【中图分类号】G812 【文献标识码】A 【文章编号】2095-2813（2025）15-0171-04

Analysisof Influencing Factors on Exercise Prescription Adherence Under the Background of Integration ofSportsandMedicine

—Base on the Social-Ecological Model Theory

LIU Yang1 HE Zheng1 DONG Gaofang² 1.PhysicalEducationInstitute，Hebei NormalUniversity，Shjiazhuang，Hebei Province，O5o21China;2.HeBei General Hospital， Shijiazhuang，Hebei Province，O5Oo51 China

[Abstract] The integrationof sportsand medicineisanimportantnational policyin China andakeysafeguard for residents'health.Exercise prescription is thecore means ofachieving sports and medical integration.The current standard paradigm for prescribing exercise is to follow the FITT-VP principle，which includes physiological and training elementssuchasexercise frequency，exerciseintensityexercise style，exercisetime，total exercisevolume， and exercise progresson，and is formulated and implemented accordingly.However，the intervention period of exercise prescriptionsis generally longer and the long-term adherence cannot be guaranteed without external support.The adherence to exercise prescriptions is influenced by multilevel complex factors such as individual，psychological，andenvironmental factors，and thesocial ecological model theoryisaclasic theoryof interactions among multiple factors.Thisarticle systematicallyreviewed the interactive relationshipsand action paths of the factors that influence adherence to exercise prescriptions from five levels：the demographic，physiological， psychological，social，andenvironmental withintheframeworkof thesocial ecologicalmodel theory.Therelevant results can provideuseful theoretical references for improving adherence to exercise prescriptions and improving the FITT-VP principle.

[Keywords] Exerciseprescription; Adherence;Social-ecological model; Sportsand medical integration

体力活动缺乏是多种代谢疾病的重要诱因，严重威胁我国居民健康。《“健康中国2030”规划纲要》提出体医融合路径，运动处方作为核心手段，在疾病预防和健康促进中发挥关键作用[1]。根据2023年发布的《运动处方中国专家共识（2023）》，运动处方的设计应该包含运动频率、运动强度、运动方式、运动时间、运动总量和运动进阶（Frequency，Intensity，Training Time，TrainingType，Volume，Progression）6个要素，即FITT-VP原则[2]。这使得运动处方可根据不同的临床证据，将健身方法打包为目标明确、程序清晰的执行方案，从而有效保障体育锻炼的科学性和健康促进效果。然而在实际生活中，居民往往难以完成运动处方所要求的全部训练周期和运动量。当前FITT-VP的相关研究主要关注生理适应，忽视心理和社会支持，导致长期依从性较低。为提升运动处方效果，该文，分析多层次影响因素的互动关系，旨在优化FITT-VP的要素配置，提高处方执行的长期依从性，促进居民健康。

1运动处方的依从性亟待改善

1.1运动处方长期依从性不足

运动处方（ExercisePrescription）由美国生理学家PETERKARPOVIC于20世纪50年代提出，经过发展，美国运动医学会（ACSM）于1975年发布首版《ACSM运动测试与处方指南》，至2022年更新至第11版。该指南以FITT-VP原则为框架，定义运动处方为针对不同年龄、体适能及健康状况的人群制订的促进健康和防治慢病的运动方案[2]。运动处方需通过健康筛查、运动测试及基于疾病的FITT-VP配置，遵循循证医学保障效果。但因其见效周期长（肥胖干预3＼～6个月，心肺耐力改善4周至8个月），且FITT-VP侧重生理适应，忽视心理社会因素，导致退出率居高不下。……