关键词: 基层医疗, 卫生专业人员, 气候变化, 健康风险, 卫生应对, 影响因素分析

Abstract: Background　Some studies have pointed out the important role of primary health care in climate change adaptation from a theoretical perspective.However，it is still unclear how the primary health care system in China is currently responding to health risks due to climate change，and what factors affect the perceptions，the support proposed measures and barriers of primary healthcare practitioners in coping with these health risks.Objective　To understand the current perceptions，the support proposed measures and barriers of primary healthcare practitioners in coping with health risks due to climate change，explore the influencing factors and conduct an importance evaluation.Methods　A stratified cluster sampling method was used to conduct a cross-sectional survey among 733 primary healthcare practitioners from 3 prefecture-level cities based on the regional per capita GDP of Guangdong Province in 2017.A self-designed questionnaire was used to investigate their perceptions to deal with health risks due to climate change，their support for proposed measures to address heatwaves and dengue fever，and barriers in response to climate change.The random forest model was used to analyze the importance of influencing factors.Results　 The average score of primary healthcare practitioners in the willingness of responding to the health risks due to climate change，was （15.4±3.5）points，of which the average score of concern on vulnerable groups was the highest〔（3.2±0.7）points〕.The support for heatwave response measures's average score（15.7±3.2）points，which the average score of support for protection of high-risk groups was the highest〔（3.2±0.7）points〕.The support for dengue response measures's average score（22.7±4.3）points，which the average score of mosquito control was the highest 〔（3.3±0.7）points〕.Barriers perceived in climate change response，with an average score of（4.9±2.5）points，of which insufficient funds 〔（0.7±0.5）points〕 and the difficulty of setting climate change response as institutional priorities 〔（0.7±0.5）points〕 were major barriers perceived by primary healthcare practitioners.The analysis results of the random forest model showed that education and working area were important factors affecting primary healthcare practitioners' willingness to deal with health risks due to climate change；education and household income per capita were important factors affecting the support for proposed measures to address heatwaves and dengue fever，while seniority and working area were important factors affecting barriers perceived in health risks due to climate change response.Conclusion　Primary healthcare practitioners have a generally high willingness to deal with health risks due to climate change and support proposed measures.The lack of funds and the difficulty of setting health risks due to climate change response as institutional priorities are major barriers perceived.Education，working area，income and seniority are important factors affecting the response to health risks due to climate change.

Key words: Primary care, Healthcare practitioner, Climate change, Health risk, Health response, Root cause analysis