Prevalence of insufficient daily physical activity and its association with health indicators among Chinese primary and secondary school students: a cross-sectional study.

The prevalence of insufficient daily 2-hour physical activity varied significantly across demographic variables among Chinese primary and secondary school students.

• A cross-sectional study was conducted using random cluster sampling across seven Chinese administrative regions from May to July 2025.
• Significant differences in prevalence of insufficient physical activity were observed across all demographic variables (all p < 0.001).
• Higher prevalence rates were observed among students in rural areas (30.50%), private schools (29.41%), and boarding students (30.03%).
• Students with lower frequency of reunions with parents also showed higher prevalence of insufficient physical activity.
• Statistical analyses included descriptive statistics, chi-square tests, and multivariable logistic regression performed using SPSS 26.0.

Key risk factors for insufficient daily physical activity were identified among Chinese school students.

• Risk factors included lack of health cognition and low perceived value of physical activity.
• Structural and resource-based risk factors included lack of sports facilities, insufficient allocated physical education time, and lack of access to smart devices.
• These factors were identified through multivariable logistic regression analysis.

Significant urban-rural and regional disparities were found in access to smart devices and academic stress levels.

• Disparities in access to smart devices were statistically significant (t = 3.142, p = 0.002).
• Disparities in academic stress levels between urban and rural or regional groups were also statistically significant (t = 2.499, p = 0.012).
• These disparities suggest differential barriers to physical activity participation depending on geographic and socioeconomic context.

Social support and cognitive factors were associated with achievement of the daily 2-hour physical activity target.

• The study analyzed the association between social support and cognitive factors and physical activity levels.
• Data were collected using standardized scales measuring physical activity levels, achievement of the daily 2-h physical activity target, academic stress, and health cognition.
• The study covered China's seven major administrative regions to provide nationally representative data.

The education department was reported to have implemented measures including differentiated management for higher grades in response to physical activity insufficiency.

• The education department increased the guarantee of student system construction.
• Differentiated management was implemented specifically for higher grades.
• These policy recommendations were derived from findings on health cognition, resource availability, and time allocation as significant associated factors.