To understand the physical activity, social network connectedness, and mental health status of rural older adults, and to examine whether social networks show an indirect association between physical activity and mental health. Standardized quality control was applied to 61 pre-specified questionnaires. To understand physical activity, social network connectedness, and mental health status inclusion criteria and global physical activity questionnaire (GPAQ) scoring rules, yielding a descriptive-analysis sample of 60 respondents and a valid total-physical-activity sample of 55. Spearman correlation, Cronbach’s alpha, robust linear regression, and mediation path analysis with 10,000 bias-corrected bootstrap replications were employed. The primary outcome was World Health Organization-five (WHO-5) well-being index. The secondary outcome was patient health questionnaire (PHQ)-9 depressive symptoms. Models were adjusted for age, gender, household economic status, and degree of activity limitation. The median total physical activity was 5040 metabolic equivalent (MET)-min/week, with 44 out of 55 (80.0%) reaching 600 MET-min/week. The median daily sedentary time was 422.5 minutes. Lubben social network scale (LSNS)-6 was 15.5±6.2, with 12 out of 60 (20.0%) in the priority range for social isolation. PHQ-9 was 7.85±6.58, with 21/60 (35.0%) reaching the moderate-or-above screening level. WHO-5 was 63.7±26.2, with 19 out of 60 (31.7%) in the priority support range for poor well-being. WHO-5 was correlated with PHQ-9, and all three scales showed high internal consistency. The adjusted indirect effect was 1.07 points (95% confidence interval -0.29 to 4.42) for WHO-5 and -0.26 points (95% confidence interval -1.01 to 0.06) for PHQ-9, both in the direction consistent with improved mental health. This survey effectively characterized the activity structure, social connectedness, and mental health needs of rural older adults. Scale reliability, the convergent relationship between the two psychological indicators, and multiple robustness checks jointly support the applied value of the findings. The study develops a practical pathway from needs identification and priority-group targeting to companion-based activities, primary-level screening, stratified referral, and periodic re-assessment, which can serve the design of the “Three Going to the Countryside” program and grassroots health actions.
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Yu, S., Peng, Z., Zhong, Z., Li, D. (2026) Physical Activity and Mental Health among Rural Older Adults: The Mediating Role of Social Connectedness. Journal of Disease and Public Health, 2(3), 33-45.