Explaining Physical Activity and Self-Rated Health Through Motivation and Perceived Service Quality: A Structural Equation Model

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript “Explaining Physical Activity and Self-Rated Health through 2 Motivation and Perceived Service Quality: A Structural 3 Equation Model” is clear and informative, offering a new perspective on how the quality of sports infrastructure services increases motivation to exercise, which in turn increases physical activity and leads to better self-rated health.

1. The reviewer has a few comments, most of which concern formatting:

• The abstract contains numerous abbreviations that may not be clearly understood by the reader.
• Not all abbreviations are listed at the end of the manuscript (line 425).
• The abbreviation „PA“ appears for the first time in line 85, although physical activity is discussed extensively earlier in the text. Similarly, the abbreviation is not used consistently throughout the work.Tekst (Rida 79-83) vajaks viidet.
• Figure 1 needs to be supplemented. The figure reflects the text in line 113, but not lines 17-118 (“... aim was to clarify how environmental quality and exercise motivation together influence health-related exercise behavior”). The hypotheses presented below the figure should clearly correspond to the figure.Joonis 2 selgitav tekst (rida 227-228) peaks olema joonise all.
• In Figure 2, the p values could be presented on a scale of <0.05, 0.01, and 0.001.
• The abbreviations in Table 3 should be spelled out, as figures and tables must be understandable on their own.References should be numbered in order of appearance and indicated by a numeral or numerals in square brackets—e.g., [1] or [2,3], or [4–6].

2. What type of informed consent was obtained from the subjects, verbal or written? Please describe what you mean by "anonymous questionnaires" (line 133).
3. How long did it take to complete the questionnaire? What conditions were provided for the subjects to complete it (space, ability to complete it alone, etc.)?
4. It is noted as a limitation that the different ages of the subjects may affect the results, but in the reviewer's opinion, the analysis of both age and gender remains too superficial in this regard.

Comments for author File: Comments.pdf

Author Response

The abstract contains numerous abbreviations that may not be clearly understood by the reader. Not all abbreviations are listed at the end of the manuscript (line 425). 

Thank you for pointing this out, we added abbreviations on page 10, line 424.

 

The abbreviation „PA“ appears for the first time in line 85, although physical activity is discussed extensively earlier in the text. Similarly, the abbreviation is not used consistently throughout the work.

Thank you, we improved that throughout the article.

Figure 1 needs to be supplemented. The figure reflects the text in line 113, but not lines 17-118 (“… aim was to clarify how environmental quality and exercise motivation together influence health-related exercise behavior”). The hypotheses presented below the figure should clearly correspond to the figure.  

Thank you, we changed line that mentioned “environmental”; it was meant as environment in fitnes.

In Figure 2, the p values could be presented on a scale of <0.05, 0.01, and 0.001. 

Thank you for pointing this out, we changed that accordingly on Figure 2, Page 6.

The abbreviations in Table 3 should be spelled out, as figures and tables must be understandable on their own. References should be numbered in order of appearance and indicated by a numeral or numerals in square brackets—e.g., [1] or [2,3], or [4–6].

The abbreviations in Table 3 have been fully spelled out to ensure the table is understandable as a standalone item. In addition, all references have been checked, renumbered where necessary, and are now cited in numerical order using square brackets (e.g., [1], [2,3], [4–6]).

What type of informed consent was obtained from the subjects, verbal or written? 

Written, we added that in lines 139 and also 412.

Please describe what you mean by "anonymous questionnaires" (line 133). 

No names or surnames were taken, or any other identifying data. 

 How long did it take to complete the questionnaire? What conditions were provided for the subjects to complete it (space, ability to complete it alone, etc.)?

On average, participants required approximately 5 to 7 minutes to complete the full questionnaire. The questionnaire was designed to be brief and user-friendly, using validated short-form scales to minimize fatigue and improve completion rates. They had enough space.

It is noted as a limitation that the different ages of the subjects may affect the results, but in the reviewer's opinion, the analysis of both age and gender remains too superficial in this regard.

