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

摘要： 背景　已有研究从理论层面指出了初级卫生保健在气候变化适应中的重要作用，然而，我国初级卫生保健体系应对气候变化健康风险的现况如何，基层医疗卫生人员的行为意愿、措施支持和应对障碍主要受到哪些因素的影响目前尚不清楚。目的　分析基层医 疗卫生人员应对气候变化健康风险的行为意愿、措施支持与应对障碍，探讨其影响因素并进行重要性评价。方法　依据2017年人均地区生产总值采用分层整群抽样的方法对广东省3个地级市的733例基层医疗卫生人员进行横断面调查。采用自行设计的问卷调查其应对气候 变化健康风险的行为意愿、高温热浪应对措施支持度、登革热应对措施支持度和应对气候变化健康风险障碍度，采用随机森林模型进行影响因素重要性评价。结果　基层医疗卫生人员应对气候变化健康风险的行为意愿平均得分（15.4±3.5）分，其中关注敏感人群平均得 分最高〔（3.2±0.7）分〕；高温热浪应对措施的支持度平均得分（15.7±3.2）分，其中高危人群防护的支持度平均得分最高〔（3.2±0.7）分〕；登革热应对措施的支持度平均得分（22.7±4.3）分，其中灭蚊的支持度平均得分最高〔（3.3±0.7）分〕；应对气候变 化健康风险障碍度平均得分（4.9±2.5）分，其中资金不足〔（0.7±0.5）分〕和难以纳入主要工作〔（0.7±0.5）分〕是基层医疗卫生人员感知到的最突出障碍。随机森林模型分析结果显示，教育水平和工作地域是基层医疗卫生人员应对气候变化健康风险的行为意愿 的重要影响因素，教育水平和家庭人均年收入是基层医疗卫生人员对热浪和登革热应对措施支持度的重要影响因素，而在职时间和工作地域是基层医疗卫生人员感知到的气候变化健康风险应对障碍程度的重要影响因素。结论　基层医疗卫生人员应对气候变化健康风险的 行为意愿和措施支持度整体较高，资金不足和难以把应对气候变化健康风险纳入主要工作是其感知到的最主要障碍。教育水平、工作地域、收入水平和在职时间是影响基层医疗卫生人员应对气候变化健康风险的重要因素。

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