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Configurational paths to promoting physical activity among older adults with type 2 diabetes in China: an fsQCA study

Bo Zhang¹, Panpan Huai¹, Jintao Wang²

¹School of Nursing, Shanxi Medical University, Shanxi Province, Taiyuan, China.

Frontiers in Endocrinology

|January 2, 2026

Abstract

Objective:

To deeply analyzes the configurational paths to promoting physical activity in older adults with type 2 diabetes (T2DM), revealing the impact of different combinations of various factors on physical activity.

Methods:

This study applied fuzzy-set qualitative comparative analysis (fsQCA) method to identify combinations of Multi-theory Model (MTM) constructs associated with higher physical activity levels.

Results:

A total of 1119 older adults with T2DM were included. A single influencing factor does not constitute a necessary condition for promoting physical activity in older adults with T2DM. In contrast, two combinations of the seven influencing factors led to high level of physical activity, and substitutability and complementarity were observed among the various factors of the configuration path.

Conclusion:

This study confirmed that the formation of physical activity in older adults with T2DM has multiple concurrent causal relationships and multiple configuration paths. By revealing the synergy among factors, the MTM framework has been expanded. This study offers a novel configuration perspective for understanding the physical activity behavior of this population and provides key evidence for designing diverse physical activity management measures.

Keywords:

multi-theory model older adults physical activity qualitative comparative analysis type 2 diabetes

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