The Mediating Role of Health-Promoting Behaviors in the Relationship between Generalized Anxiety Disorder Symptoms and Health-Related Quality of Life among University Students

The health-related quality of life (HRQoL) of university students significantly influences their long-term well-being. Therefore, identifying factors that affect HRQoL is crucial. This study aimed to investigate the mediating role of health-promoting behaviors in the relationship between generalized anxiety symptoms and health-related quality of life among university students. This study employed a fundamental research design with a descriptive, correlational approach to data collection. The statistical population included undergraduate, master's, and doctoral students enrolled in universities in Neyshabur during the 2023–2024 academic year. A total of 497 students were selected using cluster sampling. Data were gathered using the Generalized Anxiety Disorder Scale, the 12-item Short Form Health Survey (SF-12), and the Health-Promoting Lifestyle Profile–Short Form. Data analysis was performed using SPSS and LISREL software, with Structural Equation Modeling (SEM) used to test the hypothesized relationships. A significant relationship was found between generalized anxiety symptoms, health-promoting behaviors, and health-related quality of life (p < 0.05). Furthermore, health-promoting behaviors significantly mediated the relationship between generalized anxiety symptoms and health-related quality of life, as indicated by model fit indices (CFI = 0.96, NFI = 0.94, NNFI = 0.96, IFI = 0.96, RFI = 0.93, GFI = 0.92, RMSEA = 0.059). These findings suggest that professionals in psychology-related fields—such as clinical and health psychologists—can play a vital role in enhancing students' quality of life. By designing and implementing interventions that reduce generalized anxiety symptoms and promote health-enhancing behaviors, they can contribute meaningfully to the overall well-being of university students.