Study on the influencing factors of college students' healthy lifestyles based on the capability, opportunity, motivation-behavior model.

Social responsibility was the strongest predictor of healthy lifestyles among college students.

• β = 0.449, 95% CI [0.413, 0.466]
• Social responsibility was positioned as the core Motivation component in the COM-B model
• Study included 4,036 participants from six universities in Shandong Province, China
• Multiple linear regression combined with the Bootstrap method was used to explore variable mediation

Social responsibility partially mediated the relationships of both eHealth literacy and social support with healthy lifestyles.

• eHealth literacy was operationalized as the Capability component and social support as the Opportunity component of the COM-B model
• Bootstrap method was used to test mediation effects
• The mediation was partial, meaning direct effects of eHealth literacy and social support on healthy lifestyles also remained
• The mean score for healthy lifestyles was 3.95 (±0.74)

Academic major negatively moderated the relationship between eHealth literacy and healthy lifestyles.

• β = -0.127, p < 0.001
• Bootstrap was applied to test moderation effects
• Major was one of three moderating variables examined alongside mental health and sense of hope

Mental health status negatively moderated the relationship between social support and healthy lifestyles.

• β = -0.087, p < 0.001
• Mental health was assessed using a validated scale
• This negative moderation suggests that poorer mental health weakened the positive relationship between social support and healthy lifestyles

Sense of hope positively moderated the relationship between social responsibility and healthy lifestyles.

• β = 0.040, p < 0.001
• Sense of hope was the only moderator with a positive moderation effect among the three moderators tested
• Sense of hope was assessed using a validated scale administered as part of the cross-sectional survey

The study sample consisted of 4,036 college students with a slight female majority and more lower-grade than upper-grade students.

• 1,811 were male (44.9%) and 2,225 were female (55.1%)
• 2,216 lower-grade students (55.0%) and 1,820 upper-grade students (45.0%)
• Cross-sectional survey conducted from May to June 2022 using stratified cluster sampling across six universities in Shandong Province, China
• Validated scales were administered to assess healthy lifestyle, eHealth literacy, social support, social responsibility, mental health, and sense of hope