Safeguarding traditional Chinese medicine intangible cultural heritage and enabling its potential public health reuse: a theory-informed qualitative study in Jiangsu, China.

BACKGROUND: TCM intangible cultural heritage (ICH) preserves medical knowledge, embodied therapeutic and pharmaceutical skills, and culturally embedded health practices. This study examined how such heritage may be safeguarded as a living knowledge system while enabling potential reuse in public health-related settings. METHODS: We conducted an abductive, theory-informed qualitative analysis using grounded theory coding procedures. Fifteen semi-structured stakeholder interviews constituted the primary analytical dataset, while 32 policy documents, safeguarding reports, public heritage descriptions, and media materials were used for contextualization and triangulation. Data-led open and axial coding generated 17 categories and six main categories. Only after this category system had stabilized was Schellenberg's dual-value theory used for post-coding interpretation. RESULTS: The data-led stage generated 17 categories and six main categories. A subsequent theory-informed stage organized the six main categories into three higher-order interpretive domains: internal capabilities, external drivers, and amplification pathways. The model proposes that public-health-related reuse may generate resources, recognition, institutional support, and transmission incentives that feed back into primary-value safeguarding. The higher-order domains and the primary/secondary-value mapping constitute post-coding analytical interpretations. CONCLUSION: TCM ICH can be understood as a living cultural and knowledge-practice resource with potential public health relevance. The findings offer a provisional, mechanism-generating account of interactions among safeguarding, institutional support, communication, technology, and regulated market activity. Evaluation of causal effects and population-level health outcomes requires further research.