Community health education is widely recognized as an effective health promotion strategy with low costs and high benefits. Nevertheless, existing research on health education needs lacks an analytical framework based on various community types, making it difficult to fully explain the differentiated and diverse health education needs under the complex population composition of urban communities.

To investigate the health education needs of residents in different types of communities and whether there are significant differences, thereby providing support for community health medical science popularization efforts.

This study was conducted in Hangzhou from April to June 2024, employing a mixed-methods research approach. The qualitative research phase involved purposive sampling to select open-ended interviews from heterogeneous, transformed, homogeneous and system-based community types, aiming to understand residents' perceptions of health education needs. A total of 14 residents were included, along with 21 policy texts to understand the knowledge system residents should possess in health education. Nvivo 12.0 software was utilized to perform a three-level coding of the text data, categorizing health education content needs based on resident perspectives and policy document analysis. Based on the identified themes, a questionnaire was designed. In the quantitative research phase, residents from four community types were selected as survey subjects, and the Likert 5-point scale was used to quantify the needs for health education content. Then, descriptive statistics, nonparametric tests, and multivariate Logistic regression models were employed to investigate the degree of these needs and differences in health education content among different community types.

The qualitative research synthesized eight primary themes of health education: major disease prevention and control, healthy lifestyles, maternal and child health, mental health, environmental health, medication health, emergency and safety, and sex education, encompassing 23 specific educational topics. A total of 299 valid questionnaires were collected in the quantitative research, with a response rate of 94.03%. The results highlighted that the highest need is first aid knowledge [5 (4, 5)], followed by cancer prevention and treatment [4 (4, 5)]. Kruskal-Wallis H test results indicated that residents' educational level, income level, and different types of communities had a significant impact on the health education needs (P<0.05). Further multivariate Logistic regression analysis showed that different educational levels significantly influenced the needs for diabetes prevention (P<0.05) and life safety education, different income levels significantly affected the needs for cardiovascular and cerebrovascular disease prevention and infectious disease prevention (P<0.05), and different types of communities had significant differences in the needs for natural environmental pollution prevention, infectious disease prevention, diabetes prevention, cardiovascular and cerebrovascular disease prevention, first aid knowledge, and life safety education (P<0.05).

Residents' perceptions of community health education needs are diverse, influenced by multiple factors such as educational level, income level, and community health resources. Different types of communities should closely align with residents' perceptions of health education needs for precise targeting, while ensuring the effectiveness and equity of educational resources.