Social adaptability and its associations with eHealth literacy and physical activity among first- and second-year medical students in China: a cross-sectional study.

BACKGROUND: First- and second-year medical students face multiple challenges during the transition to university, including increased academic demands, changes in learning environments, and difficulties in social adaptation. Social adaptability is closely related to students' mental health and psychosocial functioning. eHealth literacy and physical activity have been identified as important behavioral and cognitive factors that may be associated with social adaptability. OBJECTIVE: This study aimed to examine the level of social adaptability among first- and second-year medical students and to explore its associations with eHealth literacy and physical activity. METHODS: An online questionnaire survey was conducted in two waves, in October 2023 and 2024, using a stratified online convenience sampling approach among first- and second-year students at Wannan Medical College in Wuhu, Anhui, China. The Social Adaptation Inventory, eHealth Literacy Scale, and Physical Activity Rating Scale-3 were used to assess students' social adaptability, eHealth literacy, and physical activity. RESULTS: Among the 2,026 participants, social adaptability was positively correlated with physical activity (Spearman's r s = 0.219, P < 0.001) and eHealth literacy (Spearman's r s = 0.348, P < 0.001). In the final hierarchical regression model, physical activity (β = 0.124, P < 0.001) and eHealth literacy (β = 0.294, P < 0.001) remained positively associated with social adaptability after adjustment for gender, year of study, place of origin, program duration, student leadership status, and survey wave. The final model explained 16.9% of the variance in social adaptability (R 2 = 0.169; adjusted R 2= 0.166). CONCLUSION: Physical activity and eHealth literacy were independently associated with social adaptability among first- and second-year medical students. However, given the cross-sectional design and the modest explanatory capacity of the model, these findings should be interpreted as associations and require confirmation in longitudinal and intervention studies.