Evolutionary game model of health care and social care collaborative services for the elderly population in China.

INTRODUCTION: The synergy of health care and elderly social care organizations has become the focus of the research on integrated health care and social care. This study aims to propose a collaborative strategy among health care and elderly social care service providers. METHODS: An evolutionary game model is applied for performance analysis and optimization of the cooperation between health care and elderly social care organizations. The behavioural strategies and the impact of key parameters on promoting the cooperation of the players are presented in detail. RESULTS: Simulation experiments and sensitivity analysis results indicate that (1) the behavioural evolution of health care organizations and elderly social care organizations forms three types of integrated health care and social care services, namely, the bilateral cooperation type, health care organization-led type and elderly social care organization-led type. (2) Increasing the additional benefits for cooperation and reducing the additional costs for cooperation can promote the willingness to synergize to provide integrated health care and elderly social care services. At the early stage of evolution, increasing the costs that elderly social care organizations pay to purchase health care services or pay for negotiation in the bilateral cooperation type can provide incentives for health care organizations to cooperate while reducing the cooperation preferences of elderly social care organizations. However, the long-term impact of the costs on the behavioural strategies for cooperation of the two players cannot be determined. CONCLUSION: The behavioural decisions on cooperation between health care and elderly social care organizations influence each other; commitment to integration and effective collaboration can be achieved by increasing the additional benefits and reducing the marginal costs. The findings suggest that the political-economic context and government policies have a greater influence on promoting cooperation, thus yielding positive or negative results for integrated care practice.

The community residents' NIMBY attitude on the construction of community ageing care service centres: a cross-sectional study.

BACKGROUND: China is the country with the largest elderly population. To actively respond to this ageing population, China has proposed the Community Aged Care Service Centre (CACSC) network as the major elderly care development policy. However, many residents resisted the development of the CACSC network, which affected its smooth implementation. Based on the theory of "Not in My Backyard" (NIMBY), this paper proposes a model of the influencing factors of community residents on the opposition to the construction of CACSCs. METHODS: Residents living in urban communities over the age of 20 in China are the target of this study. The questionnaires were collected in the form of electronic questionnaires created on a professional website, and hyperlinks to the questionnaires were distributed through social media. The descriptive statistical analysis, T-tests, ANOVA and structural equation modelling were performed on cross-sectional survey data from 509 questionnaires. RESULTS: The research results show that superstition, the NIMBY attitude, and perceived risk have a significant positive impact on the opposition to the construction of CACSCs, while the negative impact of perceived benefit on the opposition intention is not significant. Moreover, perceived knowledge has a significant positive impact on perceived benefit and a significant negative impact on superstition and perceived risk. CONCLUSIONS: Strengthen policy advocacy on ageing, clarify the service content of CACSC and encourage young people to participate in public welfare activities for the elderly can reduce the opposition of community residents to the construction of a CACSC.

Ethical considerations for conducting sexual and reproductive health research with female adolescents engaged in high-risk behaviours in China.

BACKGROUND: Chinese female adolescents engaged in sex trade and substance use are often criminalized and stigmatized. As a result of these cultural, legal and political constraints, ethical concerns can discourage investigators from engaging these adolescents in research. This paper aims to address the ethical tensions between protection and inclusion in conducting sexual and reproductive health (SRH) research with adolescents engaged in high-risk behaviours. Processes of moral reasoning, and examples and practical mechanisms in managing such ethical challenges were presented in the hope of advancing the research ethics policies and practice with adolescents. METHODS: We extracted ethical issues from three previously conducted SRH studies involving 517 Chinese female adolescents. Utilizing the principles of justice, beneficence, and respect for persons as articulated in the Belmont Report as a framework, we thematically summarised the key ethical considerations regarding inclusion and protection, then examine the ethical tensions and solutions within the local context. RESULTS: Findings suggest that the balance between protection and inclusion can be achieved by both considering the evolving decision-making capacity of adolescents as well as the level of risk. A community-based participatory approach shows promise in advancing adolescent engagement and empowerment. Ethically robust approaches contribute to the greater relevance and validity of the findings. CONCLUSIONS: Our studies suggest that it is crucial to achieve adolescents' meaningful involvement in all levels of research and interventions, researchers need to shift their perspectives of the target population from subjects to key stakeholders in design and implementation of research.