Title : Factors associated with physical inactivity among adults with metabolic syndrome based on the COM B model: A cross sectional study
Abstract:
Background: Regular physical activity can improve metabolic health in adults with Metabolic Syndrome (MetS). However, insufficient physical activity is highly prevalent among this population. There is limited evidence analysing influencing factors of physical inactivity and their action pathways for exercise behaviour change within frameworks.
Objective:This study aimed to describe the current status of physical activity and sedentary time among adults with MetS; to identify correlates of physical activity based on the COM-B model; and to examine the direct and indirect effects of capability, opportunity and motivation on physical activity.
Methods: A cross-sectional method was adopted. A total of 266 participants aged 18-59 years diagnosed with MetS were recruited from the physical examination centre of a community hospital in China between April and June 2026.Data were collected by general information questionnaire, Short Form International Physical Activity Questionnaire (IPAQ SF), physical functioning subscale of SF 36, Exercise Social Support Scale, Physical Activity Neighborhood Environment Scale (PANES CHN), Self Report Habit Index (SRHI), and Exercise Identity Scale (EIS). Hierarchical multiple linear regression was performed to screen relevant factors, and structural equation modelling combined with the Bootstrap procedure was applied to test mediating effects.
Results: Participants exhibited insufficient physical activity and long sedentary duration. Hierarchical regression revealed that high income status (β = 0.391, P < 0.001), bachelor’s degree educational attainment (β = 0.185, P = 0.023), postgraduate degree or above (β = 0.104, P = 0.048), and occupation as production, construction and transportation workers (β = 0.180, P = 0.011) were positively correlated with physical activity. The COM B theoretical framework model explained 33.8% of the variance in physical activity. Physical capability significantly and positively predicted motivational process (β = 0.345, P < 0.001) and exerted a significant positive direct effect on physical activity (β = 0.120, P = 0.039). Environmental opportunity positively predicted motivational process (β = 0.299, P < 0.001) and physical activity (β = 0.138, P = 0.039). Motivational process had a positive effect on physical activity (β = 0.451, P < 0.001). A significant positive correlation was observed between environmental opportunity and physical capability (β = 0.242, P < 0.001).
Conclusion: Insufficient physical activity is prominent among young and middle aged adults with MetS. Although they possess basic physical capability, obvious deficiencies exist in motivational domains such as exercise habits and exercise identity. The COM-B model is suitable for interpreting physical activity behaviours in this population, and spontaneous motivation plays a pivotal role.
