{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:15:35Z","timestamp":1778652935187,"version":"3.51.4"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n As a cornerstone of China\u2019s healthcare system, Traditional Chinese Medicine (TCM) contributed significantly to both public health outcomes and cultural preservation. Although perceived value was known to shape healthcare decisions, its specific impact on TCM utilization among medical professionals remained unclear. This study employed the Andersen Behavioral Model to examine how predisposing, enabling, and need factors influenced TCM utilization among healthcare workers, with a focus on the mediating roles of usage intention and loyalty.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional survey was administered to 1,483 healthcare professionals. We collected data on demographic profiles, TCM-related perceptions (perceived value, satisfaction, intention, and loyalty), and actual service usage over the preceding year. To identify predictors of utilization and test the hypothesized mediation pathways, we performed multiple logistic regression analyses and utilized the Model 4 macro in the SPSS PROCESS plugin.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The survey revealed that 49.09% of participants had utilized TCM services, with massage and manual therapies being the predominant modalities. Logistic regression demonstrated that sex, officially budgeted post, physical pain or discomfort, and chronic conditions significantly predicted utilization. Perceived value (OR\u202f=\u202f1.037,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) and satisfaction (OR\u202f=\u202f1.149,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) emerged as strong positive drivers. Mediation analysis confirmed that utilization intention mediated the relationship between perceived value and actual behavior (indirect effect\u202f=\u202f0.023, 95%CI: 0.007\u20130.041), while loyalty mediated the link between satisfaction and utilization (indirect effect\u202f=\u202f0.056, 95%CI: 0.009\u20130.101).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n TCM utilization among healthcare professionals was driven by a combination of predisposing factors (sex, officially budgeted post, perceived value, satisfaction) and need factors (chronic disease status, physical pain or discomfort) in the Andersen Model. The mediating effects of intention and loyalty highlighted the importance of psychological factors in service adoption. To boost TCM engagement, interventions should be implemented based on healthcare professionals\u2019 clinical needs and educational level, while also fostering stronger loyalty and usage intention. These results offered actionable insights for optimizing TCM service delivery within the medical community.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1827392","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:55:09Z","timestamp":1778651709000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The prevalence, determinants, and mechanisms of traditional Chinese medicine service utilization among healthcare professionals: a study based on the Andersen Behavioral Model"],"prefix":"10.3389","volume":"14","author":[{"given":"Jie","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Health Management, School of Public Health, Nantong University","place":["Nantong, China"]},{"name":"Nantong Center for Disease Control and Prevention","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhouxiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Health Management, School of Public Health, Nantong University","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yulei","family":"Chen","sequence":"additional","affiliation":[{"name":"Nantong Hospital of Traditional Chinese Medicine","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruyu","family":"Li","sequence":"additional","affiliation":[{"name":"The Second People\u2019s Hospital of Tongzhou District","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiyue","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Health Management, School of Public Health, Nantong University","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinru","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Health Management, School of Public Health, Nantong University","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuexia","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Health Management, School of Public Health, Nantong University","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/S2095-4964(17)60364-9","article-title":"Prospects of a comprehensive evaluation system for traditional Chinese medicine services","volume":"15","author":"Xu","year":"2017","journal-title":"J Integr Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"117046","DOI":"10.1016\/j.socscimed.2024.117046","article-title":"Interprovincial spatial distribution patterns and socioeconomic factors on traditional Chinese medicine (TCM) service utilization in China","volume":"353","author":"Zhang","year":"2024","journal-title":"Soc