Sports participation and physical health outcomes: the mediating roles of educational attainment and health-related behaviors

Participation in sports has been associated with better physical health, but the educational and behavioral pathways through which this association operates have not been sufficiently investigated in public health research. Therefore, this study examined an integrated public health model from sports participation to physical health outcomes and the mediating effects of educational attainment and health-related behaviors. A quantitative cross-sectional survey

Design: was used to investigate adults aged 18 years and older who had participated in organized or informal sporting activities. Data collection was conducted using a 20-item questionnaire developed by the researchers using adapted items from established validated instruments. The questionnaire assessed four constructs: Sports Participation, Educational Attainment, Health-Related Behaviors, and Physical Health Outcomes, with five items used to measure each construct. Of the 700 questionnaires administered, 586 were returned, of which 520 complete and eligible responses were retained for analysis. The data were examined using descriptive statistics, Pearson correlation, regression procedures, and bootstrap mediation testing based on 5,000 resamples. Sports participation showed significant positive associations with physical health outcomes ( β = 0.41, p < 0.001) and educational attainment ( β = 0.55, p < 0.001), whereas educational attainment also demonstrated a significant association with physical health outcomes ( β = 0.36, p < 0.001). A statistically significant indirect effect was observed through educational attainment [indirect effect = 0.198, 95% CI (0.132, 0.271)] as well as through health-related behavioral patterns [indirect effect = 0.224, 95% CI (0.151, 0.306)]. The overall model explained 58% of the variance in physical health outcomes ( R 2 = 0.58). The study contributes by integrating educational and behavioral pathways within a unified sports health framework, with implications for integrated public health promotion, and coordinated interventions across educational, community, and health policy settings in practice.