Efficacy of physical activity interventions on psychological outcomes in refugee, asylum seeker and migrant populations: A systematic review and meta-analysis

Purgato, Marianna; Richards, Justin; Prina, Eleonora; Kip, Ahlke; Piccolo, Lidia Del; Michencigh, Giulia; Rimondini, Michela; Rudi, Doriana; Vitali, Francesca; Carta, Mauro Giovanni; Morina, Nexhmedin; Schena, Federico; Barbui, Corrado

doi:10.1016/j.psychsport.2021.101901

Cited by 18 publications

(26 citation statements)

References 66 publications

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“…The issue of further assessment and promotion of PA among asylum seekers may also be seen in light of the WHO Global Action Plan on Physical Activity 2018–2030 [ 60 ], including an accentuated need to identify high risk groups of insufficient PA, to increase the knowledge and delivery of context and culturally sensitive actions to promote PA, and subsequently, to facilitate both mental and physical health. According to the few recent reports on PA and sport among forced migrant populations, such actions may not only be attributed to physical and psychological outcomes but also as a facilitator of social health, such as greater acculturation, integration, social inclusion, and feelings of belonging [ 38 , 58 , 61 – 63 ]. In regard to promotion of PA, and partially related to our findings of more than one in eight asylum seekers being completely inactive, it may also be noted that recent research has demonstrated important health benefits even at much lower doses than advocated by generic PA guidelines, and especially when moving from completely inactive to some activity [ 64 , 65 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, these symptom clusters may as well be closely interrelated in regard to their influence on PA, such as avoiding activities or exercise due to lack of energy or motivation, fear of bodily arousal (e.g., muscle tension, increased heart rate, shortness of breath), or fear of intrusive memories that may be triggered by physical strain. In addition, despite a recently increased attention [ 38 , 40 ], the role of social, cultural, environmental, and policy factors on PA participation among people with PTSD in general [ 32 ], and forced migrant populations in particular [ 53 , 58 , 59 ], is still understudied and need to be further addressed by future research.…”

Section: Discussionmentioning

confidence: 99%

“…For example, insufficient PA is generally proposed to be bi-directionally associated with depression, sleeping problems, and chronic pain, while these symptoms or conditions are also associated with symptoms of PTSD [ 14 , 16 , 34 , 35 ]. Interventions including PA and exercise have been shown to alleviate the severity of PTSD symptoms and to have beneficial effects on prevalent psychological comorbidity such as depression and anxiety [ 36 – 38 ]. Further, regular PA is also associated with a range of favorable health aspects that may be of particular importance concerning forced migrants’ health, including increased energy and daily life functioning, resilience and self-management of stress, sleep quality, physical health status, self-esteem and self-confidence, cognitive performance, and improved social relations [ 26 , 27 , 39 , 40 ].…”

Section: Introductionmentioning

confidence: 99%

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Physical activity, post-traumatic stress disorder, and exposure to torture among asylum seekers in Sweden: a cross-sectional study

