{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T15:31:51Z","timestamp":1786375911604,"version":"build-2736575974"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"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>The quiet quitting phenomenon, a new emerging and hidden turnover behavior, is prevalent among primary healthcare (PHC) workers. Addressing their quiet quitting requires exploring possible managerial factors of management practice such as goal-setting, organizational centralization, organizational culture and incentives in the workplace, which are rarely jointly considered but offering great value for the construction of healing workplaces amid current medical reform. This study explores the associations between management practices in primary healthcare institutions and quiet quitting among PHC workers. We further construct a sequential-parallel mediation model to test two distinct indirect pathways triggered by goal-setting: the first is a sequential chain mediation pathway via organizational centralization and organizational incentives, and the second is a single mediation pathway via organizational culture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a two-wave cross-sectional study surveyed PHC workers on-site from all 11 primary healthcare institutions in a county where the management abilities have been strengthened in the context of health poverty revitalization. Measurements of managerial factors and quiet quitting are based on their classic scale with acceptable reliability and validity. Structural equation modeling (SEM) and mediation analysis were used for statistical analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mechanism shows that goal-setting have significant negative association with quiet quitting through two pathways. Firstly, goal-setting has a significantly positively association with organizational centralization (\u03b2 = 0.774,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Organizational centralization has a positive association with incentives (\u03b2 = 0.742,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05) and incentives are negatively associated with quiet quitting (\u03b2 = \u22120.229,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Secondly, goal-setting has a positive association with organizational culture (\u03b2 = 0.787,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05), organizational culture is negatively associated with (\u03b2 = \u22120.649,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05) quiet quitting. Final mediation effect analysis shows that the association between goal-setting and quiet quitting through organizational culture (indirect effect = \u22120.511,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.01) is much greater than combined association between organizational centralization and incentive (indirect effect = \u22120.132,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study offers key insights into quiet quitting among primary healthcare workers, highlighting that reasonable managerial design may help reduce quiet quitting and protect employees' well-being.<\/jats:p>\n                  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