Sci Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.gerinurse.2022.02.025","article-title":"Status of traditional Chinese medicine healthcare services in nursing homes across China","volume":"45","author":"Meng","year":"2022","journal-title":"Geriatr Nurs"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.eujim.2014.12.006","article-title":"Challenges and opportunities of integrating traditional Chinese medicine into mainstream medicine: a review of the current situation","volume":"7","author":"Chan","year":"2015","journal-title":"Eur J Integr Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e0316892","DOI":"10.1371\/journal.pone.0316892","article-title":"Utilization of transitional care management services and 30-day readmission","volume":"20","author":"Kim","year":"2025","journal-title":"PLoS One"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1016\/j.joim.2023.10.001","article-title":"Promoting whole person health: exploring the role of traditional Chinese medicine in polish healthcare","volume":"21","author":"Rybicka","year":"2023","journal-title":"J Integr Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.joim.2024.11.004","article-title":"How are different traditional Chinese medicine modalities deployed by clinical practitioners in China? Findings from a national survey. Journal of","volume":"23","author":"Guo","year":"2025","journal-title":"Integrative Medicine"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"532420","DOI":"10.3389\/fpubh.2020.53242010.3389\/fpubh.2020.532420","article-title":"A comprehensive evaluation of China's TCM medical service system: an empirical research by integrated factor analysis and TOPSIS","volume":"8","author":"Li","year":"2020","journal-title":"Front Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.3760\/cma.j.issn.0366-6999.2009.13.013","article-title":"The utilization of traditional Chinese medicine and associated factors in Taiwan in 2002","volume":"122","author":"Shih","year":"2009","journal-title":"Chin Med J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"811730","DOI":"10.3389\/fpubh.2021.811730","article-title":"Acceptability of traditional Chinese medicine in Chinese people based on 10-year's real world study with mutiple big data mining","volume":"9","author":"Guo","year":"2022","journal-title":"Front Public Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1186\/s12906-020-02910-x","article-title":"Belief in and use of traditional Chinese medicine in Shanghai older adults: a cross-sectional study","volume":"20","author":"Xin","year":"2020","journal-title":"BMC Complementary Med Ther"},{"key":"ref12","volume-title":"A Behavioral model of Families' use of Health Services","author":"Andersen","year":"1968"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1097\/MLR.0b013e31817a835d","article-title":"National health surveys and the behavioral model of health services use","volume":"46","author":"Andersen","year":"2008","journal-title":"Med Care"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1177\/13634615231225130","article-title":"A Chinese help-seeking model for psychological distress in primary care: An adaptation of Andersen's behavioral model of health services use","volume":"61","author":"Sun","year":"2024","journal-title":"Transcult Psychiatry"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1186\/s12889-023-15885-4","article-title":"Determinants of province-based health service utilization according to Andersen\u2019s behavioral model: a population-based spatial panel modeling study","volume":"23","author":"Xin","year":"2023","journal-title":"BMC Public Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s40258-014-0100-2","article-title":"Disease-specific impoverishment impact of out-of-pocket payments for health care: evidence from rural Bangladesh","volume":"12","author":"Hamid","year":"2014","journal-title":"Appl Health Econ Health Policy"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1186\/s12913-016-1825-4","article-title":"The impact of predisposing, enabling, and need factors in utilization of health services among rural residents in Guangxi, China","volume":"16","author":"Li","year":"2016","journal-title":"BMC Health Serv Res"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s12875-022-01697-9","article-title":"Factors associated with the utilization of community-based health services among older adults in China\u2014an empirical study based on Anderson\u2019s health behavior model","volume":"23","author":"Lin","year":"2022","journal-title":"BMC Primary Care"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"105","DOI":"10.3969\/j.issn.1002-1167.2024.05.013","article-title":"Evaluation and optimization of Mobile medical consultation system design from a perceived value perspective","volume":"44","author":"Chen","year":"2024","journal-title":"Library Tribune"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"227","DOI":"10.2147\/PPA.S398644","article-title":"Medical conditions and preference of traditional Chinese medicine: results from the China healthcare improvement evaluation survey","volume":"17","author":"Zhao","year":"2023","journal-title":"Patient