community, so it is vital to improve public understanding of CHF, as well as to improve the quality of community health equipment and services, to improve reciprocal referral mechanisms between hospitals and the community, and to develop policies on chronic disease management for chronic older people.

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Socioecological drivers of burnout – a mixed methods study of military health providers

Olapeju,

Dong,

Soh

et al. 2024

Front. Public Health

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IntroductionHealth provider burnout is highly prevalent (28–51%) in the US and may contribute to a projected national health provider shortage by 2030. The Socioecological Model (SEM) is a proven conceptual framework used to identify influencing factors and design relevant solutions to improve health outcomes across multiple ecological levels. This study applied the SEM to identify modifiable drivers and solutions of burnout across multiple levels among US Military health providers.MethodsWe conducted a cross-sectional mixed methods study using an online survey (N = 129) and in-depth interviews (N = 25) of active duty military health providers. Our primary quantitative outcome was self-reported definite, unrelenting, or complete burnout. Our quantitative analysis included chi-square tests of association and bootstrapped multivariable logistic regressions to explore SEM-informed correlates of burnout, controlling for contextual variables. Our qualitative data explored providers individual experience with workplace stress and burnout, providing details on factors influencing burnout at the individual, interpersonal, organizational and military levels. The qualitative data was systematically coded and analyzed using grounded theory.ResultsAbout two-thirds (63%) of surveyed providers self-reported burnout. Individual-level factors significantly associated with burnout included a positive coping style (AOR = 0.21; 95% CI: 0.08–0.56), perceived control over workload (AOR = 0.17; 95% CI: 0.04–0.66), and satisfaction with the current job (AOR = 0.11; 95% CI: 0.03–0.39). At the organizational level, providers described as overworked (AOR = 10.58; 95% CI: 3.30–33.91) or in hectic or chaotic primary work areas (AOR = 7.54; 95% CI: 2.33–24.38) had higher rates of burnout. At the military level, providers who were happy with their career path and promotion plan (AOR = 0.16; 95% CI: 0.06–0.44) reported lower rates of burnout. The organizational level had the highest cumulative impact of modifiable factors on burnout (AOR: 0.15; 95% CI: 0.06, 0.36). Qualitative interviews corroborated survey findings and highlighted the individual level manifestations of burnout, the role of interpersonal support as mitigators of burnout and the complexity of governmental and military policies impacting provider wellness.DiscussionIdentified factors influencing burnout at various levels may inform potential data-driven interventions to ensure a functional and vibrant US Military health. Data-driven strategies may include opportunities to balance work demands with resources and ability to cope as well as improve positive coping skills, attitudes and experiences related to work.

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The Social Ecological Model: A Framework for Understanding COVID-19 Vaccine Uptake among Healthcare Workers—A Scoping Review

Cited by 3 publications

References 98 publications

Is the Effect of Educational Attainments on Trust in Scientists Underestimated?

Is the Effect of Educational Attainments on Trust in Scientists Underestimated?

Facilitators and Barriers in Managing Elderly Chronic Heart Failure Patients in Primary Care: A Qualitative Study of Medical Personnel’s Perspectives Using the Socio-Ecological Model

Socioecological drivers of burnout – a mixed methods study of military health providers

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