Physical activity and sport participation among adolescents: associations with mental health in different age groups. Results from the Young-HUNT study: a cross-sectional survey

Adolescent mental health interventions: a narrative review of the positive effects of physical activity and implementation strategies

Introduction

The psychological well-being of adolescents is a global concern due to increasing societal pressures and mental health issues. Physical activity is known to enhance physical health and has potential benefits for mental health, including reducing symptoms of anxiety and depression, boosting self-esteem, and improving social skills. This narrative review explores how physical activity can serve as an intervention to help adolescents manage psychological stress and prevent mental health issues.

Methods

An extensive literature search was conducted using databases such as PubMed, PsycINFO, Web of Science, and Scopus. Keywords included "adolescent mental health," "physical activity," "psychological intervention," "types of exercise," "anxiety," "depression," "self-esteem," "social skills," and "emotional regulation." Studies were included based on relevance, peer-reviewed status, and involvement of adolescent populations. Data were extracted and analyzed qualitatively, focusing on the psychological impacts of different types of physical activity. Sixty one articles were eventually included.

Results and conclusion

The review identified multiple studies highlighting the positive effects of various physical activities on adolescent mental health. Aerobic exercises were found to improve mood and cognitive function, strength training reduced depressive symptoms and increased self-efficacy, team sports enhanced social skills and a sense of community, and mind-body practices like yoga and tai chi improved stress management and emotional regulation. The findings suggest that physical activity can play a significant role in promoting adolescent mental health. Implementation strategies in school and community settings, including integrating physical activity into school curricula, offering diverse activity options, training professional instructors, encouraging family and community involvement, and regular monitoring and evaluation, are recommended. Future research should address limitations such as sample diversity and long-term effects. This narrative review underscores the importance of physical activity in enhancing adolescent mental health. Effective implementation strategies and multi-sector collaboration are essential for maximizing the benefits of physical activity interventions.

How to reduce anxiety symptoms through individual sport in youth: A longitudinal study over 8-month observation

Background

Anxiety symptoms are widely observed among the youth, and engagement in sports has been demonstrated to mitigate these symptoms. Nonetheless, the effectiveness of specific sports and the potential moderating role of psychological factors, such as self-esteem and self-efficacy, on the influence of sports on anxiety, remains to be elucidated. This study was designed to longitudinally assess the impact of sports participation on anxiety symptoms among young individuals.

Methods

The study encompassed 163 university students, with a male predominance of 81.6%, and explored the influence of sport-related factors (such as mastery of table tennis skills, level and engagement) and psychological aspects (including self-efficacy, self-esteem and resilience) on anxiety symptoms, employing an 8-month longitudinal approach. Physical activity, sedentary and sleep behaviour, along with age, body mass index (BMI), and sex, were accounted for as confounding variables.

Results

The study found that high table tennis performance score was found to buffer the development of anxiety symptoms in students with decreased self-esteem in an exploratory moderation model. Self-esteem and self-efficacy were negatively associated with the development of anxiety symptoms, whereas physical activity factors did not have a direct effect.

Conclusion

This study highlights the potential of table tennis as a form of sport to alleviate anxiety symptoms in university students, particularly among those with decreased self-esteem. Future research should address the study's limitations and explore the potential moderating effects of other psychological factors. Overall, these findings suggest a potential new approach to treating anxiety symptoms among university students.

Effects of school-based physical activity on volition in exercise, sleep quality and internet addiction in Italian adolescents

School-settings represent ideal context to promote healthy habits as in adolescence most risk factors may occur or intensify leading to the adoption of unhealthy lifestyles. Thus, a deeper understanding of the factors promoting healthy lifestyles in adolescents is of utmost importance. This observational study aims to investigate: 1) gender-related differences in physical activity (Physical Activity Questionnaire for Adolescets - PAQ-A), sleep quality (Pittsburgh Sleep Quality Index - PSQI) and internet addiction (Internet Addiction Test - IAT) levels and Volition in Exercise (VE); 2) the relationship between PAQ-A and VE, PSQI and IAT; 3) the effects of a five-month (T0; T5) school-based physical activity (PA) intervention on the above-mentioned factors. PAQ-A,VE, PSQI and IAT were assessed before (T0) and after (T5) a school-based PA intervention. The PA intervention consisted of coordinative exercises and team sports performed for 1 h twice a week. At T0, girls showed lower PAQ-A, PSQI scores, lower volition facilitators ("self-confidence" and "coping with failure") and higher volition inhibitor ("postponing training") than boys. Significant correlations were observed for volition factors an IAT in males and volition and PSQI and IAT in females. After the PA intervention (T5), "postponing training" and "self-confidence" factors were reduced compared to T0. Exercise specialists should consider gender differences in volition in exercise factors during a school-based PA to plan and realize PA protocols aiming at maximizing exercise adherence to tackle sedentary behaviors in adolescents.

Direct and Indirect Effects of Youth Sports Participation on Emotional Intelligence, Self-Esteem, and Life Satisfaction

The present study investigated the mediating effects of emotional intelligence and self-esteem between youth sports participation and life satisfaction, as well as the comparative effects of different types of sports involvement (team, individual, and non-participation) on these selected variables. A sample of 1053 Portuguese adolescents (612 girls and 441 boys), aged between 12 and 18 years (M = 14.40; SD = 1.55), completed the following self-report measures: the Wong and Law Emotional Intelligence Scale, the Rosenberg Self-Esteem Scale, and the Satisfaction with Life Scale. The structural equation modeling results indicated a complete mediating role of two emotional intelligence dimensions (use of emotion and self-emotional appraisal) and self-esteem in the relationship between sports participation and adolescents' life satisfaction. Team sport participants reported higher emotional intelligence and self-esteem scores than their non-sport participant counterparts who revealed lower levels of emotion use than their individual sport participant peers. These findings provide novel insights into the potential emotional and psychological mechanisms underlying the association between youth sports participation and life satisfaction.

Exercise, grit, and life satisfaction among Korean adolescents: a latent growth modeling analysis

BACKGROUND

Life satisfaction among Korean students is declining substantially, and multifaceted improvement efforts are required.

METHODS

We analyzed longitudinal change trajectories for exercise, grit, and life satisfaction levels among Korean adolescents using latent growth modeling with longitudinal data from the Korean Children and Youth Panel Surveys of 2,142 students (male: 1,070, female: 1,072) from sixth grade (2020) through eighth grade (2022).

RESULTS

The model, which tracked linear changes in the students' exercise, grit, and life satisfaction, showed consistent declines over three school years for all variables. We also identified a longitudinal causal relationship among exercise, grit, and life satisfaction. A higher grit intercept was associated with higher intercept for-and a partial mediating effect between-exercise and life satisfaction. The grit slope was positively related to the life satisfaction slope, and both the intercept and exercise slope had positive effects on life satisfaction. Moreover, grit had a longitudinal mediating effect between exercise and life satisfaction.

CONCLUSIONS

We discuss the longitudinal change trajectories of exercise, grit, and life satisfaction, the causal and mediating effects among them, and the implications of the findings. These findings bolster our understanding of Korean adolescents' life satisfaction and have practical significance for designing programs to improve their quality of life.

Physical and Psychosocial Benefits of Sports Participation Among Children and Adolescents with Chronic Diseases: A Systematic Review

BACKGROUND

This study aims to identify sports interventions for children and adolescents (CaA) with chronic diseases and evaluate their impact on physical, psychological, and social well-being. The findings of this study will contribute to our understanding of the potential benefits of sports interventions for CaA with chronic diseases and inform future interventions to promote their overall health and well-being.

METHODS

A systematic review was conducted in eight databases. This systematic review followed PRISMA guidelines and utilized a comprehensive search strategy to identify studies on sport-based interventions for CaA with chronic diseases. The review included randomized controlled trials and observational studies that focused on physical and psychosocial outcomes.

RESULTS

We screened 10,123 titles and abstracts, reviewed the full text of 622 records, and included 52 primary studies. A total of 2352 participants were assessed with an average of 45 ± 37 participants per study. Among the included studies involving CaA with chronic diseases with an age range from 3 to 18 years, 30% (n = 15) autism spectrum disorders, 21% (n = 11) cerebral palsy, 19% (n = 10) were attention deficit hyperactivity disorder, and 17% (n = 9) obesity. Other diseases included were cancer (n = 5), asthma (n = 1) and cystic fibrosis (n = 1). Interventions involved various sports and physical activities tailored to each chronic disease. The duration and frequency of interventions varied across studies. Most studies assessed physical outcomes, including motor performance and physical fitness measures. Psychosocial outcomes were also evaluated, focusing on behavioural problems, social competencies, and health-related quality of life.

CONCLUSION

Overall, sport-based interventions effectively improved physical and psychosocial outcomes in CaA with chronic diseases. Interventions are generally safe, and participants adhere to the prescribed protocols favorably. Despite that, there is little evidence that interventions are being implemented. Future studies should include interventions tailored to meet the common issues experienced by CaA with chronic conditions, providing a comprehensive understanding of the impact of sports interventions on those affected.

REGISTRATION

The methodology for this review was pre-determined and registered in the PROSPERO database (registration number: CRD42023397172).

