Policy cognition, perceived stress, coping dimensions, and adolescent health behaviors under physical education...

Physical education is increasingly embedded in high-stakes entrance examinations in China. However, the cross-sectional associations among adolescents' policy cognition, perceived stress, distinct coping dimensions, and health behaviors remain insufficiently understood.

A cross-sectional questionnaire survey was conducted among 1,513 junior secondary students enrolled in one participating school in Yunnan Province, China. Rural-urban background was measured as an individual-level self-reported characteristic and did not represent the location or institutional classification of the participating school. Task-oriented, emotion-oriented, and avoidance-oriented coping were modeled as three correlated but distinct constructs. Five documented health-behavior outcomes were analyzed: physical activity, dietary habits, weekday sleep duration, screen-time behavior, and overall routine regularity. Sensitivity analyses adjusted first for sex and rural-urban background and then for PE talent status, school PE lessons, extracurricular physical activity, family exercise frequency, and parental encouragement.

A correlated three-factor coping model fitted substantially better than a one-factor model. In the fully adjusted model involving 1,198 participants, perceived stress was negatively associated with physical activity (β = -0.246), dietary habits (β = -0.167), weekday sleep duration (β = -0.167), screen-time health score (β = -0.183), and overall routine regularity (β = -0.164). Task-oriented coping was positively associated with the five outcomes (β = 0.254, 0.174, 0.157, 0.222, and 0.192, respectively; all p < 0.001). Emotion-oriented coping was not independently associated with the outcomes, whereas avoidance-oriented coping was negatively associated with dietary habits (β = -0.213, p < 0.001). Direct associations between policy cognition and most health outcomes were attenuated after extended covariate adjustment.

Perceived stress and task-oriented coping were the most consistent cross-sectional correlates of the documented health-behavior outcomes. The results are associational and do not establish temporal ordering, causal mediation, or intervention effectiveness.