Sample distribution table.

Purpose
This 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.
Methods
Student 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.
Results
The structural equation modeling revealed a significant direct effect of eHealth literacy on university students physical activity behaviour (β=0.065, p<0.001). Mediation analysis delineated an indirect pathway through peer relationships: eHealth literacy significantly enhanced peer relationship quality (β=0.251, p<0.001), which subsequently predicted increased physical activity (β=0.058, p<0.001). Peer relationships significantly mediate between eHealth literacy and university students physical activity (β=0.251, p<0.001). Additionally, sleep quality serves as a moderating variable (β=0.029, p<0.001), significantly moderating the direct effect of eHealth literacy on university students physical activity, with the 95% confidence intervals consistently excluding zero.
Conclusion
EHealth 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
本研究旨在通过有调节的中介模型（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。具体而言，本研究将同伴关系设定为中介变量，并考察睡眠质量对电子健康素养与大学生锻炼行为之间关联的调节效应。本研究深入剖析了其中涉及的复杂交互作用，并阐明了电子健康素养通过多维度路径对锻炼行为产生影响的具体机制。

研究方法
本研究通过针对多个学院开展的问卷调查收集大学生数据。研究采用分层目的性抽样方法筛选参与者，选取南京晓庄学院、扬州大学、商丘学院以及扬州工业职业技术学院四所高校，以确保样本具备区域与类型学代表性。最终共回收有效问卷14892份用于后续分析，并使用SPSS 26.0及PROCESS宏程序对电子健康素养、身体活动、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）分析结果显示，电子健康素养对大学生身体活动行为具有显著的直接正向影响（β=0.065, p<0.001）。中介分析明确了一条通过同伴关系的间接路径：电子健康素养可显著提升同伴关系质量（β=0.251, p<0.001），而同伴关系质量的提升又能显著预测身体活动水平的增加（β=0.058, p<0.001）。即同伴关系在电子健康素养与大学生身体活动之间发挥了显著的中介作用（β=0.251, p<0.001）。此外，睡眠质量作为调节变量（β=0.029, p<0.001），对电子健康素养与大学生身体活动的直接效应具有显著的调节作用，其95%置信区间始终不包含0，验证了调节效应的显著性。

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大学生锻炼行为的影响中发挥中介作用。同时，睡眠质量是影响电子健康素养对大学生锻炼行为直接效应的调节变量。