The effects of different types of leisure-time physical activity on positive mental health among adolescents: a mixed-methods systematic review and meta-analysis.

This systematic review and meta-analysis investigated the effects and experiences of different types of leisure-time physical activity (LTPA) on various positive mental health (PMH) outcomes among adolescents.

The **interventions/exposures** were specific types of LTPA, which could include activities like football, yoga, running, fitness training, resistance training, and dancing. The review specifically excluded cool-down exercises, muscle stretching, post-exercise recovery, and pre-exercise/warm-up routines, focusing instead on the main activity itself.

For **comparators**, quantitative studies included in the review either compared participants' PMH before and after an LTPA intervention (pre-post designs) or compared an LTPA group to a control group that did not engage in the specific LTPA. Qualitative studies, by their nature, did not typically involve a comparator group but explored participants' experiences.

The **outcome measures** focused exclusively on positive mental health and well-being. This encompassed a broad range of constructs, including:

**Psychological well-being**: Aspects like a sense of purpose, personal growth, autonomy, and environmental mastery.

**Emotional well-being**: Affective and emotional aspects of experiences, such as happiness, life satisfaction, and positive mood.

**Social well-being**: Feelings of belonging, social integration, and contribution to the community.

**Physical well-being**: Though often linked to physical health, this domain was also considered in the context of overall well-being.

**Self-concept**: Including global self-concept and its subcategories, such as physical self-concept.

Studies that focused on mental disorders or illnesses (e.g., depression, anxiety disorders) were explicitly excluded to maintain a focus on positive mental health.

The review synthesized findings from 44 primary research articles. The **population** of interest across all included studies was adolescents, specifically defined as individuals aged 10–19 years, consistent with the World Health Organization (WHO) definition of adolescence.

Crucially, all included studies were from **non-clinical populations**. This means the participants were generally healthy adolescents without a diagnosed mental illness or disorder. This focus ensures that the findings are relevant to the general adolescent population rather than those undergoing clinical treatment for specific conditions.

The **sample size** for a meta-analysis refers to the cumulative number of participants across all included studies. While the abstract states that 44 articles were included from an initial 8,149 records, it does not provide the total number of participants across these 44 studies. Therefore, we know the synthesis is based on a substantial body of research involving adolescents from various non-clinical settings, but the exact aggregate participant count is not specified in the abstract.

The **setting** for the original studies would have varied widely, encompassing schools, community sports clubs, fitness centers, and other environments where adolescents engage in leisure-time physical activities.

As a mixed-methods systematic review and meta-analysis, this study did not conduct its own measurements but rather synthesized the measurements reported in the 44 included primary studies.

For the **quantitative studies** included in the meta-analysis, PMH outcomes would have been measured using a variety of validated psychometric instruments and scales. These typically involve self-report questionnaires designed to assess different dimensions of well-being and self-concept. Examples of such instruments, though not explicitly listed in the abstract, commonly include:

**Scales for emotional well-being**: Such as the Satisfaction with Life Scale (SWLS), Positive and Negative Affect Schedule (PANAS), or various mood questionnaires.

**Scales for psychological well-being**: Such as Ryff's Scales of Psychological Well-being, which measure autonomy, personal growth, self-acceptance, purpose in life, environmental mastery, and positive relations with others.

**Scales for social well-being**: Such as the Social Well-being Scale, assessing social integration, social contribution, social coherence, social actualization, and social acceptance.

**Scales for self-concept**: Such as the Physical Self-Perception Profile (PSPP) or various self-esteem scales.

These quantitative measures typically yield numerical scores, allowing for statistical analysis of changes or differences between groups.

For the **qualitative studies** included in the review, PMH experiences were measured through methods designed to capture rich, descriptive data about participants' subjective perspectives. These commonly included:

**Interviews**: One-on-one conversations with adolescents to explore their feelings, thoughts, and experiences related to LTPA and its impact on their mental health.

**Focus groups**: Group discussions where adolescents could share and discuss their experiences, often revealing shared themes and diverse viewpoints.

These qualitative data sources would have been analyzed using thematic analysis or similar methods to identify recurring patterns, themes, and narratives related to PMH facilitators and experiences.

The review's methodology ensured that only studies using appropriate and relevant measures for PMH outcomes were included, whether quantitative scales or qualitative inquiry methods.

This study employed a **mixed-methods systematic review and meta-analysis** design. This approach combines