{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:01:03Z","timestamp":1785326463108,"version":"3.55.0"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"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":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Health Lifestyle Instructors (HLIs) play a pivotal role in community health promotion. The quality of and satisfaction with their own access to health science information may directly influence their work effectiveness, which in turn affect residents\u2019 health literacy and the outcomes of chronic disease prevention and control. This cross-sectional questionnaire-based study aimed to (1) explore factors associated with satisfaction with access channels for health science popularization among HLIs and (2) examine whether self-rated health status statistically mediated the association between Healthy Cell Project (HCP) establishment and satisfaction with access channels. The findings were intended to provide an evidence base for optimizing HLIs training programs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Access channels for health science popularization were identified through multiple-response analysis. Potential factors associated with satisfaction with these access channels were first screened using univariate analysis, followed by logistic regression analysis. The mediating role of self-rated health status was examined using the SPSS PROCESS macro with the bootstrap method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3,032 valid questionnaires were analyzed. Online searches and community publicity constituted the primary access channels for health science information. Among new media platforms, WeChat official accounts and short-video applications were the most frequently used. Significantly higher satisfaction with access channels was observed among HLIs who reported better self-rated health, worked in township\/community\/village units, or were affiliated with institutions that had established the HCP (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). Significant correlations emerged among self-rated health, the establishment of the HCP, and satisfaction with access channels (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.085\u20130.135,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). Mediation analysis suggested that self-rated health status partially mediated the association between HCP establishment and satisfaction with access channels (effect size\u202f=\u202f0.063, 95% CI: 0.031\u20130.104), although the explained variance was small (\n                      <jats:italic>\n                        R\n                        <jats:sup>2<\/jats:sup>\n                        =\n                      <\/jats:italic>\n                      0.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Access channels for health science popularization among HLIs were characterized primarily by online - offline integration, with differences in satisfaction across groups. Self-rated health status partially mediated the association between HCP establishment and satisfaction with access channels in this cross-sectional analysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1874724","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:10:37Z","timestamp":1785323437000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with access channels and satisfaction with health science popularization among health lifestyle instructors"],"prefix":"10.3389","volume":"14","author":[{"given":"Xu-peng","family":"Chen","sequence":"first","affiliation":[{"name":"Nanjing Municipal Center for Disease Control and Prevention","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-su","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Nanjing Municipal Center for Disease Control and Prevention","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Nanjing Municipal Center for Disease Control and Prevention","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-wen","family":"Wei","sequence":"additional","affiliation":[{"name":"Nanjing Municipal Center for Disease Control and Prevention","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-ya","family":"Ji","sequence":"additional","affiliation":[{"name":"Nanjing Municipal Center for Disease Control and Prevention","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-li","family":"Gou","sequence":"additional","affiliation":[{"name":"Nanjing Municipal Center for Disease Control and Prevention","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua-feng","family":"Yang","sequence":"additional","affiliation":[{"name":"Nanjing Municipal Center for Disease Control and Prevention","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.ijnurstu.2019.03.005","article-title":"Health education: a Rogerian concept analysis","volume":"94","author":"Pueyo-Garrigues","year":"2019","journal-title":"Int J Nurs Stud"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1093\/fampra\/cmae002","article-title":"Overview of the participation of community health Workers in Primary Health Care in 6 Latin American countries and a proposal for their integration into the health system: a qualitative study","volume":"41","author":"Zu\u00f1iga","year":"2024","journal-title":"Fam 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