We appreciate the reviewer’s insightful comment regarding age and gender effects. Our primary aim was to test the hypothesized sequential model linking perceived service quality, motivation, physical activity, and health across a broad adult population. While we acknowledge that age and gender could moderate these relationships, our approach in the original manuscript remained exploratory and descriptive due to limitations in statistical power for subgroup analysis and the focus on the latent path structure. We agree that future studies should be designed specifically to test moderation by age and gender (or some additional things, like education,..) using stratified sampling or invariance testing, which would provide more conclusive insights into how demographic characteristics influence the motivational-health pathway.

Reviewer 2 Report

Comments and Suggestions for Authors

Including information on the prevalence of physical activity among adults in Slovenia in the introduction would strengthen the manuscript.

The introduction could be strengthened by more clearly defining the research gap and highlighting the distinct contribution of this study. It is recommended to explicitly identify aspects of the relationship between environmental and motivational factors affecting physical activity and health in the adult population that prior research has not explored.

In lines 34-35, the authors stated that physical activity has a crucial role in ... treating chronic diseases. PA could prevent or manage chronic diseases, but treating them is exaggerated. Please revise that statement.

In the text, references are expressed by numbers placed in square brackets [ ] and listed in the Reference section in the citation order.

On row 77 it stays written: Additionally, lack of motivation is a well-known barrier to regular exercise. An adult do not struggle with a lack of motivation - a barrier to exercising regularly, will not exercise at all, never. My recommendation is to revise this sentence.

Abu-Omar et al. (2004 was cited in lines 89-90, but it doesn't appear in the references. Anyway, the article was written in 2004 based on 2002 Eurobarometer data, while the next data series you refer to is from 2025. My recommendation is to keep the recent one and abandon the outdated article.

Material and Methods.

The heterogeneity of the target population is not supported by data on age range, the number of women and men, and the percentage of those who are occasionally or regularly involved in physical activities.

A single question about health, with a self-reported answer, inspires fragile trust in this item and model section.

On line 211, a correction is needed (see).

References should not appear in the Results section.

Table 3 needs a footnote explaining the variables. 

NFI, GFI, CFI, and so on must be included, with their names in the Abbreviation section (rows 425 and further).

The phrase between rows 245-251 needs 1. a rephrase and 2. the novelty argument to be used in the introduction.

Crucial is a powerful word; therefore, I recommend using it with caution and not for every and each concept: physical exercise is crucial, motivation is crucial, the exercise environment is crucial, and the study evidence is crucial.

Discuss the self-reported data bias and how it may impact the findings.

Proofread for minor typographical errors, especially in the second author's affiliations and correspondence details.

 

Author Response

Including information on the prevalence of physical activity among adults in Slovenia in the introduction would strengthen the manuscript.

Thank you for pointing this out, we added this information in lines 123-126. "To capture a diverse sample, participants were approached in multiple venues, including public parks, shopping malls, and outside fitness centers in Slovenia, which is known to be country with high procentage of people, who are enough physically active; 55,9%."

reference: Petrič, M., & Remec, M. (2018). Physical activity habits of adult population in Slovenia. European Journal of Public Health, 28(suppl_4), cky214-054.

The introduction could be strengthened by more clearly defining the research gap and highlighting the distinct contribution of this study. It is recommended to explicitly identify aspects of the relationship between environmental and motivational factors affecting physical activity and health in the adult population that prior research has not explored.

Thank you, we added this on page 3, lines 99-105.

In lines 34-35, the authors stated that physical activity has a crucial role in ... treating chronic diseases. PA could prevent or manage chronic diseases, but treating them is exaggerated. Please revise that statement. 

Thank you for comment, we revised that on page 1, line 34.

In the text, references are expressed by numbers placed in square brackets [ ] and listed in the Reference section in the citation order.

Thank you for comment, all references have been checked, renumbered where necessary, and are now cited in numerical order using square brackets (e.g., [1], [2,3], [4–6]).