Association between sports participation and resilience in school-attending students: a cross-sectional study

Aim

This research sought to identify the association between sports participation and resilience in children and adolescents as a means to enhance mental health.

Methods

A comprehensive survey was carried out, encompassing primary, middle, and high school students from chosen educational institutions. The analytical sample comprised 67,281 students of school age. Sports participation and resilience were evaluated using validated assessment tools, while relevant covariates, such as sex and school grade, were assessed through self-reported questionnaires. Generalized Linear Models were applied to ascertain the association between sports participation and resilience for the entire sample, and separately for subgroups divided by gender or school grade, after controlling for covariates.

Results

Among the 67,281 school students, males constituted 51.9% of the sample. Approximately 47.1% of the entire sample reported no sports participation, and the average resilience score was 24.7. The regression model analysis revealed that, in the entire sample, increased in sports participation was linked to higher resilience scores (odds ratio [OR] for 1-3 times per month: 1.20, 95%CI: 1.16-1.24; OR for 1-2 times per week: 1.38, 95%CI: 1.33-1.43; OR for 3 times or more per week: 1.72, 95%CI: 1.65-1.79). Analyses stratified by gender and school grade indicated that sports participation was consistently associated with greater resilience.

Conclusion

This study provides cross-sectional evidence supporting the positive association between sports participation and the resilience of children and adolescents, underscoring the potential of encouraging sports participation as a strategy for promoting mental health resilience. The findings presented herein should be subject to further confirmation or refutation in future research endeavors.

Anxiety and depression symptoms in adolescents and young adults with juvenile idiopathic arthritis: results of an outpatient screening

BACKGROUND

Previous studies have shown that growing up with rheumatic conditions can fuel dissatisfaction and psychological distress, which in turn affects disease self-management and treatment adherence. Primary objective of this study was to estimate the prevalence of anxiety and depression symptoms in adolescents and young adults (AYA) with juvenile idiopathic arthritis (JIA) and to identify correlates of conspicuous screening results.

METHODS

Initiated as part of the COACH multicenter observational study, outpatients aged 12 to 21 years participating in the National Pediatric Rheumatological Database (NPRD) were prospectively screened for mental health using the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder Scale-7 (GAD-7).

RESULTS

Data from 1,150 adolescents with JIA (mean age 15.6 ± 2.2 years; mean disease duration 7.2 ± 4.9 years, 69% female, 43% oligoarthritis, 26% polyarthritis) were analysed. Overall, 32.7% (n = 316) of AYA showed conspicuous screening results, of whom 30.4% reported clinically relevant suicidal or self-harm thoughts. About 19% of screened patients showed moderate to severe depressive or anxious symptoms. AYA with conspicuous screening results were older (15.8 vs. 15.2 years; p < 0.0001), more often female (81% vs. 64%; p < 0.0001) and more often overweight (25% vs. 17%; p = 0.006). They had higher disease activity (physician global assessment on NRS 0-10; 1.7 vs. 1.2; p < 0.0001), more functional limitations (CHAQ; 0.44 vs. 0.14; <0.0001) and rated their health status worse (NRS 0-10; 3.5 vs. 1.8; p < 0.0001) than AYA with inconspicuous screening results. Females (OR 2.33 [CI 1.53-3.56]; p < 0.0001), older age (OR 1.09 [CI 1.01-1.18]; p = 0.026), patients with more functional limitations (OR 3.36 [CI 1.98-5.72]; p < 0.0001), and patients with worse subjective health status (OR 1.17 [CI 1.07-1.27]; p < 0.0001) were more likely to have a conspicuous screening result. Regular sports participation was associated with a lower likelihood of conspicuous screening result (OR 0.69 [CI 0.49-0.98]; p = 0.039).

CONCLUSIONS

A large-scale outpatient screening of AYA with JIA in Germany shows a high prevalence of anxiety and depression symptoms. The need for routine screening for early detection of mental health problems became apparent.

Long-term recreational exercise patterns in adolescents and young adults: Trajectory predictors and associations with health, mental-health, and educational outcomes

Individual and societal factors influencing the formation of long-term recreational exercise habits during the transition from adolescence to young adulthood are not well explored. Using data from the Longitudinal Survey of Australian Youth (LSAY), a population-representative cohort study of Young People followed from age 15 to 25, we aimed to (1) model longitudinal recreational exercise trajectories from age 16 to 24, (2) examine predictors at age 15 of entering these trajectories, and (3) explore the association between the trajectories and health, mental health and educational achievement outcomes measured at the final study wave (age 25). Self-reported recreational exercise frequency data from 9353 LSAY participants were analysed using group-based trajectory modelling. We modelled the evolution of two patterns of recreational exercise behaviour: daily exercise, as per public health guidelines (Model 1); and at least once weekly exercise (Model 2). Model 1 trajectories were guideline-adherent exercisers (17.9% of the sample), never guideline exercisers (27.5%), guideline drop-outs (15.2%) and towards guideline (39.4%); Model 2 trajectories were weekly exercise (69.5% of the sample), decreasing (17.4%), increasing (4.8%), and infrequent (8.3%). For both models, at age 15, trajectory membership was predicted by gender, self-efficacy, time spent participating in sport, time spent watching TV, parental socioeconomic status, and academic literacy. At age 25, people in the guideline-adherent exerciser trajectory (model 1) reported better general health relative to other trajectories, Those in the weekly exerciser trajectory (model 2) had better general health and reduced rates of psychological distress, were happier with life and were more optimistic for the future relative to participants in less than weekly trajectory groups. Exercise-promoting interventions for Young People should specifically address the needs of females, people with low self-efficacy, reluctant exercisers, higher academic achievers, and those experiencing socioeconomic disadvantage.

The association between physical activity, self-efficacy, stress self-management and mental health among adolescents

This study aimed to explore the interplay between physical activity, self-efficacy, stress self-management and mental health among adolescents. The study gathered data from an online survey conducted among 400 Chinese middle school students (mean age = 13.74 years). The collected data were analyzed using SPSS 27.0 and PROCESS 4.1. The findings indicated a positive and significant relationship between physical activity, self-efficacy, stress self-management, and mental health. Notably, the association between physical activity and mental health was entirely mediated by self-efficacy and stress self-management. Moreover, self-efficacy and stress self-management exhibited a chain mediation effect on the relationship between physical activity and mental health. It is suggested that interventions focusing on physical activity should prioritize strategies for enhancing students' self-efficacy and stress self-management skills as integral components of promoting adolescents' mental health. Future research should delve into identifying specific types of physical activities that have a greater potential to enhance self-efficacy and stress self-management abilities.

Team Approach: Diagnosis, Management, and Prevention of Sudden Cardiac Arrest in the Athlete

» Sudden cardiac events during sports competition are rare but tragic occurrences that require a timely, comprehensive response by well-prepared athletic trainers and medical providers. This sequence should prioritize prompt emergency medical system activation, immediate initiation of cardiopulmonary resuscitation (CPR), automated early defibrillation (AED), and comprehensive advanced life support efforts.» Exercise-induced cardiac remodeling, referred to as the "athlete's heart," refers to a host of adaptive changes that increase cardiac chamber size and wall thickness to allow for greater pressures and volumes during exercise. This remodeling phenotype may overlap with other inherited cardiomyopathies and cardiac abnormalities, which can complicate clinical care. The long-term implications of this electrical and structural remodeling on cardiac function are unknown.» Although the best screening strategies to optimize primary prevention of sudden cardiac arrest is an evolving topic, the effectiveness of CPR and early defibrillation use in treating out-of-hospital sudden cardiac arrest has been well-established, despite their reported underuse.

The Influence of the COVID-19 Pandemic on Baseline Concussion Symptom Assessments Among Adolescents

Introduction The COVID-19 pandemic resulted in the cancellation of high school sports in spring 2020, a modified resumption of sports in the 2020-2021 academic year, and a return to pre-pandemic sports in 2021-2022. This cancellation had a major impact on the quality of life of adolescent athletes, but it is unknown exactly how these pandemic-driven sports disruptions on athlete baseline (preseason) symptoms affected quality of life. Therefore, the current study retrospectively evaluated symptom inventories from Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) assessments to determine whether the cancellation of sports during the COVID-19 pandemic affected baseline (preseason) self-reported symptoms among adolescent athletes. Methods Our study used a retrospective cohort design to evaluate high school athletes with complete ImPACT assessments in the academic years before (2018-2019 and 2019-2020), during (2020-2021), and after (2021-2022) the pandemic. Specifically, data from a 22-item symptom report called the Post-Concussion Symptom Scale (PCSS) assessed during ImPACT was collected and analyzed using generalized linear models with a Tweedie exponential dispersion model and post hoc Tukey's honestly significant difference tests. The main outcomes were the total symptom severity score and the affective cluster score. Secondary outcomes were the analysis of the vestibular-somatic, cognitive-sensory, and sleep-arousal symptom clusters. Results Of the 104,274 ImPACT assessments, the total symptom severity score on the PCSS was different across years (p<0.001). There were lower symptom scores in 2020-2021 (5.33, 95% CI = 5.13-5.54) than in 2018-2019 (6.82, 95% CI = 6.63-7.01), 2019-2020 (6.94, 95% CI = 6.75-7.14), and 2021-2022 (6.44, 95% CI = 6.25-6.64). The cluster scores on the PCSS for affective, cognitive-sensory, sleep-arousal, and vestibular-somatic were also lower (p<0.001) in 2020-2021 than in 2018-2019, 2019-2020, and 2021-2022. Conclusion Contrary to our expectations, total symptom severity and cluster scores on the PCSS during the pandemic (2020-2021) were significantly lower than during the years before and after the pandemic-driven sports disruptions, suggesting the pandemic did not negatively affect these athletes as expected. These results also suggested that self-reported symptoms utilized in the PCSS component of ImPACT may not be as sensitive to sports disruption among adolescent athletes as other quality-of-life measures, especially during the COVID-19 pandemic.

