Formation and influencing factors of health communication competence among Chinese physical education teachers based on the ecological systems theory.

Health communication is of paramount importance in promoting physical activity participation and reducing sedentary behavior. However, limited research has been conducted on the health communication competence (HCC) of physical education (PE) teachers. Thus, this study aims to investigate the factors and mechanism influencing the development of HCC among PE teachers base on Ecological System Theory (EST). The interview method was first used to collect influencing factors and form theoretical models. An online survey questionnaire was used to collect data from 394 PE teachers in primary and secondary schools in China. The data were randomly divided into two subsamples and subjected to exploratory (n = 184) and confirmatory factor analyses (n = 210). The hypothesis was verified using a structural equation model approach. (1) The formation of HCC among PE teachers is influenced by multiple factors, including social factors (0.396), school factors (0.379), and individual factors (0.210), encompassing a total of 13 sub-factors. (2) Physical education teachers' HCC is primarily shaped by external factors, and aligns with the EST's hierarchy. This study could help PE teachers identify the factors and mechanism that affect the formation of their HCC. As primary influencing factors, the government and relevant stakeholders should clarify the specific roles and provide policy support for PE teachers when formulating health-related policies.