Physical activity and HRQoL among adolescents: the mediating roles of cognitive reappraisal and stress self-management.

INTRODUCTION: Physical activity is important for adolescent health, but the psychological pathways linking physical activity to health-related quality of life (HRQoL) remain unclear. This study examined the association between physical activity and HRQoL among secondary school students, focusing on the mediating roles of cognitive reappraisal and stress self-management. METHODS: A paper-based questionnaire survey was conducted in April 2026 among secondary school students in Jiangsu Province, China. A total of 500 questionnaires were distributed, and 420 valid responses were retained. Physical activity, cognitive reappraisal, stress self-management, and HRQoL were measured using validated scales. SPSS 26.0 and AMOS 23.0 were used to conduct descriptive statistics, reliability and validity tests, correlation analysis, and structural equation modeling. RESULTS: The structural model showed a good fit to the data. Physical activity was positively associated with cognitive reappraisal and stress self-management. Cognitive reappraisal was positively associated with stress self-management, and both cognitive reappraisal and stress self-management were positively associated with HRQoL. The mediation results were consistent with a significant indirect association between physical activity and HRQoL through cognitive reappraisal and stress self-management. DISCUSSION: Physical activity was associated with better HRQoL among adolescents, partly through cognitive reappraisal and stress self-management. These findings suggest that school-based physical activity may support adolescents' quality of life by strengthening psychological regulation and stress management.