FIDES Athlete Development Programme: project background and study protocol of an embedded multiple case study

Most sports science research revolves around male subjects. As a result, most of the knowledge and practices within sports are male-centric. Failing to take the biological, psychological and social (biopsychosocial) particularities of females into account is believed to hinder optimal sports participation, development and performance, with potential negative effects on the health and well-being of females. To close the knowledge gap and alleviate these issues, we aim to develop and evaluate a 12-video educational intervention that addresses female-specific subject matter: the FIDES Athlete Development Programme. The study is designed as an embedded multiple case study where at least 1320 Swedish female athletes aged 13-16 will participate, in addition to their parents and their coaches. The girls will be recruited through their sports clubs, with half being exposed to the FIDES Athlete Development Programme and the other half serving as control cases. The primary outcomes are well-being and sporting experience. To further increase our understanding of the intervention and its implications, interviews and focus group interviews with a reference group of girls and focus group interviews with a randomly selected subsample of coaches and parents will also be performed. The project is approved by the Swedish ethics committee (number: 2023-05264-01) and will be carried out in compliance with the Declaration of Helsinki. Results from the project will be published open access in peer-reviewed journals, at national and international conferences, in mass media, and a PhD thesis. The anonymised data will be made openly available in a data repository.

Is Frequency of Practice of Different Types of Physical Activity Associated with Health and a Healthy Lifestyle at Different Ages?

Physical activity (PA) has been shown to be related to physical and mental health. Yet there are few studies on how the frequency of PA relates to health and a healthy lifestyle. We aimed to investigate how the frequency of different PAs is associated with the following health indicators: body mass index (BMI), substance consumption, physical health, and mental health. We focused on three types of PA: (1) medium- to high-intensity aerobic exercise; (2) low- to medium-intensity relaxing exercise; and (3) outdoor leisure PA. A total of 9617 volunteers, aged 19 to 81, participated in the study. The relationships between the frequencies of the three types of PA and health-related and sociodemographic factors were analyzed using multinomial logistic regression. We found that women more frequently engaged in PA type 2, and men in types 1 and 3. A higher frequency of PA was associated with lower BMI and less or no smoking behavior; higher education (PAs 1 and 3); higher age (PAs 2 and 3); better physical health (PAs 1 and 3); and better mental health (PA 3). In conclusion, higher frequency of different PAs was significantly associated with better physical and mental health, less smoking, higher age, and a higher level of education.

Outpatient screening for anxiety and depression symptoms in adolescents with type 1 diabetes - a cross-sectional survey

BACKGROUND

The daily demands of type 1 diabetes management may jeopardize adolescents' mental health. We aimed to assess anxiety and depression symptoms by broad-scale, tablet-based outpatient screening in adolescents with type 1 diabetes in Germany.

METHODS

Adolescent patients with type 1 diabetes mellitus (n = 2,394; mean age 15.4 y [SD 2.0]; 50.7% male) were screened for anxiety (GAD-7) and depression symptoms (PHQ-9) by self-report questionnaires and linked to clinical data from the DPV patient registry. Logistic regression was used to estimate the contribution of clinical parameters to positive screening results.

RESULTS

Altogether, 30.2% showed a positive screening (score ≥ 7 in either test), and 11.3% reported suicidal ideations or self-harm. Patients with anxiety and depression symptoms were older (15.7 y [CI 15.5-15.8] vs. 15.3 y [CI 15.2-15.4]; p < 0.0001), had higher HbA1c levels (7.9% [CI 7.8-8.0] (63 mmol/mol) vs. 7.5% [CI 7.4-7.5] (58 mmol/mol); p < 0.0001), and had higher hospitalization rates. Females (adjusted odds ratio (aOR) 2.66 [CI 2.21-3.19]; p < 0.0001), patients > 15 years (aOR 1.40 [1.16-1.68]; p < 0.001), who were overweight (aOR 1.40 [CI 1.14-1.71]; p = 0.001), with HbA1c > 9% (> 75 mmol/mol; aOR 2.58 [1.83-3.64]; each p < 0.0001), with a migration background (aOR 1.46 [CI 1.17-1.81]; p < 0.001), or smoking (aOR 2.72 [CI 1.41-5.23]; p = 0.003) had a higher risk. Regular exercise was a significant protective factor (aOR 0.65 [CI 0.51-0.82]; p < 0.001). Advanced diabetes technologies did not influence screening outcomes.

CONCLUSIONS

Electronic mental health screening was implemented in 42 centers in parallel, and outcomes showed an association with clinical parameters from sociodemographic, lifestyle, and diabetes-related data. It should be integrated into holistic patient counseling, enabling early recognition of mild mental health symptoms for preventive measures. Females were disproportionally adversely affected. The use of advanced diabetes technologies did not yet reduce the odds of anxiety and depression symptoms in this cross-sectional assessment.

Health-related behaviors and symptoms of anxiety and depression in Spanish nursing students: an observational study

Background

Symptoms of anxiety and depression are prevalent among young adults and are a significant public health issue. College students are at a higher risk of experiencing poor mental health than other young people due to several factors, including moving away from home, financial pressures, heavy workload, poor time management skills, competitivity, new processes of socialization and insufficient coping mechanisms, among others. In addition, nursing students' mental and physical health may also be affected by unhealthy lifestyle habits and health-related behaviors.

Aim

To determine the prevalence of symptoms of depression and anxiety, and the association between these symptoms and health-related behaviors, in a population of Spanish student nurses.

Methods

Cross-sectional study on a sample of 339 nursing students. We used the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire-Short form, the Spanish Healthy Eating Index and an "ad hoc" questionnaire for sociodemographic variables. The association between psychological symptoms and health-related behaviors was analyzed through binary logistic regression models.

Results

The prevalence of symptoms of depression and anxiety was 3.8% and 24.5%, respectively. Negative health-related behaviors were frequent, namely tobacco and alcohol consumption, suboptimal physical activity and diet. Moderate physical activity was associated with a lower probability of experiencing depressive symptoms. Symptoms of anxiety were related to a low level of physical activity, an unhealthy diet and alcohol consumption ≥2 times a week.

Conclusion

Student nurses could benefit from the implementation of both physical and mental health promotion initiatives.

Interactions between genetic risk for 21 neurodevelopmental and psychiatric disorders and sport activity on youth mental health

Childhood is a sensitive period where behavioral disturbances, determined by genetics and environmental factors including sport activity, may emerge and impact risk of mental illness in adulthood. We aimed to determine if participation in sports can mitigate genetic risk for neurodevelopmental and psychiatric disorders in youth. We analyzed 4975 unrelated European youth (ages 9-10) from the Adolescent Brain Cognitive Development Study. Our outcomes were eight Child Behavior Checklist (CBCL) scores, measured annually. Polygenic risk scores (PRSs) were calculated for 21 disorders, and sport frequency and type were summarized. PRSs and sport variables were tested for main effects and interactions against CBCL outcomes using linear models. Cross-sectionally, PRSs for attention-deficit/hyperactivity disorder and major depressive disorder were associated with increases in multiple CBCL outcomes. Participation in non-contact or team sports, as well as more frequent sport participation reduced all cross-sectional CBCL outcomes, whereas involvement in contact sports increased attention problems and rule-breaking behavior. Interactions revealed that more frequent exercise was significantly associated with less rule breaking behavior in individuals with high genetic risk for obsessive compulsive disorder. Associations with longitudinal CBCL outcomes demonstrated weaker effects. We highlight the importance of genetic context when considering sports as an intervention for early life behavioural problems.

The Effect of Exercise on School Life Satisfaction in Korean Children and Adolescents Considering the Mediation Effects of Physical Health Awareness, Self-Esteem, and Depression

Background

This study analyzed physical health awareness, self-esteem, and depression as mediation factors in the effect of exercise on school life satisfaction. It compared these between Korean children and adolescents.

Methods

Based on the 2020 Survey on the Human Rights of Children and Adolescents in Korea, data were extracted on 2,896 children in grades 4 to 6 and 5,727 adolescents in grades 7 to 12. A structural equation model was designed and multi-mediation analysis was conducted using phantom variables. To verify the differences between children and adolescents, latent means, path coefficients, and mediating effect confidence intervals were analyzed.

