ArticleFrontiers in public health2026
Structured environmental cues and youth sports consumption: an AI-powered behavioral modeling approach.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Physical inactivity among children and adolescents represents a critical global public health challenge, imposing an annual economic burden exceeding $27 billion on healthcare systems worldwide. Despite this pressing concern, the complex, cross-level relationships between structured environmental cues-spanning household, school, and community domains-and youth sports consumption remain inadequately understood, particularly across the heterogeneous urbanrural continuum characteristic of rapidly developing economies. Methods: This study employed a longitudinal survey (China Health and Nutrition Survey, CHNS) comprising 4,240 child-wave observations nested within 940 households and 182 communities. We benchmarked conventional multilevel regression against three machine learning approaches-gradient boosting, random forest, and LSTM sequence models-using temporal and spatial holdout validation. Feature-level and interaction-level interpretability was recovered via SHAP decomposition to quantify the magnitude and breakdown of urbanrural interplay in multi-layered environmental factors shaping youth sport consumption. Results: The gradient boosting model significantly outperformed the multilevel baseline, achieving a holdout Discussion: This study provides novel evidence that public space recreation infrastructure yields substantially greater behavioral returns in resource-limited communities, challenging assumptions that uniform investment strategies are optimal across socioeconomic strata. The findings offer a new methodological and intervention paradigm for promoting youth physical activity in socioeconomically diverse, rapidly urbanizing regions, emphasizing targeted infrastructure investment in disadvantaged communities as a high-return public health strategy.
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