On row 77 it stays written: Additionally, lack of motivation is a well-known barrier to regular exercise. An adult do not struggle with a lack of motivation - a barrier to exercising regularly, will not exercise at all, never. My recommendation is to revise this sentence.

Thank you for suggestion, we revised this part on page 2, line 70-72.

Abu-Omar et al. (2004 was cited in lines 89-90, but it doesn't appear in the references. Anyway, the article was written in 2004 based on 2002 Eurobarometer data, while the next data series you refer to is from 2025. My recommendation is to keep the recent one and abandon the outdated article.

Thank you for comment, we abandoned this article.

Material and Methods.

The heterogeneity of the target population is not supported by data on age range, the number of women and men, and the percentage of those who are occasionally or regularly involved in physical activities.

We thank the reviewer for pointing this out. In response, we have now included the age range and gender distribution in the revised Methods section (line 135-136) to better describe the heterogeneity of our sample. Regarding physical activity levels, we measured activity using the IPAQ-Short Form, which yields continuous MET-minute scores. For this reason, we did not categorize participants by percentage engaging in moderate or vigorous activity. However, we acknowledge the value of such categorizations and will consider presenting activity levels by IPAQ categories (low, moderate, high) in future work or supplementary materials, if deemed useful.

A single question about health, with a self-reported answer, inspires fragile trust in this item and model section.

We appreciate the reviewer’s comment regarding the use of a single-item self-rated health (SRH) measure. While it is indeed a subjective indicator, self-rated health has consistently demonstrated strong validity and predictive utility in epidemiological and behavioral health research. Numerous studies have shown that a single-item global health rating is a robust predictor of morbidity, functional decline, and even all-cause mortality, often outperforming more complex clinical measures. Also, it is very short and practical.

On line 211, a correction is needed (see).

Thank you very much, English is not my mother language. We improved that.

References should not appear in the Results section.

We improved this, thank you for suggestion.

Table 3 needs a footnote explaining the variables. 

Indeed, we added footnote with abbreviations.

NFI, GFI, CFI, and so on must be included, with their names in the Abbreviation section (rows 425 and further).

Indeed, thank you, we added abbreviations (row 423).

The phrase between rows 245-251 needs 1. a rephrase and 2. the novelty argument to be used in the introduction.

Thank you for suggestion. We added the novelty argument in introduction (lines 98-105) and we also rephrased this sentence in discussion (lines 251-255)

Crucial is a powerful word; therefore, I recommend using it with caution and not for every and each concept: physical exercise is crucial, motivation is crucial, the exercise environment is crucial, and the study evidence is crucial.

Thank you for your advice, we changed wording throughtout the text.

Discuss the self-reported data bias and how it may impact the findings.

Thank you for this improvement, we additionally discussed this in the limitations section, lines 369-371.

Proofread for minor typographical errors, especially in the second author's affiliations and correspondence details.

Thank you, we improved wording and also author details.

 

Reviewer 3 Report

Comments and Suggestions for Authors

Please see attached file for review.

Best regards

Comments for author File: Comments.pdf

Author Response

The introduction provides a clear and logical theoretical foundation. Some sections are descriptively dense, particularly where SDT and service quality literature overlap; a tighter synthesis could improve conciseness. The novelty claim (“This makes our study unique”) would benefit from more cautious phrasing, as related SEM studies exist, albeit with different variable configurations.

Thank you for your comment, we more clearly defined the research gap and novelty claim (lines 98-105) and highlighted the contribution of this study. Also, we improved "Although previous studies have examined links between PA and quality of life [20], the role of psychological mediators in PA behavior [21], and associations among motivation, life satisfaction, and exercise [13], few have tested an integrated model that simultaneously positions exercise motivation and PA as sequential mediators between perceived service quality and SRH" in lines 251-255.

A cross-sectional survey with SEM is appropriate for testing complex relational and mediational hypotheses. The cross-sectional design limits causal inference, although the authors appropriately acknowledge this in the limitations section. The conditional administration of SQAS (only for fitness center users) introduces structural missingness, which is not fully discussed in terms of its impact on the SEM. The design is suitable for explanatory modeling, but causal language should remain carefully constrained (which the authors largely do).