Results

Structural modeling and bootstrapping revealed that the direct and indirect paths were significant in both groups (P<0.01). Comparing the mean differences, children showed higher means than adolescents did in all variables. Among the direct paths, the paths of physical health awareness from exercise practice and school life satisfaction from physical health awareness were higher in adolescents (P<0.01), and the path of school life satisfaction from exercise practice was higher in children (P<0.01). The indirect paths showed that the mediating effect of health awareness between exercise and school life satisfaction was stronger among adolescents.

Conclusion

Physical and mental health directly and indirectly affect school life satisfaction, with different patterns in children and adolescents. This study emphasizes the need for different strategies for children and adolescents who are experiencing physical and mental health problems and difficulties adjusting to school life.

General lifestyle factors explain young athletes' mental health more than perceived coach autonomy support: a cross-sectional study on basketball players and gymnasts aged 10-22

Objectives

This study described differences in lifestyle factors (sleeping problems/fatigue, pressure/activation), perceived coach autonomy support and indicators of mental health (well-being and poor general mental health) across various age groups (children ≤12 years, youths 13-15 years, junior to senior ≥16 years) and sports (basketball and gymnastics). Second, the relationships between lifestyle factors and mental health indicators were explored, hypothesising that the relationships would be mediated by perceived coach autonomy support.

Methods

A cross-sectional study design was implemented by using an online survey which assessed lifestyle and environmental factors as well as mental health indicators. Participants were recruited through sports clubs in basketball and gymnastics. A total of 209 athletes (77 basketball players and 132 gymnasts) in the age range of 10-22 (median=13) years volunteered to complete the survey.

Results

Separate two-way analyses of variance showed significant main effects for age group on sleeping problems/fatigue, sleep quantity, pressure/activation, well-being and poor general mental health, with higher scores reported for older age groups of athletes. Path analysis displayed sleeping problems/fatigue and pressure/activation to significantly affect decreased well-being and poor general mental health; however, the relationships were not mediated by perceived coach autonomy support.

Conclusion

Lifestyle factors play a prominent role in mental health outcomes. Researchers studying athlete mental health should consider both general lifestyle and sports-related factors, considering developmental phases in the young athlete's sporting context and overall life.

Effects of sports on school adaptability, resilience and cell phone addiction tendency of high school students

BACKGROUND

Sport help promote healthy physical and mental development of high school students. To date, there have been few studies on the effect of sport on school adaptability, resilience and cell phone addiction tendency of high school students.

AIM

To explore the effects of sports on school adaptability, resilience and cell phone addiction of high school students.

METHODS

A stratified random sampling method was used to select 600 students from two high schools in Lhasa, and Physical Activity Rating Scale, School Adjustment Scale for High School Students, Chinese Adolescents Resilience Scale, and Mobile Phone Addiction Index were used for field questionnaire survey.

RESULTS

Sport was positively correlated with school adaptability and resilience (P < 0.01), school adaptability was positively correlated with resilience (P < 0.01) and cell phone addiction was negatively correlated with sports, school adaptability and resilience (P < 0.01). The direct effect of sport on cell phone addiction was significant (P < 0.001), accounting for 20.51% of the total effect. The mediating effect of school adaptability on sport and cell phone addiction was significant (P < 0.001), accounting for 17.38% and 35.36% of the total effect value, respectively. School adjustment and resilience had a significant chain-mediated effect on sport and cell phone addiction (P < 0.001), accounting for 26.75% of the total effect.

CONCLUSION

Sport affected the cell phone addiction tendency of senior high school students through the mediating effect of school adaptability and resilience, and through the chain mediation effect of both.

Examining the associations between physical activity, self-esteem, perceived stress, and internalizing symptoms among older adolescents

INTRODUCTION

In older adolescence, stress has been found to be prevalent. It has been seen that higher physical activity (PA) relates to lower stress levels, which, in turn, relates to fewer anxiety and depressive symptoms (internalizing symptoms). However, how these associations function is not fully understood. PA is strongly associated with greater self-esteem in adolescents. As greater self-esteem is thought to aid better coping with stress and has been seen as beneficial for mental health in adolescents, PA may be associated with lower stress and better mental health through self-esteem and more adaptive stress appraisals. Therefore, the aim of the study was to examine the relationships between PA, self-esteem, stress, and mental health.

METHODS

A cross-sectional design was employed, and path analysis was implemented. PA, self-esteem, stress appraisals, distress tolerance, perceived stress, anxiety, and depression were assessed using online questionnaires from 244 adolescent participants from the United Kingdom (aged 15-19, M = 16.75 [SD = 0.82], 145 female).

RESULTS

Path analysis revealed that PA was associated with lower perceived stress through increased self-esteem, adaptive appraisals, and higher distress tolerance (total standardized indirect effect; p = .007 (-0.25 to -0.11). Moreover, lower perceived stress was associated with lower anxiety (standardized direct effect; p < .001 [2.65-4.0] and depressive symptoms (standardized direct effect; p < .001 [0.33-0.63]).

CONCLUSIONS

Findings suggest that higher PA could be effective in improving mental health among older adolescents, due to its association with perceived stress through higher self-esteem and more adaptive appraisals of stress.

Organized Sports Activities Are Safe for Children With Sickle Cell Disease: A Pilot Intervention Study

Historically, children with sickle cell disease (SCD) are advised to refrain from sports activities, based on the assumption that physical exercise can trigger vaso-occlusive episodes. This pilot intervention study examined the safety (ie, no vaso-occlusive episodes) of a 10-week organized sports program for children with SCD. Eight children with SCD (5 boys/3 girls), aged 7 to 12 years old, received 10 training sessions (each 90 min) once a week. Training sessions were performed by a professional soccer club under the supervision of a medical team from the Wilhelmina Children's Hospital. During the study period, one child experienced a vaso-occlusive crisis, which could not be directly related to the organized sports program. None of the other children experienced vaso-occlusive episodes. The results of this study indicate that children with SCD can participate safely in moderate-intensity organized sports activities when personalized medical background and practical training information is shared with the trainer beforehand. All children continued their sports participation after the study period.

Evaluating the impact of injury prevention interventions in child and adolescent sports using the RE-AIM framework and CERT: A systematic review

BACKGROUND

Participation in sport is a popular pastime for children and adolescents that improves their physical health, mental health and motor skills. Musculoskeletal injuries are a relatively common downside of sports participation and can have negative long-term consequences. Injury prevention programmes have demonstrated effectiveness in child and adolescent sports, provided compliance is adequate. However, little is known about the factors which relate to their impact on the wider community and whether the prevention programmes have been adopted and maintained in the long-term. The objective of this review was to assess the current literature on exercise-based injury prevention interventions in child and adolescent sports (aged under 19 years) against the 'Reach', 'Effectiveness', 'Adoption', 'Implementation', 'Maintenance' (RE-AIM) framework and Consensus of Exercise Reporting Template (CERT), to ascertain level of reporting for the components which relate to external validity.

METHODS

Seven electronic databases; PubMed, Medline, SPORTDiscus, PsycINFO, CINAHL, Scopus and The Cochrane Library, were searched from date of inception to July 2022 using the themes of: 'Child and Adolescent', 'Sport', 'Injury' and 'Prevention'. Eligibility criteria included: Experimental trial design, exercise-based intervention programmes, primary outcome of injury incidence and participants aged under 19 years. Two reviewers assessed each trial independently against the RE-AIM model dimension items checklist (RE-AIM MDIC) and Consensus on Exercise Reporting Template (CERT) before reaching a consensus on reporting.

RESULTS

Forty-five unique trials met the eligibility criteria. Mean reporting level for all studies across the whole RE-AIM MDIC was 31% (SD ± 16.2%, Range 7-77%). The domain of 'effectiveness' was the most comprehensively reported (60%), followed by 'implementation' (48%), 'reach' (38%), 'adoption' (26%) and 'maintenance' (7%). The mean reporting score for the CERT was 50% (SD ± 20.8, range 0-81%).

CONCLUSION

Published data on injury prevention in child and adolescent sports is highly focussed on the effectiveness of the intervention, with little consideration given to how it will be adopted and maintained in the long-term. This has led to considerable gaps in knowledge regarding optimal programme implementation, with a lack of data on adoption and maintenance contributing to the gap between research and practice. Future research needs to place greater focus on external validity and consider incorporating the study of implementation and feasibility as part of effectiveness trial design. This approach should provide the data that will help narrow the considerable gap between science and practice.

TRIAL REGISTRATION

PROSPERO Registration number CRD42021272847.

Socio-economic inequalities in body mass index among preschool children: do sports programs in early childhood education and care centers make a difference?

Background

Overweight in childhood is considered to be one of the most serious public health challenges. Many studies have investigated individual-level determinants of children's body mass index (BMI), yet studies exploring determinants at the meso-level are sparse. The aim of our study was to examine how a sports focus at early childhood education and care (ECEC) centers moderates the effect of parental socio-economic position (SEP) on children's BMI.

Methods

We used data from the German National Educational Panel Study and included 1,891 children (955 boys and 936 girls) from 224 ECEC centers in our analysis. Linear multilevel regressions were used to estimate the main effects of family SEP and the ECEC center sports focus, as well as their interaction, on children's BMI. All analyses were stratified by sex and adjusted for age, migration background, number of siblings, and employment status of parents.

