The relationship between perceived quality physical education and 7-day physical activity among secondary school students in China: the mediating role of exercise self-efficacy

Qin et al. Archives of Public Health (2025) 83:242 https://doi.org/10.1186/s13690-025-01731-z Archives of Public Health Open Access RESEARCH The relationship between perceived quality physical education and 7-day physical activity among secondary school students in China: the mediating role of exercise self-efficacy Ling Qin1,2, Walter King Yan Ho3 and Selina Khoo2* Abstract Background The United Nations Educational, Scientific and Cultural Organization has highlighted that quality physical education (QPE) can lead to a more active lifestyle for adolescents. However, previous studies have not explored the relationship between students’ perceptions of QPE and physical activity (PA). According to Bandura’s social cognitive theory, self-efficacy plays a crucial role in influencing behaviour, including PA engagement. Therefore, this study aimed to investigate the relationship between students’ QPE perception and 7-day PA among Chinese secondary school students, with a focus on analysing the potential mediating role of exercise self-efficacy (ESE) between these two factors. Methods This study employed a cross-sectional design. Adolescents (N = 2,349) from 10 secondary schools in China participated in this study through providing self-reports. The dependent variables included students’ perceptions of QPE measured across 10 dimensions. ESE was considered as the mediator, reflecting psychological functioning. 7-day PA served as the outcome variable. All multiple regression models were adjusted for covariates including sex, age, ethnic background, and school location. Results Significant differences were observed across sex, ethnicity, and school location in the ten dimensions of QPE perception, ESE, and 7-day PA. All 10 QPE dimensions were positively associated with PA (r = 0.285 to 0.476, p < 0.001), with the strongest associations observed for family and community sports resources. Mediation analyses showed that ESE mediated the association between each QPE dimension and PA: the standardized indirect effects ranged from β = 0.095 to 0.158 and exceeded the corresponding direct effects in every model; the proportion mediated ranged from 52.20% to 80.12%. Conclusions Teachers and policymakers should design activities that cater to female students’ interests and needs, enhance their self-efficacy, and encourage their active participation in PA. Ensuring equitable access to resources and opportunities for physical education and PA is also crucial. Interventions promoting PA should adopt a collaborative approach that integrates the efforts of families, schools, and communities. Moreover, rather than focusing solely on *Correspondence: Selina Khoo Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creati vecommons.org/licenses/by-nc-nd/4.0/. Qin et al. Archives of Public Health (2025) 83:242 Page 2 of 15 increasing PA, interventions should prioritise strengthening ESE for long-term success. Future studies should focus on longitudinal designs and expand the sample size to enhance the generalisability of the findings. Keywords Quality physical education, Physical activity, Exercise self-efficacy, Middle school, Students, China Text box 1. Contributions to the literature • Social cognitive theory provides a framework to analyse exercise selfefficacy as a mediator between perceived quality physical education and students’ 7-day physical activity. • Perceptions of quality physical education positively influence students’ 7-day physical activity. • Exercise self-efficacy mediates the relationship between perceptions of quality physical education and 7-day physical activity. • These findings underscore the necessity for targeted public health interventions to enhance physical activity levels among secondary school students. Introduction Physical activity (PA) plays a critical role in fostering the physical, psychological, emotional, and cognitive development of children and adolescents, contributing to their overall health and well-being [1–3]. Despite these well-documented benefits, global data indicate that only 27–33% of children and adolescents meet the recommended 60 min of moderate to vigorous daily PA [4]. A 2022 report from China indicated that PA levels among adolescents remain low [5]. Insufficient PA among children and adolescents is also a leading cause of overweight and obesity in China [6]. Additionally, insufficient PA in children and adolescents increases the risk of cardiovascular diseases and chronic conditions such as diabetes [7]. In response, quality physical education (QPE) programmes have been proposed to improve students’ PA and foster healthier lifestyles [8, 9]. Studies have highlighted the benefits of QPE in enhancing PA levels. Masurier and Corbin identified 10 reasons for implementing QPE in schools, underscoring its potential to increase participation in PA [10]. Similarly, Ball et al. contended that a well-implemented QPE programme could significantly benefit students by increasing their moderate to vigorous physical activity (MVPA) levels [11]. Moreover, QPE programmes are designed to cultivate positive attitudes toward PA by promoting enjoyment of movement and development of transferable physical skills [12]. However. literature leaves some clear gaps. First, few studies have examined how students’ perceptions of QPE influence their PA levels, or the dimensions of QPE most relevant to PA outcomes. Second, students’ perceptions of QPE are rarely measured systematically. Students’ perceptions of their learning environment, teaching methods, and curriculum significantly affect their academic performance, engagement, and overall satisfaction with their educational journey [13–15]. Evaluating students’ perceptions of QPE allows for a reflective analysis of the strengths and weaknesses of previous PE programmes. Third, existing research on school-based interventions, including PE and extracurricular PA programmes, presents mixed findings regardin (...truncated)