School-based physical activity interventions for mental health promotion and mental disease prevention in children and adolescents in high-income countries: a systematic review and meta-analysis
- Forfatter(e)
- Ditzen-Janotta, C., Schwarz, S., Wendel, F., Kunzler, A. M., Schoenweger, P., Kirschneck, M., Merkel, L., Movsisyan, A., Weber, M., Rehfuess, E., Coenen, M., Jung-Sievers, C.
- År
- 2026
- Tidsskrift
- European Archives of Psychiatry & Clinical Neuroscience
- Volum
- 21
- Sider
- 21
- Kategori(er)
- Angst og engstelighet (inkl. både vansker og lidelse) Atferdsproblemer, antisosial atferd og atferdsforstyrrelser Depresjon og nedstemthet (inkl. både vansker og lidelse) Livskvalitet og trivsel
- Tiltakstype(r)
- Skole/barnehagebaserte tiltak Fysisk aktivitet
- Abstract
This systematic review evaluates the effectiveness of school-based physical activity (PA) interventions in mental health promotion and mental disease prevention among children and adolescents in high-income countries. Adhering to the PRISMA guidelines, an electronic database search was conducted in MEDLINE, Embase, PsycINFO and PubMed, for randomized controlled trials (RCTs), including cluster-RCTs, published between January 2014 and June 2025. We included studies of any universal school-based intervention that aimed to promote mental health or prevent mental disease through increasing all kinds of PA and reducing sedentary behaviour. Title/abstract and full text screening was carried out independently and in duplicate based on inclusion and exclusion criteria. The search identified 1131 unique records, of which 25 studies were finally included in the systematic review. Out of those, 12 studies were identified reporting a positive effect of PA interventions on the mental health of children and adolescents. We performed meta-analyses of 19 studies reporting on symptoms of depression, anxiety, psychological difficulties, internalizing or externalizing problems, psychological well-being and health-related quality of life (HRQoL). Only the meta-analysis of studies reporting on HRQoL provided very-low certainty evidence for a positive intervention effect (SMD 1.08, 95% confidence interval (CI) 0.24 to 1.91). No significant intervention effect was found for other outcomes of interest. The certainty of evidence (according to GRADE) was very low for all but three of the assesed outcomes due to high risk of bias in the included studies and the considerable heterogeneity between studies. To improve the detectability of mental health benefits of universal PA interventions in schools in replication studies, high-quality study designs, coordinated outcome instruments and longer follow-up periods are needed.