Results

Our analysis confirmed the wellknown health inequalities in childhood overweight with a social gradient toward a higher BMI for children from lower SEP families. An interactive effect between family SEP and ECEC center sports focus was found. Boys with low family SEP not attending a sports-focused ECEC center had the highest BMI among all boys. In contrast, boys with low family SEP attending a sports-focused ECEC center had the lowest BMI. For girls, no association regarding ECEC center focus or interactive effects emerged. Girls with a high SEP had the lowest BMI, independent of the ECEC center focus.

Conclusion

We provided evidence for the gender-specific relevance of sports-focused ECEC centers for the prevention of overweight. Especially boys from low SEP families benefited from a sports focus, whereas for girls the family's SEP was more relevant. As a consequence, gender differences in determinants for BMI at different levels and their interaction should be considered in further research and preventive measures. Our research indicates that ECEC centers may decrease health inequalities by providing opportunities for physical activity.

A systematic review of the evidence for effectiveness of interventions to address transport and other unintentional injuries among adolescents

INTRODUCTION

Globally, injuries are a leading cause of mortality and morbidity for adolescents, which disproportionately affect the disadvantaged. To build an investment case for adolescent injury prevention, evidence is needed as to effective interventions.

METHODS

A systematic review of peer-reviewed original research published between 2010-2022 was conducted. CINAHL, Cochrane Central, Embase, Medline and PsycINFO databases were searched for studies reporting the effectiveness of unintentional injury prevention interventions for adolescents (10-24 years), with assessment of study quality and equity (e.g., age, gender, ethnicity, socio-economic status).

RESULTS

Sixty-two studies were included; 59 (95.2%) from high-income countries (HIC). Thirty-eight studies (61.3%) reported no aspect of equity. Thirty-six studies (58.1%) reported prevention of sports injuries (commonly neuromuscular training often focused on soccer-related injuries, rule changes and protective equipment). Twenty-one studies (33.9%) reported prevention of road traffic injury, with legislative approaches, commonly graduated driver licensing schemes, found to be effective in reducing fatal and nonfatal road traffic injury. Seven studies reported interventions for other unintentional injuries (e.g., falls).

DISCUSSION

Interventions were strongly biased towards HIC, which does not reflect the global distribution of adolescent injury burden. Low consideration of equity in included studies indicates current evidence largely excludes adolescent populations at increased risk of injury. A large proportion of studies evaluated interventions to prevent sports injury, a prevalent yet low severity injury mechanism. Findings highlight the importance of education and enforcement alongside legislative approaches for preventing adolescent transport injuries. Despite drowning being a leading cause of injury-related harm among adolescents, no interventions were identified.

CONCLUSION

This review provides evidence to support investment in effective adolescent injury prevention interventions. Further evidence of effectiveness is needed, especially for low- and middle-income countries, populations at increased risk of injury who would benefit from greater consideration of equity and for high lethality injury mechanisms like drowning.

Symptoms of depression and anxiety among elite high school student-athletes in Sweden during the COVID-19 pandemic: A repeated cross-sectional study

The COVID-19 pandemic precipitated numerous changes in daily life, including the cancellation and restriction of sports globally. Because sports participation contributes positively to the development of student-athletes, restricting these activities may have led to long-term mental health changes in this population. Using a repeated cross-sectional study design, we measured rates of depression using the Patient Health Questionnaire-2 and anxiety using the Generalized Anxiety Disorder-2 scale in student-athletes attending elite sport high schools in Sweden during the second wave of the pandemic (February 2021; n = 7021) and after all restrictions were lifted (February 2022; n = 6228). Depression among student-athletes decreased from 19.8% in 2021 to 17.8% in 2022 (p = .008, V = .026), while anxiety screening did not change significantly (17.4% to 18.4%, p > .05). Comparisons between classes across years revealed older students exhibited decreases in depressive symptoms, while younger cohorts experienced increases in symptoms of anxiety from 2021 to 2022. Logistic regressions revealed that being female, reporting poorer mental health due to COVID-19, and excessive worry over one's career in sports were significant predictors of both depression and anxiety screenings in 2022. Compared to times when sports participation was limited, the lifting of restrictions was associated with overall reduced levels of depression, but not anxiety.

Psychological adaptation level optimization to attain the goal of sustainable education

The article aimed to study the psychological adaptability of university students. Along with that, the influence of sports activities on enhancing the psychology of students is also examined. The study also analyzes the impact of music on the psychoogy of students. A two-factor model is used for analyzing the level of college students' mental health. In this study, data was collected from 555 first-year undergraduate university students through an online questionnaire survey. Levels of both positive and negative psychological factors among students are examined. The findings indicate that students who participate in sports appear to have higher levels of positive psychological characteristics than students who do not exhibit any interest in participating in sports. Additionally, students that participate in sports have lower levels of negative psychological effects than nonparticipants. As a result, the study concluded that sports and other physical activities have a positive effect on the psychology of university students. The advantages of physical activities and sports in enhancing the mental and emotional health of students are highlighted in this study. To improve students' psychology and attain better academic results, educational institutions should provide students with various opportunities for sports.

Does exercise participation promote happiness?: Mediations and heterogeneities

This paper uses a nationally representative and large-scale dataset from China to empirically examine the relationship between exercise participation and happiness. To address the problem of reverse causality between the two factors, the instrumental variable (IV) approach is used to deal with endogeneity to some extent. It is demonstrated that higher frequencies of exercise participation are positively related to happiness. Findings also demonstrate that physical exercise could significantly decrease depressive disorders, improves self-rated health conditions and reduces the frequency of health problems affecting people's work and life. At the same time, all of above health factors significantly influence subjective wellbeing. When these health variables are included in regressions, the correlation between exercise participation and happiness declines. This confirms that physical activity helps to improve happiness by enhancing mental and overall health conditions. In addition, results show that physical activities are more prominently related to happiness for male, older and unmarried individuals and those living in rural areas, lacking social security and with higher levels of depression as well as lower socioeconomic status. Furthermore, a series of robustness checks are carried out and exercise participation's positive role in improving happiness is further confirmed using different happiness measures and instrumental variables, various IV models, as well as penalized machine learning methods and placebo tests. With the increasing emphasis of improving happiness as an important goal in the global public health policy, findings of this paper have important policy implications for enhancing subjective wellbeing.

Prevalence of depression and anxiety, and associated factors, among Chinese primary and high school students: A cross-sectional, epidemiological study

INTRODUCTION

This study aimed to investigate the prevalence of depression and anxiety, and associated factors, among Chinese children and adolescents aged 8-18 years who attend primary or high school.

METHODS

A total of 23 005 primary and high school students were recruited from February to December, 2019 for this cross-sectional study. The questionnaire included demographic information, questions assessing suicidality, resilience, depression (Center for Epidemiological Studies Depression Scale for Children), and anxiety (Screen for Child Anxiety Related Disorders). Binary logistic regression was used to analyze the independent correlates of depression and anxiety.

RESULTS

Overall, 13.06% of participants experienced depressive symptoms, 22.34% experienced anxiety symptoms, 26.34% experienced transient suicidal ideation, 2.23% had serious suicidal ideation, and 1.46% had a history of suicide attempts. Anxiety (odds ratio [OR], 4.935; 95% confidence interval [CI][4.442-5.485]), suicidality (OR, 2.671; 95% CI[2.203-3.237]), skipping breakfast (OR, 1.920; 95% CI[1.348-2.736]), sleep duration (OR, 0.470; 95% CI[0.398-0.556]) and self-expectations (OR, 1.924; 95% CI[1.550-2.389]) were associated with depression (all p < .05). Depression (OR, 4.424; 95% CI[3.983-4.914]), female sex (OR, 1.903; 95% CI[1.759-2.060]), school-based traumatic experience(s) (OR, 1.905; 95% CI[1.747-2.077]), relationships with teachers (OR, 1.575; 95% CI[1.103-2.249]), and suicidality (OR, 1.467; 95% CI[1.218-1.766]) were associated with anxiety symptoms (all p < .05).

DISCUSSION

Depression and anxiety are common among school-age children and adolescents in China. Childhood school- and family-based traumatic experience(s), female sex, and lifestyle factors (eating breakfast, sleep duration, exercising, and Internet use) are significantly associated with mental health among children and adolescents. Developing interventions targeting these factors to protect students from depression and anxiety are needed.

Athletes are not at greater risk for death by suicide: A review

INTRODUCTION

Suicide represents a major mental and public health issue. Elite athletes share certain individual and environmental characteristics that may increase their risk for mental illnesses, ultimately leading to suicide. This notion conflicts with the general perception of athletes, being the healthiest representatives of society.

METHODS

A comprehensive literature search was carried out through PubMed and Embase databases for relevant publications.

