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Physical activity habit automaticity is prospectively associated with higher quality of life through lower psychological distress, moderated by exercise identity

In a three-wave longitudinal study of 1024 Chinese university students, higher physical activity habit automaticity at baseline was associated with lower psychological distress at the second wave (B = -0.503, p < 0.001), which in turn was associated with higher quality of life at the third wave (B = -0.086, p < 0.001). The indirect effect was significant (effect = 0.043, 95% CI [0.028, 0.059]), with a mediated proportion of 30.9%, and this indirect pathway was stronger among students with higher exercise identity.

Last updated: Jul 16, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Physical Activity Habit Automaticity, Psychological Distress, and Quality of Life Among Chinese University Students: A Three-Wave Longitudinal Moderated Mediation Study.

observational

Tan Y, Liu S, Zang L · Healthcare (Basel, Switzerland) (2026)

Participants: N/A
Duration: Three waves (timing not specified in abstract)
Intervention: Physical activity habit automaticity (measured via Self-Report Behavioral Automaticity Index)
Outcome: Psychological distress (Patient Health Questionnaire-4), quality of life (EUROHIS-QOL 8-item index)
Effect Size: Indirect effect = 0.043, 95% CI [0.028, 0.059]; mediated proportion = 30.9%
Population: Chinese university students (58.98% female, final analytic sample n=1024)

Result:

PubMed: 42450873DOI: 10.3390/healthcare14131863

Mechanism Graph

Higher physical activity habit automaticity at T1
↓
Leads to lower psychological distress at T2
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Lower psychological distress at T2
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Leads to higher quality of life at T3

Limitations

  • ⚠Observational design limits causal conclusions
  • ⚠Self-report measures may introduce bias
  • ⚠Sample limited to Chinese university students, reducing generalizability

Frequently Asked Questions

What is physical activity habit automaticity?▼

It refers to the automatic, habit-like quality of engaging in physical activity, measured using the Self-Report Behavioral Automaticity Index.

How was psychological distress measured in this study?▼

Psychological distress was assessed using the Patient Health Questionnaire-4 (PHQ-4), a brief screening tool for anxiety and depression.

Did exercise identity affect the results?▼

Yes, the indirect effect of habit automaticity on quality of life through psychological distress was stronger among students with higher exercise identity.

What were the main limitations of this study?▼

The observational design prevents causal inference, self-report measures may be biased, and the sample was limited to Chinese university students.

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References

  1. 1.Tan Y, Liu S, Zang L. "Physical Activity Habit Automaticity, Psychological Distress, and Quality of Life Among Chinese University Students: A Three-Wave Longitudinal Moderated Mediation Study.." Healthcare (Basel, Switzerland), 2026. PMID: 42450873 DOI: 10.3390/healthcare14131863
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.