The development of the EUropean Physical Activity Determinants framework for Adolescents (EU-PAD-A): a mixed-methods concept mapping study within the DE-PASS COST action

Most European adolescents do not meet recommended levels of physical activity (PA), increasing their risk of long-term health issues and contributing to the burden of non-communicable diseases. To address this public health challenge, there is a need for evidence-based, age-specific frameworks that identify the key determinants influencing PA behaviours during adolescence, a critical developmental stage for habit formation. This study developed the EUropean Physical Activity Determinants framework for Adolescents (EU-PAD-A) and identified the most important and modifiable factors that can inform targeted interventions and public policy. Using Group Concept Mapping analysis, 240 experts contributed to the identification, sorting, and rating of PA determinants for adolescents. A total number of 110 determinants were grouped into nine thematic clusters. Determinants were rated for importance and modifiability, with 53% (n = 58) scoring high on both dimensions. To refine priorities for policy and practice, a focus group of experts and a survey involving 60 policy makers and stakeholders were conducted. This process led to the identification of the top 10 actionable determinants, defined as those rated highly for importance and modifiability by experts and for impact and feasibility by policy makers and stakeholders, including availability of indoor and outdoor PA facilities, beliefs about PA, and inclusive school programs. The results highlight school, family, and socio-cultural environments as critical settings for intervention. The EU-PAD-A framework offers a novel, interdisciplinary, and age-specific tool for understanding and addressing the complex drivers of adolescent PA. It provides concrete, consensus-based guidance for designing policies and programs that are feasible, impactful, and grounded in scientific evidence. As such, it represents an important step toward improving PA levels and reducing sedentary behaviour among adolescents across Europe.