High-risk influencing factors associated with physical inactivity and gender differences among Chinese university...

This cross-sectional study aimed to identify high-risk influencing factors associated with higher odds of physical inactivity among Chinese university students using data from the CPAHLS-CS. It further explored gender differences in these associations to provide evidence for developing differentiated intervention strategies. This cross-sectional study aimed to identify factors associated with IPAQ-derived low physical activity (LPA) among Chinese university students using data from the CPAHLS-CS and to examine whether these associations differed by gender.

A cross-sectional questionnaire survey was conducted among 35,696 university students from general higher education institutions across China in 2024 using stratified cluster sampling. The questionnaire was utilized to assess the students' PA levels and collect data on demographic, psychological, behavioral, and health indicators. PA level was classified into low, moderate, and high categories according to the IPAQ scoring protocol. For binary logistic regression, LPA was used as the outcome variable, with LPA coded as 1 and moderate/high PA coded as 0. Chi-square tests, Spearman correlation analysis, sex-stratified binary logistic regression, and pooled logistic regression models with gender-by-predictor interaction terms were used to examine factors associated with physical inactivity and to formally test whether these associations differed by gender.

The overall prevalence of IPAQ-derived LPA was 68.48%. When calculated within gender groups, the prevalence of LPA was 55.0% among male students and 85.5% among female students. .When calculated within each gender group, the prevalence of IPAQ-derived LPA was higher among female students than among male students. Regression analysis showed that low self-efficacy was the strongest factor associated with higher odds of LPA across genders (male students OR = 1.997, 95% CI: 1.806-2.207; female students OR = 2.169, 95% CI: 1.949-2.413). Myopia and smartphone addiction were identified as common factors associated with higher odds of LPA across genders. Depressive symptoms were a positive predictor of inactivity for both males and females. Formal interaction testing in the pooled model confirmed significant gender differences for anxiety severity and BMI. In the pooled interaction model, the associations of anxiety severity and BMI with low physical activity differed by gender. Interaction analyses showed that anxiety severity was associated with lower odds of LPA among female students, whereas higher BMI was associated with higher odds of LPA primarily among male students.

The issue of IPAQ-derived LPA among Chinese university students is severe and exhibits marked gender differences. Female students are more susceptible to IPAQ-derived LPA, while the risk for male students is more closely associated with weight perception. Low self-efficacy was identified as a key high-risk influencing factor associated with higher odds of LPA, whereas depression, smartphone addiction, and myopia were core associated factors across genders. Formal interaction analyses indicated that anxiety severity and BMI were associated with physical inactivity in a gender-dependent manner.