Investigating the influence of adolescents' social and emotional skills on health behavior: a moderated mediation analysis

Background: In the context of heightened social competition and increasing academic pressure, promoting the healthy development of adolescents has become a critical concern. This study investigates the impact and mechanisms through which adolescents' social and emotional skills influence their health behavior. Specifically, we hypothesized that social and emotional skills would positively affect health behavior, with test and class anxiety mediating and satisfaction with interpersonal relationships moderating this relationship. Methods: Using data from the 2023 OECD Survey on Social and Emotional Skills, this study employed a moderated mediation model to analyze the relationships between variables. The sample consisted of 6,737 adolescents, comprising 3,454 10-year-olds (51.3%) and 3,283 15-year-olds (48.7%); 3,484 were boys (51.7%) and 3,253 were girls (48.3%). Key variables assessed included social and emotional skills (e.g., task performance, emotional regulation), health behaviors (e.g., diet, exercise, sleep), test and class anxiety, and satisfaction with interpersonal relationships. Statistical analyses included Harman's single-factor test for common method bias, correlation analysis, regression analysis, and PROCESS macro in SPSS to test mediation and moderation effects. Satisfaction with interpersonal relationships moderated both the direct effect of social and emotional skills on health behavior and the reduction of test anxiety by these skills. Higher relationship satisfaction strengthened the direct effect (β = 0.340 vs. β = 0.250 for low vs. high satisfaction) and amplified the anxiety-reduction effect (β = -0.262 vs. β = -0.168 for high vs. low satisfaction). Conclusion: This study highlights the critical role of social and emotional skills in promoting healthy behaviors among adolescents and underscores the importance of interpersonal relationships in moderating these effects. The results provide insights for policymakers and educators to design interventions that foster both social and emotional skills and supportive relational environments to enhance adolescent wellbeing.