The importance of factors influencing elderly using of preventive services of traditional Chinese medicine

Traditional Chinese Medicine (TCM) has unique advantages in preventive services, particularly for chronic disease management and active aging. Primary care serves as a crucial platform for implementing and promoting preventive services of TCM. However, elderly individuals' using of these services remains suboptimal. This study aims to explore the factors influencing elderly individuals' using of preventive services of TCM in primary care facilities based on Andersen model and dual model of Social Cognitive Theory (SCT), and to assess the importance of these factors by dominance analysis. A multi-stage stratified cluster random sampling method was used to conduct face-to-face surveys with elderly individuals in 12 communities across six cities in Zhejiang and Guangxi provinces from July to September 2022. The survey collected data on participants' demographics, using of preventive services of TCM, and the influencing factors. A binary logistic regression model identified independent predictors of preventive services of TCM utilization, leading to the development of an optimal predictive model. These predictors were then grouped into four dimensions based on the dual model: predisposing factors, needs-based factors, enabling factors, and individual factors. Dominance analysis was used to evaluate the contribution of each dimension to the total variance in service utilization. Among 2,081 elderly participants, only 369 (17.7 %) used preventive services of TCM in the past year, with most utilizing the services 1–2 times annually. Combined analysis of the logistic regression and dominance analysis revealed that individual factors (cognitive status, self-control) were the most important predictors, followed by enabling factors (perceived service environment), predisposing factors (education level), and needs-based factors (self-reported chronic conditions, pain, or discomfort). Individual factors lay a decisive role in the elderly's decision to use preventive services of TCM. Enhancing cognitive abilities and self-management skills, alongside improving the primary care environment for preventive services of TCM, may encourage broader adoption of these services among the elderly.