Undergraduates, as the backbone of the youth group and highly educated members of the family and society, had a strong radiating function on the health of the whole population. Undergraduates have good health awareness but poor health behaviors, and the realization of proactive health among undergraduates faces a series of challenges that require conceptual change and action support.

To study the influencing factors of proactive health of undergraduates and provide suggestions for health education in colleges and universities.

A total of 4 036 undergraduates from 6 universities in Shandong Province were selected by stratified cluster sampling method to conduct a questionnaire survey on proactive health by using self-designed questionnaires (including general information questionnaires and proactive health scales). Pearson correlation analysis and multiple linear regression analysis were used for the analysis of factors affecting proactive health, and the importance of influencing factors was analyzed using random forest metrics.

The proactive health score of undergraduates was 24.61±4.65 score. Females had higher active health scores than males, while lower grade undergraduates had higher proactive health scores than higher grade (P<0.05). IncNodePurity of health responsibility, health publicity, parent-child relationship and health investment were 32 491.77, 13 331.00, 10 051.22 and 9 902.84, respectively. Health publicity (β=0.024, 95%CI=0.039-0.171, P<0.001), health communication needs (β=0.026, 95%CI=0.043-0.145, P<0.001), curriculum practice activities (β=0.033, 95%CI=0.069-0.167, P<0.001), desired state (β=0.033, 95%CI=0.008-0.019, P<0.001), and diet (β=0.019, 95%CI=0.027-0.161, P<0.001) positively regulated the relationship between health responsibility and proactive health.

Health responsibility was the key factor affecting proactive health. Health publicity, health communication needs, curriculum practice activities, desired state and diet have positive interaction with health responsibility, which enhance individual proactive health. It is suggested to form diversified health promotion relationships by creating an active ecological environment of proactive health, building classroom, performing extracurricular and self-practice education mode, and improving initiatives to promote proactive health such as synergy path of health policy.

大学生作为青年群体的中坚力量、家庭和社会的高学历成员，对全民健康具有强大的辐射功能。大学生具备较好的健康意识，但健康行为状况不佳，实现大学生主动健康面临一系列挑战，需要观念转变和行动支持。

探索主动健康的影响因素，为高校健康教育提供参考。

分层整群抽取山东省6所高校4 036名在校大学生开展问卷调查。采用自设问卷（包括一般资料调查表、主动健康量表）开展调研。采用Pearson相关分析和多元线性回归分析探究主动健康的影响因素，采用随机森林度量分析评估影响因素的重要性。

大学生主动健康得分为（24.61±4.65）分。女生主动健康得分高于男生，低年级大学生主动健康得分高于高年级（P<0.05）。大学生健康责任、健康知识宣传、亲子关系、健康投资的重要性依次为32 491.77、13 331.00、10 051.22、9 902.84，健康知识宣传（β=0.024，95%CI=0.039~0.171，P<0.001）、健康需求沟通（β=0.026，95%CI=0.043~0.145，P<0.001）、课程实践活动（β=0.033，95%CI=0.069~0.167，P<0.001）、希望状态（β=0.033，95%CI=0.008~0.019，P<0.001）、饮食情况（β=0.019，95%CI=0.027~0.161，P<0.001）正向调节健康责任与主动健康的关系。

健康责任是影响主动健康的关键因素，健康知识宣传、健康需求沟通、课程实践活动、希望状态和饮食情况与健康责任产生正向交互作用，促进了个体主动健康。可通过营造积极生态环境，形成多元健康促进关系，打造课堂、课外、自我实践教育模式，完善健康政策协同路径等举措促进主动健康。