Social adaptability and its associations with eHealth literacy and physical activity among first- and second-year medical students in China: a cross-sectional study.
Wu M, Jiang Y, et al. • Frontiers in public health • 2026
Physical activity and eHealth literacy were independently and positively associated with social adaptability among first- and second-year medical students, though the final model explained only 16.9% of the variance in social adaptability.
Key Findings
Results
Social adaptability was positively correlated with eHealth literacy among first- and second-year medical students.
Spearman's correlation coefficient r_s = 0.348, P < 0.001
eHealth literacy remained positively associated with social adaptability in the final hierarchical regression model (β = 0.294, P < 0.001) after adjustment for covariates
eHealth literacy was assessed using the eHealth Literacy Scale
Sample consisted of 2,026 participants from Wannan Medical College in Wuhu, Anhui, China
Results
Social adaptability was positively correlated with physical activity among first- and second-year medical students.
Spearman's correlation coefficient r_s = 0.219, P < 0.001
Physical activity remained positively associated with social adaptability in the final hierarchical regression model (β = 0.124, P < 0.001) after adjustment for covariates
Physical activity was assessed using the Physical Activity Rating Scale-3
The association with eHealth literacy (β = 0.294) was stronger than the association with physical activity (β = 0.124)
Results
The final hierarchical regression model explained a modest proportion of variance in social adaptability.
R² = 0.169 and adjusted R² = 0.166, meaning the model explained 16.9% of the variance in social adaptability
The model included physical activity, eHealth literacy, and covariates: gender, year of study, place of origin, program duration, student leadership status, and survey wave
Both physical activity and eHealth literacy were independently associated with social adaptability after full adjustment
Authors note the modest explanatory capacity as a limitation requiring confirmation in longitudinal and intervention studies
Methods
The study used a cross-sectional online survey design with stratified convenience sampling conducted across two annual waves.
Surveys were conducted in October 2023 and October 2024
Total sample size was 2,026 first- and second-year medical students
Participants were drawn from Wannan Medical College in Wuhu, Anhui, China
Social adaptability was assessed using the Social Adaptation Inventory
Survey wave was included as a covariate in the regression model
Background
First- and second-year medical students face multiple challenges during university transition that relate to social adaptability.
Challenges identified include increased academic demands, changes in learning environments, and difficulties in social adaptation
Social adaptability is described as closely related to students' mental health and psychosocial functioning
eHealth literacy and physical activity were identified as 'important behavioral and cognitive factors that may be associated with social adaptability'
The study specifically targeted the early university transition period (first and second year)
What This Means
This research suggests that among medical students in their first and second years of university in China, both physical activity and the ability to find and use health information online (called eHealth literacy) are positively linked to how well students adapt socially to their new environment. The study surveyed 2,026 students at Wannan Medical College across two years (2023 and 2024), finding that students with higher eHealth literacy and greater physical activity tended to report better social adaptability. The connection with eHealth literacy was somewhat stronger than the connection with physical activity.
However, the factors measured in this study — including physical activity, eHealth literacy, gender, year of study, and several other background characteristics — together only explained about 17% of the differences in social adaptability between students. This means that many other factors not captured in this study also play important roles in how well students adapt socially. The researchers note that because this was a cross-sectional study (meaning everyone was surveyed at one point in time), it is not possible to determine whether physical activity or eHealth literacy actually cause better social adaptation, or whether students who adapt better simply tend to be more physically active and better at finding health information online.
This research suggests that promoting physical activity and digital health literacy skills among incoming medical students could potentially be useful components of programs designed to support student wellbeing and social adjustment during the challenging transition to university. Future studies using longitudinal designs or intervention trials would be needed to confirm whether improving these behaviors actually leads to better social adaptability.
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Wu M, Jiang Y, Wang L, Wu S, Sun J, Tao Z, et al.. (2026). Social adaptability and its associations with eHealth literacy and physical activity among first- and second-year medical students in China: a cross-sectional study.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1807832