We appreciate the reviewer’s thoughtful remarks. We acknowledge that the conditional administration of the SQAS to fitness center users introduces structural missingness. As noted, this design choice reflects the real-world relevance of SQAS items. To address this, we applied Full Information Maximum Likelihood (FIML) estimation, which appropriately handles missing-at-random data under SEM. We now added this in Limitations section, lines 376-378). Thank you for highlighting this important topic.

Instruments are well-described and validated, with appropriate references. Measurement model (CFA) is not explicitly reported. For SEM papers, journals typically expect:

Factor loadings

Construct validity (e.g., AVE, CR)

We did not estimate an item-level CFA, as the structural model was based on composite (mean) scores used as observed variables. This is now clarified in the revised Methods section (196-200).

No discussion of:

Missing data handling

Thank you, we added this part in lines 133-135.

Normality assessment

Justification for maximum likelihood estimation with Likert-type data

Although the variables were measured using Likert-type scales, maximum likelihood estimation was applied. With five or more response categories and a large sample (N = 546), such variables can be treated as approximately continuous and ML estimation is robust to moderate deviations from normality. Given the large sample size, no severe problems due to non-normality were expected.

The use of single-item self-rated health is defensible but would benefit from stronger methodological justification within SEM context.

Thank you, we added this justification in lines 186-191.

Regarding results: Path coefficients are clearly reported with β values and p-values. Model fit indices are presented both narratively and in Table 3, with clear thresholds.

We thank the reviewer for their positive assessment of the clarity of our results reporting. We appreciate the acknowledgment.

Minor issues

The magnitude of effects (especially PA → self-rated health) is small; this is not critically discussed.

Thank you for this comment, we added this part in the discussion, lines 289-296.

Indirect (mediation) effects are described conceptually but not quantified with confidence intervals, which is increasingly expected.

Thank you for this suggestion to improve our article. We added:

In Methods (lines 200-202):

Indirect effects were tested using bootstrap resampling (2000 samples) to obtain 95% confidence intervals

In Results (lines 240-242):

The indirect effect of perceived service quality on self-rated health via exercise motivation and physical activity was statistically significant (standardized indirect effect = 0.008, 95% CI [0.002, 0.017]), indicating a significant serial mediation effect.

IN DISCUSSION (lines 291-294): Given that the model tests a three-step mediation pathway and that the final outcome is a broad global health indicator, the observed indirect effect is necessarily small in magnitude. Nevertheless, the effect is statistically reliable and supports the proposed theoretical mechanism.

Minor issues

Typographical and formatting inconsistencies (e.g., decimal commas vs points).

Thank you, we addressed this issue throuhgout the article.

Figure captions could be slightly more descriptive (e.g., noting standardized coefficients).

Thank you, we changed figure 2 caption.

Some redundancy between text and tables could be reduced.

Thank you, we tried to reduce it.

Conclusions: The policy and practice implications may be slightly overstated given the modest effect sizes and self-report measures. The conclusion could benefit from clearer emphasis on effect size interpretation, not only statistical significance.

We thank the reviewer for this valuable comment. We agree that, given the modest effect sizes and the use of self-reported measures, policy and practice implications should be interpreted cautiously.

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

This is my suggestion for the line 123-125 text:

To capture a diverse sample, participants were approached in multiple venues, including public parks, shopping malls, and outside fitness centres in Slovenia, a country with a high percentage (55,9%) of people who are sufficiently physically active.

In the reference section, there are double consecutive numbers for each citacion.

Author Response

Thank you for this suggestion. We have revised lines 123–125 to better clarify the recruitment strategy and the national context.

In addition, we corrected an error in the reference list where double consecutive numbering appeared for each citation. The reference section has now been checked and renumbered consistently.

 

Thank you for improving our article, 

 

dr. Vojko Vučković

Author Response File: Author Response.pdf