Table 1_Knowledge–behavior mechanisms and configurations for drowning prevention among Chinese school-aged children: a hybrid multi-analytical study combining regression-based mediation and fsQCA.xlsx

(2) Bootstrap mediation analysis produced a total effect of ES = −0.037 (t = −2.724, p < 0.01, 95% CI [−0.059, −0.009]). The direct effect was ES = 0.006 (t = 0.570, p > 0.05, 95% CI [−0.014, 0.026]). The mediating effect of risk attitude was ES = −0.035 (95% CI [−0.050, −0.020]).

The mediating effect of self-efficacy was ES = 0.002 (95% CI [0.00001, 0.005]). The mediating effect of sensation seeking was ES = −0.016 (95% CI [−0.023, −0.009]). The chain mediating effect of self-efficacy and sensation seeking was significant (ES = 0.003, 95% CI [0.001, 0.005]).

(3) Configurational analysis of high-risk swimming behaviors yielded an overall solution consistency of 0.887 and coverage of 0.431. The solution yielded seven sufficient configurations; the two configurations with water safety knowledge as a core present condition are foregrounded: the “disconnect between knowledge and action—attitude deviation” type and the “disconnect between knowledge and action—impulse breakthrough” type.</p>Conclusions<p>(1) Water safety knowledge is associated with high-risk swimming behaviors through two parallel mediating paths: “cognition - emotion” and “motivation - impulse”.

(2) Configuration analysis shows that the association between water safety knowledge and high-risk swimming behaviors follows a nonlinear, equifinal, and conjunctural pattern. Drowning-prevention interventions for school-age children may benefit from extending beyond knowledge transmission to comprehensive psychological adjustment.</p>