Regression analysis of mediating effects.

PurposeThis study examines how eHealth literacy influences exercise behaviour among university students through a moderated mediation model. Specifically, peer relationships are positioned as mediators, while sleep quality moderates the effect of eHealth literacy on exercise behaviour among university students. The study explores the intricate interactions involved and elucidates how eHealth literacy affects exercise behaviour through multiple dimensions.MethodsStudent data were collected via questionnaire surveys across multiple academies. A stratified purpose sampling approach was employed for participant selection, targeting four specific universities to ensure regional and typhological representation: Nanjing Xiaozhuang University, Yangzhou University, Shangqiu University, and Yangzhou Polytechnic Institute. This process resulted in 14,892 valid responses for analysis, and SPSS 26.0 along with the PROCESS macro was used to analyses variables such as electronic health literacy, physical activity, sleep quality, and peer relationships.ResultsThe structural equation modeling revealed a significant direct effect of eHealth literacy on university students physical activity behaviour (β=0.065, p. Mediation analysis delineated an indirect pathway through peer relationships: eHealth literacy significantly enhanced peer relationship quality (β=0.251, p, which subsequently predicted increased physical activity (β=0.058, p. Peer relationships significantly mediate between eHealth literacy and university students physical activity (β=0.251, p. Additionally, sleep quality serves as a moderating variable (β=0.029, p, significantly moderating the direct effect of eHealth literacy on university students physical activity, with the 95% confidence intervals consistently excluding zero.ConclusionEHealth literacy among university students can significantly and positively predict their exercise behaviour. Peer relationships mediate the effect of eHealth literacy on exercise behaviour. At the same time, sleep quality is a moderating variable influencing eHealth literacy's direct impact on university students exercise behaviour.

研究目的
本研究借助有调节的中介模型（moderated mediation model），探讨电子健康素养（eHealth literacy）对大学生锻炼行为的影响机制。其中，同伴关系作为中介变量，睡眠质量则对电子健康素养与大学生锻炼行为间的关联发挥调节作用。本研究深入解析其中的复杂交互关系，阐明电子健康素养通过多维度路径作用于锻炼行为的具体过程。

研究方法
本研究通过问卷调查法在多所院校收集学生样本数据。采用分层立意抽样法选取研究对象，共纳入四所高校以保障样本的区域代表性与类型代表性，分别为南京晓庄学院、扬州大学、商丘学院及扬州职业大学。最终回收有效问卷14892份用于后续分析。本研究采用SPSS 26.0及PROCESS宏程序（PROCESS macro），对电子健康素养、体育活动、睡眠质量及同伴关系等变量进行统计分析。

研究结果
结构方程模型（Structural Equation Modeling, SEM）分析结果显示，电子健康素养对大学生体育锻炼行为存在显著直接效应（β=0.065, p.）。中介分析明确了一条以同伴关系为路径的间接效应：电子健康素养可显著提升同伴关系质量（β=0.251, p.），而同伴关系质量又可正向预测体育活动水平的提升（β=0.058, p.）。同伴关系在电子健康素养与大学生体育锻炼行为间发挥显著中介作用（β=0.251, p.）。此外，睡眠质量作为调节变量（β=0.029, p.），可显著调节电子健康素养对大学生体育锻炼行为的直接效应，其95%置信区间始终不包含零。

研究结论
大学生的电子健康素养可显著正向预测其锻炼行为。同伴关系在电子健康素养对锻炼行为的影响中起到中介作用。同时，睡眠质量作为调节变量，可影响电子健康素养对大学生锻炼行为的直接效应。