Facility type diversity, quantity, and quality are significantly and positively associated with exercise frequency, intensity, and duration, while facility accessibility shows a significant negative association, and health awareness demonstrates the strongest overall effect on physical activity behavior.
Key Findings
Results
Facility type diversity, facility quantity, and facility quality were each significantly and positively associated with all three physical activity outcomes (exercise frequency, exercise intensity, and exercise duration).
The study examined these as 'core explanatory variables' within a theory-informed analytical framework
Associations were assessed using regression analysis alongside descriptive, correlation, and heterogeneity analyses, and robustness tests
The study was conducted via questionnaire survey across five representative cities in China
All three facility attributes (diversity, quantity, quality) showed consistent positive associations across all three activity behavior indicators
Results
Facility accessibility showed a significant negative association with exercise frequency, exercise intensity, and exercise duration.
This finding contrasts with the positive associations observed for facility diversity, quantity, and quality
Prior literature had often focused on accessibility as a key facility attribute, but this study found it negatively associated with activity outcomes
The negative direction of this association was consistent across all three physical activity behavior indicators
The authors note that existing studies have 'often focused on isolated facility attributes such as facility density or accessibility' without sufficient attention to diversity and quality
Results
Older age was associated with lower exercise participation, while being male, a civil servant, or a retiree, and having higher income and higher educational attainment were each associated with higher levels of physical activity.
These findings were derived from the individual characteristics component of the multidimensional analytical framework
The study used heterogeneity analysis to examine subgroup differences
Both income and educational attainment were positively associated with physical activity levels
The sample was drawn from five representative cities in China via questionnaire survey
Results
A supportive family exercise atmosphere and abundant community sports activities were significantly associated with higher levels of physical activity behavior.
These social environment factors were examined as explanatory variables alongside facility and individual characteristics
Both family-level and community-level social factors independently showed significant positive associations with physical activity
The study was guided by health promotion theory and behavior change theory in framing social environment as a determinant
Social environment factors were assessed as part of a multidimensional framework including facility, individual, and health awareness variables
Results
Health awareness had a particularly strong effect on physical activity behavior, with individuals possessing greater health awareness being more actively engaged in physical activity.
Health awareness demonstrated the strongest overall effect among the determinants examined in the study
The authors describe its effect as 'particularly strong' relative to other variable categories
This finding was situated within a behavior change theory framework
Health awareness was examined alongside facility attributes, individual characteristics, and social environment factors as a core explanatory domain
Methods
The study applied a multidimensional, theory-informed analytical framework to address gaps in prior research that focused on isolated facility attributes without explicit grounding in health promotion or behavior change theories.
The study was guided explicitly by both health promotion theory and behavior change theory
Four facility dimensions were examined: type diversity, quantity, quality, and accessibility
Three physical activity outcomes were assessed: exercise frequency, exercise intensity, and exercise duration
Data were collected via questionnaire survey in five representative cities in China
Analytical methods included descriptive analysis, correlation analysis, regression analysis, heterogeneity analysis, and robustness tests
What This Means
This research suggests that when it comes to getting people to exercise, not all aspects of sports facilities matter equally—and some may matter in unexpected ways. Surveying residents across five cities in China, the researchers found that having a greater variety of facility types, more facilities overall, and higher-quality facilities were all linked to people exercising more frequently, at higher intensity, and for longer durations. Interestingly, how easily accessible facilities were showed the opposite pattern: greater accessibility was actually associated with lower exercise levels across all three measures, a counterintuitive finding that challenges the common assumption that proximity alone drives physical activity.
Beyond facilities, the study found that social and individual factors also play meaningful roles. People with more supportive family environments around exercise and those living in communities with more organized sports activities tended to be more physically active. Among individual traits, being older was linked to less exercise, while being male, having higher income or education, working as a civil servant, or being retired were associated with more activity. Notably, health awareness emerged as the single strongest predictor of physical activity across all groups studied, suggesting that how much people value and think about their health may matter more than the physical environment around them.
This research suggests that policies aimed at increasing physical activity should go beyond simply building more facilities or placing them closer to residents. Improving the variety and quality of available facilities, fostering community and family-based support for exercise, and investing in public health education to raise health awareness may all be important levers. The finding that accessibility alone is not sufficient—and may even relate negatively to activity levels—points to a need for more nuanced thinking about how built environments interact with social and psychological factors to shape behavior.
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Zhang G, Chen K, Ding G. (2026). Influence of multidimensional determinants on physical activity behavior: a perspective from health promotion and behavior change theories.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1865453