The chain mediating effect of self-efficacy and health literacy between proactive personality and health-promoting behaviors among Chinese college students

Health-promoting behaviors are essential for college students as they develop lifelong health habits. To investigate how to cultivate health-promoting behaviors among college students, this study aimed to investigate the influence of proactive personality on health-promoting behaviors and to explore the mediating roles of self-efficacy and health literacy through a cross-sectional study. A total of 664 college students from six colleges in Xinxiang, China, were conveniently sampled to complete questionnaires, including the Proactive Personality Scale, General Self-Efficacy Scale, 12-item Short-Form Health Literacy Scale, and Short-Form Health Promotion Scale. Path analysis indicated that proactive personality was directly associated with health-promoting behaviors (effect value: 0.146). The mediating roles of self-efficacy (effect value: 0.165) and health literacy (effect value: 0.080) were significant. A chain mediating effect of self-efficacy and health literacy was also observed (effect value: 0.028). The positive effect of proactive personality (β = 0.146, P < 0.001), self-efficacy (β = 0.421, P < 0.001) and health literacy (β = 0.234, P < 0.001) on health-promoting behaviors was significant. These findings suggest that self-efficacy and health literacy play a chain mediating role between proactive personality and health-promoting behavior. Future interventions should target proactive personality, self-efficacy, and health literacy to enhance health-promoting behaviors in college students.