Background: Practice-Based Research Networks (PBRNs) enable collaborative primary care research. In China, since 2023, healthcare reforms emphasizing community-based primary care have spurred PBRN development. However, the research environment and incentives for primary care practitioners (PCPs) to belong to these networks remain under-explored.

Objective: This study investigates the research environment and support needed by PCPs in the Shanghai General Practice Research Network (SGPRN) to maximize PBRN development in China.

Methods: This study employed a mixed-methods explanatory sequential design. The quantitative component involved an online survey of 145 PCPs from the SGPRN, selected through purposive sampling, who expressed interest in research activities. The survey collected data on their background, research capabilities, research environment, and preferred incentives for participating in PBRN-organized research. Descriptive statistical analysis and the Kano Model were used to analyze and categorize the data. The qualitative component involved one focus group discussion and 21 semi-structured interviews with 24 PCPs from the survey sample, selected to validate and complement the quantitative findings. Interview data were analyzed iteratively using a qualitative descriptive approach. Quantitative and qualitative data were integrated through joint display and meta-synthesis.

Results: Most PCPs (85 %) reported a supportive research environment, with 69 % integrating research with clinical practice. However, only 43 % had sufficient research time, and 50 % access to collaborators. Qualitative findings revealed limited professional support and fragmented time as key barriers. Incentives required included opportunities to acquire research skills, leading personally relevant studies, securing primary authorship, and accessing shared data, all contingent on transparent collaboration and trust. All these preferences aligned with institutional performance-driven policies.

Conclusion: The SGPRN research environment is currently neutral to slightly favorable, strongly driven by performance-oriented policies. PCPs participate in PBRN research primarily to enhance their research expertise and achieve publication-driven career advancement. Despite these motivations, China’s PBRNs need to draw on international strategies, enhancing research training, fostering collaborative platforms, and prioritizing practice-oriented, high-quality research to improve patient care, while aligning with local general practitioners’ professional aspirations for advancing the discipline and clinical practice, to reconcile and overcome the limitations of output-focused, impractical research policies.

General practice research focuses on a range of topics, such as patients' physical health and mental health, physicians' competencies and career motivation, quality of healthcare and physician-patient relationships and cooperation. However, these are not resolved well only using quantitative research which is still dominated in the field of general practice of China. In this case, qualitative method is often required, although it is considered to be subjective, and is mainly used to describe a phenomenon that is little known in a small sample. Mixed methods research, which incorporates qualitative and quantitative research and combines the advantages of both, can analyze specific problems more extensively and intensively, is suitable for studying complex problems, and for general practice research as an approach integrating clinical medicine and sociology. However, mixed methods research in general practice is still in its early phase in China, and the standardization of its design and implementation needs to be improved. For better elaborating the key points in the design and implementation of mixed methods research, we detailed a study using mixed methods, providing a reference for general practitioners to carry out mixed methods research.

Background: Cardiovascular disease remains the leading cause of morbidity and mortality globally. Cardiovascular health measurements are closely associated with cardiovascular outcomes. Cardiovascular health assessments can be significantly beneficial to health across whole life of individuals.

Objective: To investigate the cardiovascular health status, distribution, and influencing factors among community inhabitants of Nanjing City, and to inform the prevention and control of cardiovascular disease.

Methods: From September 2022 to August 2024, a total of 45,901 community-dwelling residents aged 35-79 years in Nanjing City were selected using a multistage, stratified, cluster random sampling method. All participants underwent questionnaire surveys, physical examinations, and laboratory tests. Cardiovascular health was quantitatively assessed using the “Life’s Essential 8” scoring standard, which includes four health behaviors (diet, physical activity, smoking, and sleep) and four health factors (BMI, blood lipids, blood glucose, and blood pressure). A score of <50 was defined as low cardiovascular health, 50-80 as moderate cardiovascular health, and >80 as high cardiovascular health.

Results: The overall cardiovascular health score of the study population was 66.9 ± 12.8. Higher scores were observed in women, married individuals, urban residents, and non-high-risk participants for cardiovascular diseases compared with men, unmarried individuals, rural residents, and high-risk participants (P<0.05). The overall score decreased with increasing age (P<0.05) and increased with higher educational levels (P<0.05). The mean scores of diet, physical activity, smoking, sleep, BMI, blood lipids, blood glucose, and blood pressure were 37.7 ± 31.0, 79.8 ± 38.8, 71.6 ± 40.3, 84.7 ± 24.0, 58.8 ± 31.4, 67.4 ± 29.5, 79.9 ± 25.4, and 45.8 ± 33.9, respectively. Among the study subjects, 7,524 (16.4%) had high cardiovascular health, 34,071 (74.2%) had moderate cardiovascular health, and 4,306 (9.4%) had low cardiovascular health. Multivariable logistic regression analysis showed that, compared with participants with low cardiovascular health, women, those aged 55-64 and 65-79 years, those with junior/senior high school or college and above education, other occupations, and non-high-risk participants were more likely to have moderate cardiovascular health, whereas labour workers, public service employees, administrative employees, and rural residents were less likely to have moderate cardiovascular health (P<0.05). Women, those with junior/senior high school or college and above education, other occupations, and non-high-risk participants were more likely to have high cardiovascular health, whereas participants aged 45-54 or 55-64 years and rural residents were less likely to have high cardiovascular health (P<0.05).