RESULTS

Recent calls for investigating suicidality among athletes resulted in a considerable amount of literature providing some evidence regarding lower rates of suicide among professional and high-performance athletes as well as similar incidence and prevalence of mental conditions, which are known as risk factors for suicide. Nevertheless, special attention is required in this population as predisposing and precipitating factors might differ from classical features of suicidality in the general population. Sports physicians, sports psychiatrists, and other mental health professionals in elite sports should be aware of early signs of affective disorders, risk of recreational drug abuse, misuse of performance-enhancing medications, sport-specific environmental stressors, serious physical injuries, and presence of physical or mental illness, all of which may increase suicidality. Traumatic brain injury (TBI) is with suicide with higher severity correlated with increased risk. Compared to active athletes, former athletes may have higher rates of suicide due to common life stressors occurring after sports retirement.

CONCLUSIONS

The findings suggest a multidisciplinary approach to suicidality in elite athletes, the main goal of which should be the reduction of suicide-related morbidity and mortality. Further research is required to clarify the existing gaps in the current knowledge of the issue. While having lower rates of suicide, athletes share some similar (affective disorders, drug abuse, mental and physical illness) and unique factors (misuse of performance-enhancing substances, sports-related stressors, sports injuries, TBI) putting them at risk of suicide during active career and retirement.

Association between sports participation and overall health in children and adolescents

Emerging evidence revealed that participating in sports may have benefits for health, but the association between sports participation and self-rated overall health has not been clearly established in children and adolescents. The present study aimed to examine the cross-sectional relationships between sports participation and self-rated overall health. A national sample of 42,777 (mean age = 9.4 ± 5.2, 48.3% girls) United States children and adolescents completed self-administered questionnaires and were included in the final analysis. The crude and adjusted odds ratio (ORs) and 95% CI were used to analyze the association between sports participation and self-rated overall health. Results indicated that children and adolescents participated in sports were more likely to report better overall health (OR = 1.92, 95%CI: 1.83, 2.02) compared to those not participating in sports. This study found that sport participation was positively associated with self-rated overall health in children and adolescents. This study offers evidence concerning adolescents' health literacy promotion.

The Influence of Adolescent Sport Participation on Body Mass Index Tracking and the Association between Body Mass Index and Self-Esteem over a Three-Year Period

This study aimed to (1) investigate gender-specific characteristics associated with low sport participation among UK adolescents, and (2) assess gender-specific BMI tracking, and gender-specific associations between BMI and self-esteem based on different levels of adolescent sport participation. Participants were 9046 (4523 female) UK adolescents. At 11- and 14 years self-esteem was self-reported and BMI was calculated from objectively measured height and weight. At 11- years sport participation was parent-reported. Gender-specific sport participation quartile cut-off values categorised boys and girls separately into four graded groups. Gender-specific χ² and independent samples t tests assessed differences in measured variables between the lowest (Q1) and highest (Q4) sport participation quartiles. Adjusted linear regression analyses examined BMI tracking and associations between BMI and self-esteem scores. Gender-specific analyses were conducted separately for sport participation quartiles. Compared to Q4 boys and girls, Q1 boys and girls were more likely to be non-White, low family income, have overweight/obesity at 11 years and report lower self-esteem at 11 years and 14 years. BMI at 11 years was positively associated with BMI at 14 years for boys and girls across sport participation quartiles. BMI at 11 years was inversely associated with self-esteem scores at 11 years for Q1 and Q2 boys, and Q1 and Q4 girls. BMI at 11 years was inversely associated with self-esteem scores at 14 years for Q1, Q3 and Q4 boys, and Q1, Q2, Q3 and Q4 girls. Gender and sport participation influence BMI tracking and the BMI and self-esteem association among adolescents.

Health benefits of physical activity for people with mental disorders: From the perspective of multidimensional subjective wellbeing

This paper uses a large scale and nationally representative dataset, Chinese General Social Survey, to empirically examine the role of physical activity in reducing the negative effects of depression among people with mental disorders. Empirical results demonstrate that physical exercise could help to alleviate depression's adverse consequences on work and life for depressed individuals. The impact mechanism is that physical activity may decrease the severity of depression, enhance life satisfaction, improve mood, and make people have a better sense of purpose and meaning in life. Therefore, from the perspective of multidimensional subjective wellbeing, evaluative wellbeing, experienced wellbeing and eudaimonic wellbeing all play mediating roles in the reduction of depression's adverse effects. Heterogeneity analysis shows that there are no significant gender differences in the health benefits of physical exercise, but its impact tends to be more prominent for depressed individuals who are younger and higher educated, with better health status, and live in urban areas. It is also found that socioeconomic status may play an important moderating role. The health benefits of physical activity seem to be greater for depressed people who have lower income, work in the secondary labor market, and have lower levels of social capital and assets. In addition, the instrumental variable approach is used to identify the causal impact of physical activity, which further proves a significant effect of it based on tackling the endogeneity problem. Meanwhile, this paper uses different explanatory and explained variables, different statistical models, as well as machine learning and placebo techniques to conduct robustness tests, all of which lend credence to above findings.

Study on the Relationship Between Diet, Physical Health and Gut Microflora of Chinese College Students

Many elements of a modern lifestyle influence the gut microbiota but few studies have explored the effect of physical health level. This study was aimed to explore the relationship between diet, physical health and gut microbiota in Chinese college students. A total of 69 college students were recruited, including 27 college athletes (AS group) and 42 healthy controls (HC group). Fecal samples were collected for 16S rRNA sequencing. According to National Standards for Students' Physical Health (2014 revision), physical fitness measurements, dietary intake and health-related data were collected via questionnaires. ①According to the physical fitness scores, the physical fitness level of AS group was significantly higher than that of HC group (P < 0.05), there were no significant differences between the two groups in the frequency of intake of food. The frequency and duration of physical activity in the AS group were higher than those in the HC group (P < 0.05); ②The proportion and relative abundances of microorganism composition is varying at two groups: on the phylum level, AS group had mainly increased Firmicutes, Actinobacteria and reduced Bacteroidetes, Proteobacteria; on the genus level, AS group had mainly increased Faecalibacterium, Bifidobacterium and reduced Bacteroides; ③The associations with the 10 most abundant bacterial genera and physical fitness, dietary factors were investigated. Changes in the gut microbiota abundance can be sometimes reflective of a physical health status. Loss of the balance of gut microbial populations will lead to flora disorders and diseases. Therefore, further studies are needed to reveal the mechanisms behind the gut microbiota in its potential role.

Perceived cognitive impairment in high school students in the United States

Introduction

Some youth experience cognitive difficulties that interfere with their ability to learn and function well in a school environment. We examined correlates of perceived cognitive impairment among high school students who completed a national survey conducted by the United States Centers for Disease Control and Prevention (CDC) in 2019.

Methods

Participants were high school students (grades 9–12) who completed the Youth Risk Behavior Survey (YRBS) in 2019. The CDC uses this survey to monitor risk behaviors. Students answered the following question ‘Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?’ as either ‘yes’ or ‘no.’ Student responses to this question were analyzed in relation to demographic variables and variables pertaining to adversity, mental health problems, and drug use.

Results

The sample included 8,349 students between the ages of 14 and 18, with 4,093 boys (49%) and 4,256 girls (51%). A large proportion reported having serious difficulty concentrating, remembering, or making decisions due to physical, mental, or emotional problems (38%). A significantly larger proportion of girls (45%) than boys (30%) reported experiencing cognitive impairment [χ²(1) = 212.23, p < 0.001; Odds Ratio = 1.95, 95% confidence interval = 1.78–2.13]. Youth who exercised regularly were significantly less likely to report cognitive impairment. Binary logistic regression was used to examine the associations between perceived cognitive impairment and adversity, mental health, and lifestyle variables separately for boys [χ²(11) = 569.158, p < 0.001; Nagelkerke R² = 0.212] and girls [χ²(11) = 1,026.189, p < 0.001; Nagelkerke R² = 0.321]. Being bullied, feeling unsafe or threatened at school, getting very low grades, insufficient sleep, and using illicit drugs were independently associated with perceived cognitive impairment in both boys and girls—after controlling for associations with depression and suicidality. Youth who denied mental health problems, psychosocial adversities, and using illicit drugs reported much lower rates of perceived cognitive impairment (boys = 13%, girls = 15%).

Conclusion

A remarkably large proportion of high school students in the United States reported experiencing serious difficulty with their cognitive functioning over the past year. Girls were significantly more likely to endorse perceived cognitive difficulties compared to boys. There was a strong association between perceived cognitive impairment and the experience of psychosocial adversity.

Research on the influence of sports participation on school bullying among college students—Chain mediating analysis of emotional intelligence and self-esteem

Purposes

This paper aims to discuss the relationship between college students’ sports participation, school bullying, emotional intelligence and self-esteem. At the same time, it explores the intrinsic mechanisms of school bullying, in order to provide a reference for reducing bullying phenomenon among college students, and pave the way for college students to lead happy, healthy and confident lives.

Methods

A total of 1,317 students (725 male students, 592 female students, 21.31 ± 3.28 years old) from four universities in Southwest China were selected as subjects for this survey. They were selected by stratified random sampling, and the data needed was obtained using a structured questionnaire. The data was subsequently processed with statistical software SPSS19.0 and AMOS21.0.

