[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.