[目的/意义]文章旨在探明网民健康谣言对抗行为的影响因素及其组态效应，为社交媒体谣言治理、社会 风险管控和健康信息内容生态改善等提供参考依据。[方法/过程]文章基于规范激活理论构建健康谣言对抗行为 影响因素模型，并利用偏最小二乘结构方程模型与模糊集定性比较分析方法进行实证检验与组态分析。[结果/结 论]后果意识和责任归属在个人规范的中介作用下对健康谣言对抗行为产生正向影响，且后果意识在感知行为效 能的正向调节作用下对责任归属产生显著正向影响，同时，存在后果-责任-道德驱动型、后果-道德-效能驱动型、 后果-责任-效能驱动型和责任-道德-效能驱动型四组触发健康谣言对抗行为的组态路径。最后，从网民行为优 化视角提出了健康谣言治理策略。

[Purpose/significance] The aim is to explore the influencing factors and configuration effects of netizens' health rumor confrontation behavior, and provide reference basis for social media rumor governance, social risk man⁃ agement, health information content ecology improvement. [Method/process] Based on the norm activation model, this paper constructs a model of factors influencing health rumor confrontation behavior, and uses the partial least squares structural equation model and fuzzy-set qualitative comparative analysis methods for empirical testing and configura⁃ tion analysis. [Result/conclusion] Awareness of consequences and ascribed responsibility have a positive impact on health rumor confrontation behavior under the mediation of personal norm, and awareness of consequences has a signifi⁃ cant positive impact on ascribed responsibility under the positive regulation of outcome efficacy,while there are four sets of configuration paths to trigger health rumor confrontation behavior: consequences- responsibility-ethics driven type, consequences-ethics-efficacy driven type, consequences-responsibility-efficacy driven type, and responsibilityethics-efficacy driven type. Finally, health rumor governance strategies are proposed from the perspective of netizens' behavioral optimization.