Developing a socio-ecological framework for promoting physical activity among Chinese children and adolescents: a Delphi–AHP study

Abstract

Purpose: Insufficient physical activity (PA) among children and adolescents poses a serious public health challenge in China, with over 84% failing to meet the World Health Organization’s daily recommendations. Despite national policies promoting PA, a lack of localized, evidence-based frameworks has hindered effective implementation. Method: Guided by socio-ecological theory, a modified Delphi method was conducted with 17 experts across two rounds to refine framework dimensions and indicators. The Analytic Hierarchy Process (AHP) was then applied to calculate indicator weights. Results: The final framework comprised four dimensions—school leadership, family involvement, community support, and societal collaboration—encompassing 17 primary indicators and 58 secondary indicators. Weight analysis highlighted schools as the most influential domain (54.37%), followed by families (23.14%), communities (12.11%), and societal collaboration (10.38%). Conclusion: This study is the first to establish a localized framework for PA promotion among Chinese children and adolescents, offering clear stakeholder responsibilities and weighted indicators to guide evidence-based interventions. While grounded in China’s unique sociocultural setting, the methodology may inform similar efforts internationally. Future research should focus on empirical validation and development of standardized assessment tools based on this framework.