{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:24:29Z","timestamp":1787293469357,"version":"build-2736575974"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"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>Sustained engagement of frontline health communication professionals is essential for effective public health promotion. While traditional material incentives show limited efficacy in maintaining intrinsic motivation, identity-based designation programs have emerged as a potential alternative, yet their impact in large-scale, real-world public health settings remains underexamined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted among all registered members of the China Oral Health Foundation Oral Health Promotion Ambassador program in June 2025. An anonymous online questionnaire was distributed via the program's official digital platform, yielding 1,071 valid responses from all 31 provincial-level regions of China. The questionnaire assessed sociodemographic characteristics, health communication practices, self-perceived impact of the ambassador designation, and practice-related challenges and needs. Self-reported significant enhancement of professional identity was the primary outcome. Chi-square tests were used for univariable screening, and binary logistic regression was employed to identify factors independently associated with significant self-reported identity enhancement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The majority of respondents (96.4%) reported that the ambassador designation enhanced their professional identity, with 57.1% reporting significant enhancement. In multivariable analysis, nursing staff showed a significantly higher likelihood of significant identity enhancement compared to junior\/attending-level dentists (OR = 1.595, 95% CI: 1.103\u20132.306,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.013). Annual participation frequency was independently associated with significant enhancement, with both the 6\u201310 times\/year group (OR = 1.490, 95% CI: 1.104\u20132.012,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.008) and the &amp;gt;20 times\/year group (OR = 1.832, 95% CI: 1.232\u20132.725,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003) showing significantly higher likelihood compared to the lowest-frequency group. Ambassadors in Western China showed a significantly lower likelihood of significant enhancement relative to Eastern China (OR = 0.710, 95% CI: 0.514\u20130.980,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.037). Officially recognized certificates (83.4%) were the most preferred incentive, ranked above material rewards (41.8%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Following the ambassador designation, participants reported improvements in professional identity, and enhancement was significantly associated with engagement frequency and professional roles. However, the heterogeneity in responses across regions and roles suggests that uniform empowerment is insufficient. Public health managers should transition toward stratified incentive architectures and provide targeted resources that address the specific structural challenges faced by different practitioner subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1881408","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:38:14Z","timestamp":1787290694000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Professional identity and engagement in oral health promotion activities among oral health ambassadors in China: a national cross-sectional survey"],"prefix":"10.3389","volume":"14","author":[{"given":"Jiakun","family":"Fang","sequence":"first","affiliation":[{"name":"Office of Operations Management, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongzhao","family":"Yu","sequence":"additional","affiliation":[{"name":"Office of Operations Management, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices","place":["Beijing, China"]},{"name":"China Oral Health Foundation","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Hao","sequence":"additional","affiliation":[{"name":"China Medical Tribune","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wensheng","family":"Rong","sequence":"additional","affiliation":[{"name":"China Oral Health Foundation","place":["Beijing, China"]},{"name":"Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1146\/annurev-orgpsych-032516-113108","article-title":"Self-determination theory in work organizations: the state of a science","volume":"4","author":"Deci","year":"2017","journal-title":"Annu Rev Organ Psychol Organ Behav."},{"key":"B2","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1186\/1472-6963-8-247","article-title":"Motivation and retention of health workers in developing countries: a systematic review","volume":"8","author":"Willis-Shattuck","year":"2008","journal-title":"BMC Health Serv Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/JOM.0000000000000964","article-title":"Job demands, job resources, burnout, work engagement, and their relationships: an analysis across sectors","volume":"59","author":"Van den Broeck","year":"2017","journal-title":"J Occupation Environ Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"112726","DOI":"10.1016\/j.socscimed.2019.112726","article-title":"The relative importance of material and non-material incentives for community health workers: evidence from a discrete choice experiment in Western Kenya","volume":"246","author":"Saran","year":"2020","journal-title":"Soc Sci Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1111\/j.1540-6210.2010.02196.x","article-title":"Revisiting the motivational bases of public service: twenty years of research and an agenda for the future","volume":"70","author":"Perry","year":"2010","journal-title":"Public Adm Rev."},{"key":"B6","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1177\/20413866211006173","article-title":"Beyond intrinsic and extrinsic motivation: a meta-analysis on self-determination theory's multidimensional conceptualization of work motivation","volume":"11","author":"Van den Broeck","year":"2021","journal-title":"Organization Psychol Rev."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/bjso.12061","article-title":"Making good theory practical: five lessons for an applied social identity approach to challenges of organizational, health, and clinical psychology","volume":"53","author":"Haslam","year":"2014","journal-title":"British J Soc Psychol."},{"key":"B8","first-page":"33","volume-title":"An Integrative Theory of Intergroup Conflict. 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