Socio-ecological factors of health literacy and physical activity among middle-aged and older Chinese adults

中国中老年人健康素养和身体活动的社会生态因素

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Abstract

BACKGROUND: In rapidly aging China, physical activity (PA) and health literacy (HL) are increasingly recognized as important components of healthy aging. METHODS: A cross-sectional online survey was conducted among Chinese adults aged ≥40 years between July and September 2023 (N = 508). PA was assessed using the Physical Activity Rating Scale-3, and HL was measured using the Chinese version of the 12-item Health Literacy Scale Short-Form. Potential correlates spanning individual, behavioral, interpersonal, and community domains were examined using LASSO regression. The robustness of selected correlates was evaluated through bootstrap resampling and repeated random cross-validation. RESULTS: Participants were predominantly urban-dwelling and highly educated, with most aged 40-54 years. For PA, regular exercise and sleep duration were identified as positive correlates, whereas female sex and longer daily sedentary time were identified as negative correlates. For HL, monthly income and regular exercise were identified as positive correlates. CONCLUSION: Using an exploratory and variable-screening framework, this study identified a small set of socio-ecological correlates associated with PA and HL among middle-aged and older Chinese adults. Given the cross-sectional design, convenience sampling, and predominantly urban and well-educated sample, the findings should be interpreted as descriptive and hypothesis-generating rather than causal. Future studies using longitudinal designs and more representative samples are needed to confirm these associations and clarify their underlying mechanisms.

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