Conclusions Cardiovascular health among community residents in Nanjing is at a moderate level. Males, older people, those with lower education levels, rural residents, and high-risk groups should be prioritized for targeted interventions. Comprehensive improvement in cardiovascular health can be achieved by strengthening interventions on diet, smoking, and blood pressure.

Objective: This review seeks to explore the main determinants of medication adherence among patients with chronic conditions, with the goal of informing future studies.

Methods: A systematic review of the literature was conducted to identify factors influencing medication adherence in chronic disease patients, using the COM-B (Capacity, Opportunity, Motivation-Behavior) model as an analytical framework.

Results: Medication adherence in patients with chronic conditions is directly or indirectly shaped by three categories of factors: capacity (e.g., physical and cognitive functioning, knowledge of disease and treatment, and habitual behavior), opportunity (e.g., access to information and learning resources, social influences, support from significant others, and financial resources), and motivation (e.g., self-efficacy, personal goals, illness perceptions, and attitudes toward medication).

Conclusion: This review highlights that medication adherence in chronic disease patients is shaped by multidimensional factors. Research has evolved from focusing on single-factor analyses to multi-dimensional approaches, with a shift from observational studies to interventional designs. Accordingly, tailored, multidimensional strategies should be developed to improve adherence among different patient groups.

With the ongoing development of primary care in China, nearly 400,000 general practitioners (GPs) are expected to be trained over the next decade. The training of competent GPs is of vital importance, which requires GP educators to explore evidence-based educational concepts, methods, and curricula tailored to the Chinese context. At present in China, the quality of GP educational intervention studies in general practice is relatively poor. and most faculty and researchers in GP lack relevant training in this area. The aim of this paper is to outline the process of conducting educational intervention research in general practice from design to publication, comprising four stages with 13 steps:constructing research questions (generating research inspiration, literature review, incorporating a theoretical/conceptual framework, refining research questions), research design (trial design, intervention, outcome evaluation), research implementation (establishing a research team, obtaining research resources, applying for ethical approval, program execution), and publication and evaluation (article writing, reflection and evaluation). This paper provides research methods and ideas for educational researchers and practitioners in GP to conduct educational intervention studies, which will contribute to the generation of high-quality educational research "evidence", further improvement of the quality of GP educational, and the training of competent general practitioners.

Background: China has 148 million people with diabetes, a heavy disease burden for the country. Health-seeking behaviour, as a core component of disease management, plays a critical role in diabetes control.

Objective: To identify multidimensional patterns of health-seeking behaviour among patients with type 2 diabetes, examine their associations with glycemic control and health resource utilization, informing targeted diabetes management.

Methods: Using follow-up and clinical data from 30,509 patients with type 2 diabetes in Putuo District, Shanghai (2023), latent class analysis (LCA) was applied to identify latent classes of health-seeking behaviour. Multinomial logistic regression was used to assess demographic, behavioral, and clinical determinants of health-seeking behaviour patterns. Multivariable logistic regression was then applied to evaluate the effects of health-seeking behaviour patterns and other factors on annual glycemic control.

Results: LCA identified four distinct patterns: specialist-dominated (14.68%), community-based (23.47%), enhanced community-based (38.72%), and comprehensive-complex (23.13%). Multinomial logistic regression showed that patients aged ≥60 were more likely to adopt community-based or enhanced community-based patterns (OR=2.117-2.667, P<0.001); longer disease duration reduced the likelihood of community-based pattern (OR=0.983, P<0.01) but increased the likelihood of comprehensive-complex pattern (OR=1.041, P<0.001); patients with complications or comorbidities were significantly more likely to fall into the enhanced community-based (OR=1.498-2.506) or comprehensive-complex patterns (OR=3.003-3.865, P<0.001). Multivariable logistic regression indicated that compared with the specialist-dominated pattern, both enhanced community-based (OR=0.923, P=0.041) and comprehensive-complex patterns (OR=0.791, P<0.001) were associated with poorer glycemic control; regular physical activity (OR=1.107, P=0.002) and HbA1c testing ≥2 times/year were protective factors for achieving annual glycemic control (OR=2.891-4.126, P<0.001).

Conclusions Health seeking behaviour among patients with type 2 diabetes shows significant heterogeneity. Age, disease duration, and complications are key drivers of behavioral differentiation. Glycemic outcomes vary significantly across health-seeking behaviour patterns, emphasizing multidisciplinary collaboration in specialist-dominated pattern, enhancing integrated management in community-based pattern, and optimizing resource allocation for patients with complex needs to achieve stratified and targeted interventions.