<b>Association between Adverse Childhood Experiences and Physical Activity among Private and Public University Students of Karachi</b>

The cross-sectional study examined the association of Adverse Childhood Experiences with physical activity levels among public and private university students in Karachi, Pakistan. Data was collected from N=500 participants (249=public, 251=private) aged mostly between 18-30 years, surveyed using the Adverse Childhood Experiences Questionnaire (ACE-Q) and the International Physical Activity Questionnaire (IPAQ). Statistical tests, including descriptive, inferential, chi-square, and logistic regression, were applied. Results showed significant disparities in ACE profiles among both sectors. Public university students reportedly have higher rates of violence-related ACE, including physical abuse (33.7% vs. 4.4%, p<0.01) and household violence (37.3% vs. 31.9%, p<0.05), while private university students showed greater family dysfunction, including parental separation and divorce (27.1% vs. 9.6%, p<0.01) and emotional neglect (58.6% vs. 49.0%). The most prevalent ACE was emotional neglect among both sectors. Physical activity level results were also different. Low PA (0–599 MET min/week) was reported by 91.2% of private university students as compared to 68.3% among public university students. High PA was not observed among either group, while moderate PA was slightly higher in the public sector (31.3% vs. 8.8%). Logistic regression models assessing the associations between ACE and PA showed statistically unstable results. The research highlights the socioeconomic status of Karachi, which is evident in contrasting ACE patterns and PA differences. Despite violence being more prevalent at public universities, students tend to have moderate PA levels. University students in private institutions tend to exhibit greater levels of seclusion and familial instability. Culturally tailored interventions that address specific vulnerabilities in sectors are recommended, such as preventing violence at public universities and promoting family support and PA promotion at private universities. Limitations include cross-sectional design, self-report bias, and unstable regression outputs.