Abstract
INTRODUCTION: The rising prevalence of non-communicable diseases (NCDs) among the youth in the world has raised the need for urgent intervention strategies. Despite this, young adults are often considered to be healthy by default and their specific health risks are thus understudied. This research has employed the qualitative approach in an attempt to explore the lived experiences, perceptions and strategies of college students in managing health risks. METHODS: From March to April 2025, semi-structured and in-depth interviews were conducted with 39 students recruited from universities across China. The data collected were studied using thematic analysis by the help of NVivo software. RESULTS: Thematic analysis identified four major themes: (i) Lived experiences of intersected risks of physical and psychological health; (ii) Cognitive appraisals of risk severity and personal susceptibility; (iii) willingness to change and underlying determinants; and (iv) Strategies utilized in health risk management, including systemic enablers and barriers. Participants described negotiating a complex landscape of health challenges, shaped by a dynamic interplay of personal, social and environmental factors. CONCLUSION: This study identifies the complex health risks experienced by college students and the complexities of how college students perceive and handle these risks. These challenges are not isolated but the result of interplay of individual behaviors, family influence, institutional policies and broader environmental contexts. The findings support a move towards comprehensive and socio-ecological approaches to the prevention of NCDs and the promotion of health in young adulthood.