Results

(1) Sports participation has a significant and positive correlation with emotional intelligence and self-esteem, likewise, it has a significant negative correlation with school bullying. Emotional intelligence has a marked positive correlation with self-esteem, at the same time it has a significant negative correlation with school bullying. In addition, self-esteem is strongly negative correlated with school bullying. (2) Sports participation has a direct effect on school bullying (ES = −0.271). Emotional intelligence (ES = −0.144) and self-esteem (ES = −0.065) also play a significant mediating role between sports participation and school bullying, and the chain mediating force of emotional intelligence—self-esteem also reaches a significant level (ES = −0.016).

Conclusion

Sports participation affects school bullying among college students not only directly but also indirectly, such as through emotional intelligence, the mediating role of self-esteem, and the chain mediating role of emotional intelligence to self-esteem. Apart from sports participation, emotional intelligence is another key factor that affects college students’ school bullying. Therefore, while attaching great importance to college students’ sport participation, schools should also provide courses aimed at developing students’ emotional intelligence.

Sport Participation Associations With Child Friend Selection and Physical Activity While at Summer Care Programs

Child physical activity (PA) declines during summer reducing PA-related health benefits. Summer care programs (e.g., Boys & Girls Clubs) can promote active play while providing opportunities for friendships. Sport participation is a positive influence on PA and social development. Purpose: This article investigates the role of sport participation in PA attainment, perceived skill competency, and social connection at a summer care program. Methods: Children self-reported PA, sport participation, and the names of up to five peers whom they played with most at the program at the start (T1; n = 100; M age = 9.94 years; SD = 1.34; 47% male) and end (T2; n = 77; M age = 9.83 years; SD = 1.46; 51% male) of summer. Network autocorrelation models were used to determine if child sport participation was significantly associated with those they played with at the program. Results:Children who reported sport participation reported significantly more PA than those who did not at T1, but not T2. Child sport participation was significantly related to that of the peers they said they spent time with while at the program for T1 (β = 0.07, p < .01), but not T2 (β = 0.06, p = .10). Additionally, PA (β = 0.08, p < .01; β = 0.07, p = .01) and skill competency (β = 0.11, p = .02; β = 0.15, p < .01) were significantly associated with sport participation at both time points. While sports participation was a key factor in child friendships at the start of summer, the program allowed children, regardless of sport participation, to become friends outside of sports. Conclusions: These results suggest summer care programs promote PA through play and provide opportunities for children to facilitate friendships regardless of sport participation.

Longitudinal changes and correlates of meeting WHO recommended levels of physical activity in the UK during the COVID-19 pandemic: Findings from the HEBECO study

Background

The COVID-19 pandemic has seen repeated government enforced restrictions on movement. This study aimed to evaluate longitudinal trends in physical activity (PA) in a self-selected UK-based sample and identify the key correlates of these trends.

Methods

From 23 April 2020 to 30 January 2021, measures of PA engagement were collected in a sample of 1,947 UK-based adults. Generalised estimating equations (GEE) explored trends in PA engagement over time, and how sociodemographic, health and contextual factors impacted participant’s attainment of World Health Organization (WHO) recommended levels of PA (constituting muscle strengthening activity (MSA), and moderate or vigorous PA (MVPA)).

Results

While one in five achieved the recommended levels of PA in the first UK lockdown in April-June 2020 (19.5%, 95%CI: 17.8–21.3%) and a similar proportion in June-July 2020 (17.7%, 95%CI: 16.1–19.5%), this reduced during the period of eased restrictions in August-September 2020 (15.2%, 95%CI: 13.7–16.9%) and the second UK lockdown in November 2020-January 2021 (14.1%, 95%CI: 12.6–15.9%). Similar trends were observed for MSA and MVPA individually. Better quality of life, higher socioeconomic position and pre-COVID-19 PA levels were associated with meeting the WHO recommended levels of PA, while those living with overweight or obesity, a limiting health condition, or isolating showed the inverse associations. Time-specific associations with MSA or MVPA were observed for gender and age.

Conclusion

Reductions in PA levels throughout the first strict lockdown continued without reversal during the ensuing period. The association of negative change with socioeconomic and health-related indices points towards deepening health inequities during the pandemic.

Associations of physical activity with academic achievement and academic burden in Chinese children and adolescents: do gender and school grade matter?

Background

Physical activity (PA) was significantly associated with cognition and mental health in children and adolescent. However, there were few studies examining the associations of PA with academic achievement (AA) and academic burden (AB) by gender and school grade. Hence, this study aimed to 1) investigate the associations of moderate-to-vigorous PA (MVPA) with AA and AB in Chinese children and adolescents, and 2) assess whether these associations vary by gender and school grade.

Methods

Using a multi-stage stratified cluster sampling design (at four different regions in Southern east China), 2653 children and adolescents (8–19 years old, 51.2% girls) were included. A self-reported questionnaire was used to collect data on study participants’ gender, school grade, family social economic status (SES), parental education level, MVPA, AA and AB. Binary logistic regression was applied to examine the associations of MVPA with AA (groups: above-average AA, average and below-average AA) and AB (groups: reporting AB, reporting no AB) with odds ratios (ORs) and 95% confidence intervals (CIs). After testing gender*grade interaction, those associations were explored by gender and school grade separately.

Results

In the overall sample, compared with children and adolescents who did not meet the PA guidelines (at least 60 min MVPA daily), children and adolescents who met the PA guidelines were more likely to have above-average (OR = 1.61, 95% CI: 1.21–2.11) AA, and report no AB (OR = 1.61, 95% CI: 1.13–2.30). In both genders, meeting the PA guidelines was positively associated with above-average AA (OR = 1.43, 95% CI: 1.01–2.03 for boys; OR = 2.22, 95% CI: 1.43–3.44 for girls). However, the significant relationship between meeting the PA guidelines and AB was observed only in girls (OR = 1.99, 95% CI: 1.17–3.39). Meeting the PA guidelines was positively associated with above-average AA (OR = 1.68, 95% CI: 1.18–2.40), and reporting no AB (OR = 1.77, 95% CI: 1.08–2.91) only in middle school students.

Conclusions

This study suggested that sufficient PA may be a contributary factor of improved AA and lower level of AB in Chinese children and adolescents. However, associations of PA with AA and AB may be different across gender or school grade. Promoting PA among girls or middle school students may be a good approach to improve AA and reduce AB.

Bad for Girls and Boys: Gender Does Not Modify the Negative Effect of Physical Inactivity on Life Satisfaction in Adolescents

Objectives:

Physical activity (PA) has a positive effect on life satisfaction (LS) among adolescents, but the moderating effect of gender and level of PA intensity have been equivocal. Our aim was to examine the pattern of physical activity by grade in high school students, and the role of gender and grade on the association between physical activity and life satisfaction.

Methods

Four repeated cross-sectional online questionnaire surveys between 2011 and 2013 were carried out among all students in one Hungarian high school (N = 3,450). Health status and behavior was assessed by the Hungarian online version of the health behavior of school-aged children (HBSC) questionnaire. Regression with robust variance estimator was used to identify determinants of life satisfaction.

Results

Good self-reported health as opposed to bad increased life satisfaction by 0.30 standard deviation; having very well or well-off family as opposed to not well-off increased LS by 0.16 standard deviation; and being inactive compared to being vigorously active decreased LS by 0.1 standard deviation.

Conclusions

Physical inactivity has a negative effect on life satisfaction in boys and girls regardless of grade but compounded by low perceived family wealth.

Associations between organized sport participation and mental health difficulties: Data from over 11,000 US children and adolescents

The purpose of this study was to explore the association between participation in organized sport and a broad array of mental health difficulties among US children and adolescents. The data (cross-sectional) were from Data Release 3.0 (one-year follow-up visits on the full cohort) of the Adolescent Brain Cognitive Development (ABCD) study-a broadly representative sample of 11,235 US children and adolescents aged 9 to 13 years. Parents/guardians provided self-reports of their child's mental health difficulties using the Child Behavior Checklist. To assess participation in organized sport, children and adolescents were categorized into one of four groups: 1) participation in team sport, 2) participation in individual sport, 3) participation in team and individual sport, and 4) non-sport participation. Participation in team sport compared to non-sport participation was associated with 10% lower anxious/depressed scores, 19% lower withdrawn/depressed scores, 17% lower social problems scores, 17% lower thought problems scores, and 12% lower attention problems scores. Participation in team sport compared to non-sport participation was also associated with 20% lower rule-breaking behavior scores for females (compared to males). Conversely, participation in individual sport compared to non-sport participation was associated with 16% higher anxious/depressed scores, 14% higher withdrawn/depressed scores, 12% higher social problems scores, and 14% higher attention problems scores. Participation in both team and individual sport compared to non-sport participation was associated with 17% lower rule-breaking behavior scores for females (compared to males). Results indicate that team sport participation was associated with fewer mental health difficulties, whereas individual sport participation was associated with greater mental health difficulties. The findings complement previous research suggesting that team sport participation may be a vehicle to support child and adolescent mental health. Additional research is needed to determine to what extent, and under what circumstances, participation in individual sport may be problematic for younger cohorts.

