Understanding how urban forest trail environments contribute to visitors’ health through cultural ecosystem benefits (CEBs) is essential for integrating human well-being into urban forest management. However, empirical evidence remains limited, particularly for treetop trails, which are underrepresented in the literature. This study investigates how environmental quality perception (EQP) influences perceived health benefits (PHBs), with CEBs conceptualized as key mediating variables. A field survey was conducted at the Fu Forest Trail in Fuzhou, Fujian Province, China, yielding 445 valid questionnaires. Structural equation modeling was employed to examine the direct and indirect pathways linking EQP, CEBs, and PHBs. The results show that high-quality treetop trail environments significantly enhance CEBs across the identity, experience, and capability dimensions. Among these, the identity dimension exerted positive effects on both experience and capability. Mediation analyses further revealed that identity and experience played significant parallel mediating roles between EQP and PHBs, whereas the mediating effect of capability was relatively weaker. In addition, a sequential mediation pathway was identified, in which EQP influenced PHBs through an identity-driven experiential process. Overall, the findings highlight the pivotal role of CEBs in translating environmental quality into health outcomes and underscore the importance of prioritizing identity- and experience-oriented benefits in the planning and management of urban treetop trails to better support public health.
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