Digital health literacy and sports participation among college students: the role of cognitive flexibility and physical activity self-efficacy.

BACKGROUND

Digital health literacy is increasingly relevant to health behavior among college students, but its relationships with sports participation and associated psychological factors remain incompletely understood. Guided by social cognitive theory and an adaptive cognitive-processing perspective, this study examined a prespecified cross-sectional path model involving digital health literacy, cognitive flexibility, physical activity self-efficacy, and sports participation.

METHODS

A cross-sectional survey was conducted among 600 Chinese college students. Participants completed the DHLI 2.0, CFI, PASE, and PARS-3. Pearson correlation analysis, structural equation modeling, and bootstrap estimation of model-specific path-coefficient products using 5,000 resamples were performed with SPSS 26.0 and AMOS.

RESULTS

Digital health literacy was positively associated with cognitive flexibility, physical activity self-efficacy, and sports participation (all p < 0.001). The structural model demonstrated a good fit to the data (χ 2/df = 1.984, RMSEA = 0.016, SRMR = 0.033, CFI = 0.986, TLI = 0.993). Within the prespecified model, digital health literacy was positively associated with cognitive flexibility (β = 0.504), physical activity self-efficacy (β = 0.213), and sports participation (β = 0.191). The three-path coefficient product was small, although its bootstrap confidence interval excluded zero (standardized estimate = 0.011, 95% CI [0.002, 0.031]).

CONCLUSION

The observed covariance pattern was consistent with the prespecified cross-sectional path model involving cognitive flexibility and physical activity self-efficacy. However, because all variables were measured at a single time point, the findings do not establish temporal ordering or causal mediation. Longitudinal and experimental studies are needed to examine temporal ordering and causal relationships among these variables.