Unraveling psychosocial mechanisms underlying exercise habit in young and middle-aged adults with metabolic syndrome: A PLS-SEM study

Young and middle-aged adults with metabolic syndrome (MetS) often struggle to maintain exercise habit despite adequate health literacy. This cross-sectional study of 211 Chinese adults applied partial least squares structural equation modeling (PLS-SEM) and multi-group analysis to examine psychosocial determinants, including social support, illness perception, exercise self-efficacy, autonomous (i.e. intrinsic) motivation, and physical activity neighborhood environment. Exercise self-efficacy and autonomous motivation showed positive associations with exercise habit, while negative illness perceptions showed negative associations. Social support showed indirect associations with exercise habit through self-efficacy and autonomous motivation, and neighborhood environment showed a mixed pattern, with a direct negative association and an indirect positive association through self-efficacy. Subgroup analyses indicated employed and healthier individuals had stronger self-efficacy-habit links, whereas unemployed or comorbid individuals had stronger social support-habit links. These findings illustrate associations among psychological and contextual factors, offering insights into potential pathways for sustainable exercise engagement.