Influence of learning stress on anxiety levels among high school students in China: the chain-mediated role of physical activity and mobile phone addiction

ObjectivesThe objectives are to explore the relationship between study stress and anxiety in high school students and the mediating role of physical activity and mobile phone addiction.DesignA cross-sectional study.Setting129 high schools were randomly selected in 13 cities of Jiangsu province, China.ParticipantsHigh school students aged 16–19 years, age and gender balance. A total of 40 000 questionnaires were distributed, with 32 974 effectively recovered.Primary and secondary outcome measuresQuestionnaires were administered offline, covering four parts: General Demographics, Learning Stress Scale, International Physical Activity Questionnaire, Mobile Phone Addiction Scale and Generalized Anxiety Scale-7. Data analysis included path analysis and correlation analysis, along with descriptive statistics, independent sample t-test, correlation analysis and structural equation model.ResultsIn this study, the proportions of anxiety, high academic pressure, low physical activity level and high mobile phone addiction were 58.18%, 46.48%, 36.40% and 39.26%, respectively. Study stress was positively correlated with anxiety (r=0.130, p