Characteristics of Cultural Responsiveness in Life Skills Education in Chinese University Campuses: Based on the KAP Model

Technical Summary: Characteristics of Cultural Responsiveness in Life Skills Education in Chinese University Campuses

Problem Statement
While Life Skills Education (LSE) is recognized globally as a culturally responsive approach to health promotion, its specific characteristics within Chinese university campuses remain insufficiently defined. Existing research often relies on descriptive statistics or structural equation models (e.g., Knowledge-Attitude-Practice or KAP models) which may fail to capture the asymmetric, multifactorial, and non-linear nature of cultural responsiveness. Specifically, there is a gap in understanding the logical starting points, causal paths, high-frequency elements, and bottleneck levels of LSE when viewed through the lens of cultural responsiveness. Furthermore, previous studies have not fully validated the "knowledge return" phenomenon as a universal logical starting point for LSE, nor have they identified specific synergistic combinations of factors that lead to high-quality, inclusive educational outcomes.

Methodology
This study employed a cross-sectional quantitative design utilizing Fuzzy Set Qualitative Comparative Analysis (fsQCA) to examine the cultural responsiveness of LSE among Chinese university students.

• Sample: Data was collected from 369 university students across four institutions in China. The sample included a mix of genders, ages (primarily 18–23), and majors (engineering, science, and liberal arts).
• Variables: The study constructed a culturally responsive KAP model based on three core dimensions:
  • Health Literacy (HL): The dependent variable (outcome), measured via an 8-item questionnaire.
  • Physical Literacy (PL): Independent variables including Confidence (Con), Motivation (Mot), and Interaction with the Environment (IWE).
  • Physical Activity (PA): Independent variables derived from the National Physical Fitness Monitoring (NPFM) system, including Physical Form (PI), Functional Indicators (FuI), and Fitness Indicators (FI).
• Data Processing:
  • Data underwent reliability and validity testing (Cronbach's α > 0.6, CR > 0.6, AEV > 0.35).
  • Outliers were removed using Grubbs' test.
  • Raw data was calibrated into fuzzy set membership scores using a direct calibration method (0.95 for full membership, 0.5 for crossover, 0.05 for full non-membership).
  • Heterogeneity in PA indicators (e.g., running times vs. jump distances) was standardized, with specific adjustments made for BMI and directional indicators (e.g., setting running times as negative values where lower is better).
• Analysis: The fsQCA algorithm (version 4.1) was applied to identify necessary conditions, causal configurations (paths), and bottleneck levels. The analysis utilized consistency thresholds of 0.8, PRI thresholds of 0.85, and a frequency threshold of 5.

Key Results
The analysis yielded four distinct culturally responsive paths and identified specific high-frequency elements and bottleneck levels:

1. Logical Starting Point Validation: The study observed partial-factor configurations (ranging from 1 to 5 factors) rather than full-factor or zero-factor configurations. This validates that "knowledge return" (Health Literacy) serves as a general, universal logical starting point for LSE, though it is not the sole determinant.
2. Causal Paths: Four specific configurations were identified linking PL and PA to HL outcomes:
   • Path 1: Low confidence, low motivation, low interaction, high physical form (missing functional and fitness indicators).
   • Path 2: Low confidence, low motivation, high physical form, high function, high fitness (missing interaction).
   • Path 3: Low confidence, low motivation, low interaction, high function, high fitness (missing physical form).
   • Path 4: High confidence, high motivation, high interaction, low physical form, high function (missing fitness).
3. High-Frequency Elements: Three factors were identified as high-frequency necessary conditions for achieving high Health Literacy:
   • Confidence (Con)
   • Physical Form (PI)
   • Functional Indicators (FuI)
   • Note: The analysis revealed that attitudes (Confidence, Motivation) and practices (Physical Form, Function) significantly influence knowledge outcomes.
4. Bottleneck Levels: The study quantified the minimum requirements for achieving specific levels of Health Literacy:
   • To achieve a 90% HL level: Requires 0.4% Physical Form and 8.4% Fitness.
   • To achieve a 100% HL level: Requires 2.1% Confidence, 1.0% Motivation, 17.4% Interaction with Environment, 2.0% Physical Form, and 9.9% Fitness. Function (FuI) showed no bottleneck level.
   • The relationship is expressed as: $100\% HL = 2.1\% \times Con + 1.0\% \times Mot + 17.4\% \times IWE + 2.0\% \times PI + 9.9\% \times FI$.

Significance and Claims
The authors claim that this study provides a novel framework for understanding the cultural responsiveness of LSE by moving beyond linear structural models to analyze asymmetric data.

• Theoretical Validation: The findings support the universality of the KAP model while demonstrating its diversity in application. The study confirms that knowledge return is a valid logical starting point but highlights that it operates through complex, non-linear synergies with physical literacy and activity.
• Practical Application: By quantifying bottleneck levels and identifying high-frequency elements, the study offers specific, actionable criteria for policymakers and educators. It suggests that to achieve high-quality, inclusive LSE outcomes, interventions must specifically target confidence, physical form, and functional capacity, alongside motivation and environmental interaction.
• Methodological Contribution: The paper presents fsQCA as a valuable tool for analyzing the cultural responsiveness of educational programs, particularly where data exhibits multifactorial and asymmetric characteristics. It proposes a new approach for cross-cultural validation of the KAP model within the context of school health promotion.

The study concludes that a culturally responsive approach to LSE, grounded in these identified paths and elements, effectively promotes the holistic development of university students within campus health promotion programs.