Improving Risk Communication and Community Engagement for Public Health Emergencies in China: A State-guided Cooperative Trust Model.

Risk communication and community engagement (RCCE) constitutes a mandatory core capacity under the International Health Regulations (IHR 2005). However, dominant RCCE frameworks are rooted in Western institutional contexts and lack theoretical adaptation to China's state-led governance system. Drawing on an integrated multi-theoretical RCCE framework, this paper systematically examines the context-specific features and the limitations of China's present RCCE model in public health emergencies (PHEs). It identifies critical institutional, adaptive, and trust-related gaps by implementing literature review, policy analysis and case studies in China's RCCE practice, and proposes a state-guided cooperative trust model to reconstruct China's RCCE system. This study addresses the theoretical misalignment between global RCCE frameworks and China's institutional context, providing actionable implications for PHE preparedness and global health security.