Abstract
BACKGROUND: Lack of physical activity among adolescents has become one of the biggest public health issues facing many countries. The family, being the primary environment for adolescents, directly impacts their level of physical activity. This study aims to reveal equivalent pathways and substitution effects of family determinants that effectively drive adolescent physical activity levels. METHODS: This study employs fuzzy-set qualitative comparative analysis (fsQCA) to conduct a stratified sampling survey of 1,738 students from 12 middle schools in the eastern, central, and western regions of China. Research data were collected through standardized questionnaires covering demographic characteristics, Physical Activity Rating Scale (PARS-3), Chinese version of the Short Form of the Parental Bonding Instrument (S-EMBU-C), Parent-Child Relationship Scale (PRC), and Family Sports Atmosphere Questionnaire (FSAQ). The study focuses on how family structure factors (family economic status, family structure) and process-oriented factors (parenting styles, parent-child relationships, family sports atmosphere) form equivalent paths and substitution effects through synergistic mechanisms, thereby enabling adolescents to meet the standard of 60 min of moderate-to-vigorous physical activity (MVPA) daily. RESULTS: A single factor is not a necessary condition for motivating adolescents to participate in physical activities; there are four equivalent pathways to motivate adolescents to engage in physical activities: the first is Family Economic Status (FES) * ~Family Structure (FS) * Parent-Child Relationship (PR) * Family Sports Atmosphere (FSA); the second is Family Economic Status (FES) * Positive Parenting Style (PPS); the third is Family Economic Status (FES) * ~Positive Parenting Style (PPS) * Parent-Child Relationship (PR) * ~Family Sports Atmosphere (FSA); the fourth is ~ Family Economic Status (FES) * Family Structure (FS) * Positive Parenting Style (PPS) * ~Family Sports Atmosphere (FSA). There exists substitution effects among structural factors, process factors, and between them, meaning that when one or more structural factors or process factors are absent, other structural factors, process factors, or combinations of factors can drive adolescents’ physical activity behaviors. CONCLUSION: The synergistic effects of structural and process factors within the family environment are more effective in driving adolescents’ participation in physical activities. Therefore, implementing family intervention measures requires simultaneous optimization of family resource allocation and interaction mechanisms, which provides a certain scientific basis for constructing a multidimensional collaborative family health promotion system.