Multiple Mediating Pathways from Psychosocial Competence to Self-Care Skills in University Students: A Cross-Validation Study Using Structural Equation Modeling and Network Analysis

Objective : This study aimed to elucidate the mechanisms through which psychosocial competence shapes self-care skills in college students by testing a hypothesized chain mediation model: "psychosocial competence → health-promoting behavior → health information literacy → self-care skills." Methods : A cross-sectional survey was conducted among 390 freshmen and sophomores. The structural equation model (SEM) was used to test the macro-level paths, while the network analysis based on the EBICglasso algorithm was adopted to explore the micro-level item associations, and the bridge strength was calculated to identify the nodes connecting different theoretical communities. Results: SEM revealed significant indirect effects for health-promoting behavior (β = 0.126, p = 0.020), health information literacy (β = 0.385, p = 0.001), and the chain pathway (β = 0.083, p = 0.002). The total indirect effect accounted for 67.1% of the total effect, and the model explained 76.7% of the variance in self-care skills (R² = 0.767). Network analysis identified two high-bridge-strength nodes: SCA1 ("Interpret fitness test data") and HIL4 ("Make decisions based on information"), which served as key connectors linking the communities of Psychosocial Competence (PSC), Health-Promoting Behavior (HPB), Health Information Literacy (HIL), and Self-Care Skills (SCA). Conclusion: Psychosocial competence influences self-care skills through multiple pathways, with health information literacy playing a central mediating role. The identified bridge nodes, SCA1 and HIL4, represent potential precise targets for health interventions among college students.