Health literacy and emotion management in exercise-resilience link: The moderating role of self-efficacy

OBJECTIVE: This study aims to investigate the mechanism by which exercise adherence influences psychological resilience through the chain mediating effects of health literacy and emotional management skills, as well as to explore the moderating role of general self-efficacy in this pathway. METHOD: A cross-sectional survey was conducted among 9103 university students using questionnaire methodology. Variables including exercise adherence, health literacy, emotional management competence, psychological resilience, and general self-efficacy were analysed employing SPSS 26.0 and the PROCESS macro, to construct a chain mediation model. RESULTS: Exercise adherence not only directly enhances psychological resilience (β = 0.137, p < 0.001) but also generates an indirect effect through the serial pathway of "improving health literacy → enhancing emotional management competence" (β = 0.026, 95% CI 0.010, 0.043, excluding zero). Concurrently, general self-efficacy positively moderates the relationship between exercise adherence and health literacy (β = 0.033, p < 0.001), thereby amplifying this chain mediation effect. CONCLUSION: This research elucidates the mechanism through which exercise adherence influences psychological resilience via chain mediation pathways. The findings provide a robust theoretical underpinning for university mental health education initiatives along with practical guidance for physical activity promotion programmes.