Prefer Adherence"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1007\/s11482-024-10419-5","article-title":"Interconnected stressors and well-being in healthcare professionals","volume":"20","author":"Lin","year":"2025","journal-title":"Appl Res Qual Life"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"675","DOI":"10.2471\/BLT.25.293465","article-title":"Integration of traditional and complementary medicine into primary health care systems: a systematic review","volume":"103","author":"Wang","year":"2025","journal-title":"Bull World Health Organ"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e2422259","DOI":"10.1001\/jamanetworkopen.2024.22259","article-title":"Use of massage therapy for pain, 2018-2023: a systematic review","volume":"7","author":"Mak","year":"2024","journal-title":"JAMA Netw Open"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"958005","DOI":"10.3389\/fphar.2022.958005","article-title":"Chinese herbal medicine for the treatment of chronic fatigue syndrome: a systematic review and meta-analysis","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Pharmacol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.ctim.2013.12.013","article-title":"Mode of action of cupping\u2014local metabolism and pain thresholds in neck pain patients and healthy subjects","volume":"22","author":"Emerich","year":"2014","journal-title":"Complement Ther Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.2147\/JPR.S453671","article-title":"Analysis of acupoint selection rules for Guasha treatment of primary headaches based on data mining","volume":"17","author":"Zhang","year":"2024","journal-title":"J Pain Res"},{"key":"ref27","first-page":"255","article-title":"Survey on the utilization of traditional Chinese medicine Services for Outpatients in tertiary traditional Chinese medicine hospitals","volume":"41","author":"Guo","year":"2024","journal-title":"Chinese Health Service Management"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2121","DOI":"10.1097\/BRS.0b013e3181edfd17","article-title":"Chinese herbal medicine for chronic neck pain due to cervical degenerative disc disease","volume":"35","author":"Trinh","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"101470","DOI":"10.1016\/j.ctcp.2021.101470","article-title":"Chinese herbal medicine for symptoms of depression and anxiety in chronic obstructive pulmonary disease: a systematic review and meta-analysis","volume":"45","author":"Yang","year":"2021","journal-title":"Complement Ther Clin Pract"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"155579","DOI":"10.1016\/j.phymed.2024.155579","article-title":"Characteristics and efficacy of traditional Chinese medicine in the therapeutic strategy of chronic coronary syndrome: a systematic review and meta-analysis","volume":"129","author":"Ma","year":"2024","journal-title":"Phytomedicine"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/2545476","article-title":"Evidence and potential mechanisms of traditional Chinese medicine for the adjuvant treatment of coronary heart disease in patients with diabetes mellitus: a systematic review and Meta-analysis with trial sequential analysis","volume":"2022","author":"Wei","year":"2022","journal-title":"J Diabetes Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"30947","DOI":"10.1038\/S41598-025-16933-2","article-title":"The current situation and factors influencing the use of traditional Chinese medicine therapies among patients with chronic disease in China: a cross-sectional study","volume":"15","author":"Cao","year":"2025","journal-title":"Sci Rep"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1186\/s12913-026-14038-8","article-title":"Utilization of traditional Chinese medicine services and associated factors: a systematic review and meta-analysis","volume":"26","author":"Ren","year":"2026","journal-title":"BMC Health Serv Res"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.25236\/FMSR.2024.060701","article-title":"Research Progress of traditional Chinese medicine Tuina in chronic pain","volume":"6","author":"Ding","year":"2024","journal-title":"Front Med Sci Res"},{"key":"ref35","volume-title":"A Study of the Impacts of Perceived Value on Users Willingness to Continue Participation Based on the Perspective of Online cause-Related Marketing","author":"Zeng","year":"2022"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.joim.2021.01.013","article-title":"Impact of the COVID-19 pandemic on intention to use traditional Chinese medicine: a cross-sectional study based on the theory of planned behavior. Journal of","volume":"19","author":"Xia","year":"2021","journal-title":"Integrative Medicine"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1827392\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:55:15Z","timestamp":1778651715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1827392\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":36,"alternative-id":["10.3389\/fpubh.2026.1827392"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1827392","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"article-number":"1827392"}}