Building a strong and healthy nation through grassroots public health services has been established as a fundamental national strategy in China. Enhancing the job performance of community health service personnel is therefore of critical importance.
This study aimed to analyze the driving factors and improvement pathways for the job performance of community health service personnel, providing insights for strengthening the capacity of primary health services.
A questionnaire survey was conducted from July to September 2023 using purposive sampling. Participants included 4 000 community health service personnel from northern (Heilongjiang Province), central (Hubei Province), western (Gansu Province), and southern (Guangdong Province) China. The questionnaire comprised the following sections: a General Information Questionnaire, Job Motivation Measurement Scale, Job Content Questionnaire, the Minnesota Satisfaction Questionnaire, the Social Support Rating Scale, the WHO-5 Well-being Index, and Job Performance Measurement Scale. Data were analyzed using fuzzy-set qualitative comparative analysis (fsQCA) .
A total of 3 854 valid questionnaires were collected, with an effective response rate of 98.2%. The fsQCA results indicated that no single factor constituted a necessary condition for high job performance. Five distinct causal configurations were found to enhance job performance, with an overall solution consistency of 0.933 5 (exceeding the 0.800 0 threshold), indicating strong explanatory power for the model. Work climate motivation, work environment motivation, and job support motivation emerged as core conditions across solutions. Compensation and benefits motivation, job satisfaction, and social support played important roles in specific pathways. Job content motivation, career development motivation, and occupational stress acted as peripheral conditions in certain configurations.
The three motivational factors of work environment motivation, work climate motivation and job support motivation are the core influencing factors to enhance the job performance of community health service workers. Job performance should be improved by optimising and improving the working environment, creating a good working atmosphere and strengthening the job support system.
At present, community health service personnel in China are facing many practical problems, which seriously affect their work enthusiasm and motivation. At the same time, the research on the relationship between work motivation and work performance of community health service personnel is still in its infancy, and there is no systematic research.
To identify potential subgroups of job performance among community health service personnel using a person-centered approach and to examine the predictive effect of work motivation on different job performance subgroups.
This study was conducted from July to September 2023, surveying 50 randomly selected community health centers or service stations in Heilongjiang, Hubei, Gansu, and Guangdong provinces. Within each community service center or station, 20 staff members were randomly selected to complete work motivation and work performance scales. A total of 4 000 staff members were surveyed, with 3 925 questionnaires returned and 3 854 valid questionnaires, resulting in an effective response rate of 98.2%. Latent profile analysis was used to determine the latent classification of community health service personnel's work performance. Multivariate linear regression analysis was employed to assess the relationship between different work performance subcategories and work motivation, while controlling for demographic variables such as gender and age.
The latent profile analysis (LPA) identified three distinct classes of job performance among community health service personnel, namely low, moderate, and high job performance groups, accounting for 14.71%, 46.16%, and 39.13% of the sample, respectively. The three-class model demonstrated good classification quality, with average posterior probabilities ranging from 93.8% to 96.6% across classes. Significant differences were observed among the three performance classes in task performance, contextual (relational) performance, and learning performance scores (all P<0.001). The low-, moderate-, and high-performance groups also differed significantly with respect to age, marital status, educational attainment, years of work experience, professional title, employment status, and average monthly income (all P<0.001). Multiple linear regression analyses indicated that, after controlling for relevant demographic characteristics, work motivation was a significant positive predictor of job performance in the low-, moderate-, and high-performance groups (β=0.264, 0.207, and 0.340, respectively; all P<0.001).
The work motivation of community health service personnel is effectively improved through corresponding incentive measures, which will directly promote the improvement and improvement of their work performance.
The assessment of work motivation among community health service providers is crucial for improving service quality. However, there is still a lack of tools to evaluate their work motivation, and a corresponding scale urgently needs to be developed.
To develop an assessment tool for the work motivation of community health service providers in order to boost their enthusiasm and proactivity at work.
Based on grounded theory, an interview outline was constructed using a literature review. From February to July 2022, in-depth interviews were conducted with personnel from community health service centers (n=40) in Heilongjiang, Hubei, Gansu, and Guangdong provinces, selected through theoretical sampling. Grounded theory was used to extract concepts and categories to form an initial scale, which, after expert review, resulted in 42 items. From August to December 2022, questionnaires were distributed online in two phases, yielding two independent samples for exploratory factor analysis (n=314) and confirmatory factor analysis (n=327). SPSS 25.0 and AMOS 17.0 were used for reliability and validity testing, assessing the scale's internal consistency, structural validity, and model fit.
A total of 800 questionnaires were distributed, and 641 valid responses were collected, with an overall effective response rate of 80.1%. The final work motivation scale for community health service providers consisted of six dimensions, including compensation and benefits, job content, work climate, working environment, career development, and work support, with a total of 29 items. The Cronbach's α coefficient for the total scale was 0.966, and the Cronbach's α coefficients for the six dimensions were 0.864, 0.878, 0.937, 0.934, 0.940, and 0.902, respectively.
The work motivation scale for community health service providers developed in this study demonstrates good reliability and validity in measuring their work motivation. It provides a measurement tool for in-depth investigation of work motivation among community health service providers and offers a reference for organizations to assess and improve employee incentive strategies.
