Association between climate change-related health risk perception and mediating factor on pro-environmental behavior among hospital workers in Shanxi Province, China

Climate change, a pressing global issue, manifests as significant shifts in temperature, precipitation, wind patterns, and sea levels, posing substantial health risks, especially in Shanxi Province, China. Hospitals, as key health institutions, play a vital role in addressing these challenges. Exploring the factors influencing hospital workers’ pro- environmental behavior (PEB) is crucial for promoting health, mitigating climate change (SDG13), and fostering sustainable collaboration (SDG17). This study is an explanatory sequential design employing initial quantitative and following qualitative method. In quantitative study, 600 questionnaires were distributed to hospital workers via “Wenjuanxing” and 543 completed questionnaires were collected, and data was analyzed using exploratory data analysis, descriptive statistics analysis, structural equation model, independent sample t-test, one-way analysis of variance, multiple linear regression, and mediating effect analysis via AMOS 26.0 and SPSS 26.0. The result illustrated that the level of PEB, climate change-related health risk perception (CHRP), pro-environmental intention (PEI), and pro-environmental attitude (PEA) was high. There were significant differences between gender, length of employment, and employment department concerning PEB, PEI, and PEA (p<0.05). Moreover, CHRP had positive effects on PEI and PEA (p<0.001), and PEI had positive effects on PEB (p<0.001). PEI mediated the relationship between CHRP and PEB (p<0.001). In qualitative study, in-depth interview was conducted based on interview outline to explain the quantitative results and clarify primary characteristics, and 16 hospital workers participated the interview. Data was analyzed by word frequency analysis and coding analysis using NVivo 14.0. Results elucidated the opinion and influencing factors of PEB and CHRP among hospital workers, demonstrated the association between CHRP and PEB from the perspective of physical and mental health, and clarified the mediating role of PEI and PEA from CHRP to PEB. This study proposed a comprehensive framework covering CHRP, PEI, PEA, and PEB, emphasizing the role of CHRP, PEI, and PEA in facilitating PEB. Enhancing CHRP can empower hospital to mitigate climate change (SDG13). The finding also underscored the need for cross-sector collaboration to achieve sustainability goals (SDG17). However, this study was cross-sectional design and only conducted in Shanxi Province. Future studies should employ longitudinal approaches and regional comparisons to promote health and environmental sustainability.

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