Associations between parental support and physical activity in children and adolescents with visual impairments: a mediating analysis of exercise self-efficacy

Purpose Physical activity (PA) is imperative for the physical and mental health of children and adolescents with visual impairments (VI). However, functional impairment often leads to reduced PA, resulting in declines in health and quality of life. Although parental support (PS) has been identified as a key social determinant of PA in typically developing youth, its specific mechanisms, particularly the mediating role of exercise self-efficacy (ESE), remain unclear in children and adolescents with VI. This study aimed to examine the associations between PS and moderate-to-vigorous physical activity (MVPA), as well as the mediating role of ESE, in this population. Methods Using a cross-sectional design, 306 children and adolescents with VI aged 7–18 (mean age 13.80 ± 2.94 years) from specialized schools in East China were recruited through convenience sampling from September to December 2024. Accelerometers were used to objectively measure PA levels, and MVPA was extracted for analysis. PS for PA and ESE were assessed using validated scales. The associations between PS and MVPA were analyzed. Structural equation modeling (SEM) and the bias-corrected (BC) percentile bootstrap method were employed to analyze the direct and indirect effects of PS on MVPA, with ESE tested as a mediator. Results PS and ESE were both positively correlated with MVPA ( r = 0.306 and 0.385, respectively; both P < 0.05). In the structural equation model, PS had a significant total effect on MVPA (β = 0.379, 95% confidence interval (CI) [0.226–0.523], P = 0.000), comprising a direct effect (β = 0.293, 95% CI [0.140–0.438], P = 0.000) and an indirect effect mediated by ESE (β = 0.085, 95% CI [0.039–0.146], P = 0.000). ESE also exerted a significant direct effect on MVPA (β = 0.35, 95% CI [0.229–0.450], P < 0.001). The model explained 26.3% of the variance in MVPA. Conclusion This study highlights that both PS and ESE are associated with MVPA in children and adolescents with VI, with ESE acting partially mediating this relationship.