The Association Between Sex and Osteoarthritis in the Physically Active Population: A Systematic Review

PURPOSE

Intense sporting activity and certain types of work increase the risk of early osteoarthritis (OA). OA can be idiopathic or associated to certain predisposing factors: female sex, obesity, history of joint injury, and joint overuse. The role of gender among the active population as a predisposing factor for OA is not well clear. This study investigated whether the risk of OA changes with age in both sexes in physically active individuals.

MATERIALS AND METHODS

This systematic review was conducted according to the PRISMA guidelines 2020. PubMed, Google Scholar, Embase, and Web of Science databases were accessed in April 2021. No time constrains were used for the search. All the published clinical studies reporting data about relationship between physical activity and OA were included.

RESULTS

Data from 7 articles were retrieved including 360,053 patients (271,903 males; 88,150 females). The mean age was 48.2±16.7 years. Males, under the age of 60 had a higher risk of developing OA. People undertaking intense physical activity, such as professional athletes or heavy workers, are more prone to develop early OA.

CONCLUSION

Physically active males demonstrated a higher risk of developing OA.

School educational models and child mental health among K-12 students: a scoping review

BACKGROUND

The promotion of mental health among children and adolescents is a public health imperative worldwide, and schools have been proposed as the primary and targeted settings for mental health promotion for students in grades K-12. This review sought to provide a comprehensive understanding of key factors involved in models of school education contributing to student mental health development, interrelationships among these factors and the cross-cultural differences across nations and societies.

METHODS

This scoping review followed the framework of Arksey and O'Malley and holistically reviewed the current evidence on the potential impacts of school-related factors or school-based interventions on student mental health in recent 5 years based on the PubMed, Web of Science, Embase and PsycExtra databases.

RESULTS/FINDINGS

After screening 558 full-texts, this review contained a total of 197 original articles on school education and student mental health. Based on the five key factors (including curriculum, homework and tests, physical activities, interpersonal relationships and after-school activities) identified in student mental development according to thematic analyses, a multi-component school educational model integrating academic, social and physical factors was proposed so as to conceptualize the five school-based dimensions for K-12 students to promote student mental health development.

CONCLUSIONS

The lessons learned from previous studies indicate that developing multi-component school strategies to promote student mental health remains a major challenge. This review may help establish appropriate school educational models and call for a greater emphasis on advancement of student mental health in the K-12 school context among different nations or societies.

School climate-related determinants of physical activity among high school girls and boys

INTRODUCTION

In the United States, physical activity (PA) among adolescents is declining; 75% of high school students do not meet daily PA guidelines. Low rates of PA are more prevalent among high school girls. Schools provide an optimal environment to target and promote PA. However, school climate has not yet been studied for its importance in promoting PA among high school students, particularly girls.

METHODS

A cross-sectional analysis was conducted using the Georgia Student Health Survey (GSHS) 2.0 data on perceptions of different school climate measures and self-reported weekly PA levels to study gender differences in the association of PA with school climate.

RESULTS

Data from a total of 362,926 students (48% males and 52% females) were analyzed. For both genders, the odds of being physically active increased with a more positive report of supportive school environments, school connectedness, peer social support, school physical environments, cultural acceptance, school safety, and adult social support. Peer victimization was associated with increased odds of PA among females but lower odds for males.

CONCLUSION

Results suggest that improving school climate can increase PA among adolescents. As new or existing school-based interventions and policies are considered by states and local governments, improving the school climate should be part of the overall strategy. Future research is needed on peer victimization among physically active females.

IMPLICATIONS AND CONTRIBUTIONS

This study evaluated gender differences in the association between measures of school climate and PA among high school students. School climate or policies fostering positive environments including feelings of safety, connectedness, and peer support may increase adolescent PA; addressing peer victimization and fights may reduce gender disparities in PA.

Association Between Concussions and Suicidality in High School Students in the United States

Importance

Prior research has shown a statistically significant association between sustaining a concussion and suicidality in adolescents, but this prior research controlled for relatively few variables predictive of suicidality.

Objective

To examine whether sustaining a concussion remained a significant predictor of suicidality after controlling for relevant covariates (e.g., sexual abuse/assault, bullying, substance use, depression), hypothesizing that the relationship between concussion and suicidality would become non-significant after controlling for these variables.

Design

This study involved secondary data analysis of the 2019 Youth Risk Behavior Surveillance (YRBS) System, a national cross-sectional study of adolescents. Analyses were stratified by gender.

Setting

A national sampling of U.S. high school students.

Participants

Eleven thousand two hundred sixty-two students in the YRBS database, including 5,483 boys and 5,779 girls.

Exposure(s)

Participants included in the analyses reported whether, in the last year, they experienced a concussion and/or suicidality.

Main Outcomes and Measures

The main outcome was suicidality (i.e., ideation, planning, attempt), which was predicted by concussion in an unadjusted analysis and by concussion along with other risk factors in a multivariable analysis.

Results

The final sample included 11,262 participants with available data on concussion and suicidality in the last year (14–18 years-old; 51.3% girls; 49.0% White). Per unadjusted odds ratios with 95% confidence intervals, there was a relationship between concussion and suicidal ideation [girls: OR = 1.46 (1.24, 1.73); boys: OR = 1.69 (1.41, 2.03)], planning (girls: OR = 1.39 [1.16, 1.66]; boys: OR = 1.76 [1.44, 2.14]), and attempt [girls: OR = 1.70 (1.32, 2.19); boys: OR = 3.13, (2.37, 4.15)]. These relationships became mostly non-significant after controlling for relevant risk factors for suicidality. The adjusted odds ratios showed no relationship between concussion and suicidal ideation [girls: OR = 1.11 (0.86, 1.44); boys: OR = 1.24 (0.92, 1.69)] or planning (girls: OR = 1.07 [0.82, 1.40]; boys: OR = 1.12 [0.82, 1.55]); but a significant relationship with suicide attempts in boys [OR = 1.98 (1.28, 3.04)], but not girls [OR = 1.05 (0.74, 1.49)].

Conclusions and Relevance

There was an association between concussion and suicidality in U.S. high school students; however, after controlling for other variables (e.g., depression, sexual abuse/assault, illicit drug use), there was no association between concussion and suicidality aside from a significant relationship between concussion and attempts in boys.

Contextual Factors Influencing Young Athletes’ Decision to Do Physical Activity and Choose a Sports’ Club: The Case of Portugal

Physical activity and sports are a central part of individuals’ lives throughout the life cycle. During adolescence, its regular practice may contribute to the development of healthy adult lifestyles, decreasing chronic disease incidence. Therefore, the reasons that drive adolescents to start practicing sports in a certain club may be multiple and understanding such causes can be important to design and implement public policies to promote active lifestyles for everyone. In this article, we report the core findings of a research on why young athletes do sports, how they choose their team-training club and how COVID-19 has had an impact on their routines. From a methodological viewpoint, a questionnaire was developed and sent to sport clubs located in NUTS2 Centro Region, Portugal, and results were analyzed through the use of geographic information systems and statistical analysis, namely association tests (Chi-square test), difference tests (Mann–Whitney test and Kruskal–Wallis test), logistic regression and descriptive analysis. Findings show that family, age group, friends, proximity to sports facilities, teammates, and club conditions are the factors that influence adolescents the most. In short, external factors have a significant preponderance to practice physical activity and choose a sports’ club. These findings can provide useful insights for clubs, coaches and policy-makers to become more aware of the relationship between sports practice and accessibility to sports halls, as well as the athletes’ behavior and their connection with the club and basketball practice. As such, these findings can motivate the design of initiatives and strategies to boost sports practice and to find ways for clubs to attract more adolescents.

High School Football and Risk for Depression and Suicidality in Adulthood: Findings From a National Longitudinal Study

BACKGROUND

There is growing public concern regarding the potential long-term effects of playing football on brain health, specifically that playing football before and during high school might cause damage to the brain that manifests years or decades later as depression or suicidality. This study examined if playing high school football was associated with increased lifetime risk for depression, suicidality over the past year, or depressed mood in the past week in men aged between their middle 30 s to early 40 s.

METHODS

Publicly available data from the National Longitudinal Study of Adolescent to Adult Health were analyzed. This longitudinal, prospective cohort study sampled nationally representative U.S. youth starting in 1994-1995 (Wave I) and most recently in 2016-2018 (Wave V). A total of 3,147 boys participated in Wave I (median age = 15), of whom 1,805 were re-assessed during Wave V (median age = 38).

RESULTS

Of the 1,762 men included in the study, 307 (17.4%) men reported being diagnosed with depression and 275 (15.6%) reported being diagnosed with an anxiety disorder or panic disorder at some point in their life. When comparing men who played high school football to those who did not, there were no differences in the proportions of the sample who had a lifetime diagnosis of depression, lifetime diagnosis of anxiety/panic disorders, suicidal ideation in the past year, psychological counseling in the past year, or current depressed mood. However, men who received psychological counseling and/or experienced suicidal ideation during adolescence were significantly more likely to report a lifetime history of depression, suicidal ideation in the past year, and current depressed mood.

CONCLUSION

Individuals who reported playing football during adolescence did not have an increased risk of depression or suicidal ideation when they were in their middle 30 s to early 40 s, but mental health problems during adolescence were associated with an increased risk for psychological health difficulties more than 20 years later.