The impact of positive psychological capital on health literacy among college students: The mediating role of health behavior intention

The health literacy level of college students not only affects their personal lifelong health, but is also related to the improvement of the whole people's health quality and the sustainable development of society. Moreover, the frequent occurrence of psychological problems will lead to the decline of the health literacy level of college students. The purpose of this study is to investigate the current level of college students' health literacy, positive psychological capital and health behavior intention, and then to explore the impact of positive psychological capital on health literacy and the mediating role of health behavior intention METHODS: In January 2025, a stratified cluster sampling method was used to select 13,853 college students from a university in northern China for a cross-sectional survey. Measures included assessments of positive psychological capital, health literacy, and health behavior intentions RESULTS: Positive psychological capital was significantly positively correlated with both health literacy and health behavior intention. Health behavior intention was also positively correlated with health literacy. Mediation analysis indicated that health behavior intention partially mediated the relationship between positive psychological capital and health literacy, the direct effect was (β = 0.083, p < 0.001), the indirect effect was (β = 0.057, p < 0.001), and the proportion of mediation accounted for was 41.84 % of the total effect CONCLUSION: Positive psychological capital is strongly associated with health literacy and exerts a direct positive effect on it. Moreover, health behavior intention serves as a partial mediator in this relationship. Therefore, universities can implement integrated interventions that combine systematic psychological capital development with health behavior planning, thereby enabling students to translate their psychological resources and behavioral intentions into concrete health-promoting actions.