et al. 2021

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Background Forced migrant populations have high rates of trauma-related ill health, including post-traumatic stress disorder (PTSD). Physical activity (PA) is well-established as an effective stress reliever, while insufficient PA is associated with adverse effects on both mental and physical health. The aim of this study was to examine the prevalence of different levels of PA and its association with PTSD symptom severity, controlled for exposure to torture, among asylum seekers in Sweden. Methods A cross-sectional survey study, with data from 455 asylum seekers, originating from Afghanistan, Eritrea, Iraq, Somalia, and Syria, residing at large housing facilities across Sweden. Level of PA was assessed by the Exercise Vital Sign and categorized as; Inactive, Insufficient PA, and Sufficient PA. Prevalence estimates for proportions of different levels of PA were calculated. Analysis of variance were conducted to determine the association between levels of PA and PTSD symptom severity, measured by the Harvard Trauma Questionnaire. Multivariable logistic regression analysis was performed to determine the contribution of PA on PTSD beyond sex, age, and exposure to torture. Results About half of the participants (53.3, 95% CI: 48.6–58.1) met the recommendations for Sufficient PA. One third of the participants (33.3, 95% CI: 28.7–37.8) were insufficiently engaged in PA, and 13.4% (95% CI: 10.1–16.7) were inactive. There was a significant difference in PTSD symptom severity between groups of asylum seekers with different levels of PA (F(2, 316) = 23.15, p < .001). When controlling for sex, age, and exposure to torture, Sufficient PA was found to be associated with less PTSD symptom severity compared to both Insufficient PA (B = 0.297, SE = 0.086, p < .001) and Inactive (B = 0.789, SE = 0.104, p < .001). Conclusions Insufficient PA was common among the asylum seekers and our findings suggest that more PA is highly associated with lower PTSD symptom severity. An increased focus on assessment and promotion of PA is justified and discussed as particularly pertinent considering the much extended time of asylum-seeking processes. The results support previous evidence of PA as a potentially important factor in the context of PTSD and forced migrants’ health.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Physical activity, post-traumatic stress disorder, and exposure to torture among asylum seekers in Sweden: a cross-sectional study

et al. 2021

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“…On a related note, some studies indicate bene cial effects of physical activity on symptom clusters associated with PTSD and depression, such as sleep problems (Stathopoulou et al, 2006;Björkman and Elkblom, 2022), although some studies were unable to replicate the signi cance of this effect (for example see Rosenbaum et al, 2015). Further, reviews and meta-analytic ndings reported a positive impact of physical activity on the psychological well-being in highly distressed populations like refugees, asylum seekers, and migrants (Purgato et al;.…”

Section: Effects Of Exercise On Sleep Quality and Psychological Distressmentioning

confidence: 99%

Moderate-intensity Aerobic Exercise Training as an Adjunct to Trauma-focused Psychotherapy in Traumatized Refugees and Asylum Seekers: Study Protocol of a Randomized Controlled Trial

Lüder

Michael

Lass‐Hennemann

et al. 2023

Preprint

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Background Refugees with exposure to multiple traumatic events are at high risk for developing trauma-related mental disorders, including Posttraumatic Stress Disorder (PTSD) and depression. Narrative Exposure Therapy (NET) is an effective treatment for the core symptoms of PTSD, but many studies did not find that it significantly reduces depressive symptoms. Endurance exercise on the other hand was consistently found to be effective in treating symptoms of depression, thereby making it a promising adjunct to NET. Up to date, no studies exist investigating the combination of NET and endurance exercise in a sample of refugees with PTSD and relevant comorbid depressive symptoms. Methods/ Design In the proposed Randomized Controlled Trial (RCT) we aim to investigate whether a combination of NET and Moderate-intensity Aerobic Exercise Training (MAET) enhances treatment outcome for refugees with PTSD and comorbid depressive symptoms. Therefore, we hypothesized a greater improvement in psychopathology in participants who receive the combined treatment. According to power calculation assuming a moderate adjuvant effect, 68 refugees and asylum seekers with a confirmed PTSD diagnosis and clinically relevant depressive symptoms will be recruited in the proposed study. Participants will be randomly assigned to receive either NET only (NET-group; n = 34) or NET plus MAET (NET+-group; n = 34). All participants will receive ten NET sessions (100 minutes each). Participants in the NET+-group will additionally take part in MAET (running exercises à 45min three times weekly). Primary (PTSD, depression) and secondary (general mental distress, sleep quality, agoraphobia) outcome measures will be assessed before treatment, directly after treatment, and at six-month follow-up. The hypotheses are planned to be tested with multiple 2x3 mixed ANOVA’s. Discussion The proposed study will be the first RCT assessing whether NET, which is currently the first-line treatment for PTSD in refugees, can be enhanced by endurance exercise. If the results will be in line with the hypotheses, the psychotherapeutic care of traumatized refugees with PTSD and comorbid depressive symptoms could be improved. Potential challenges include participant recruitment and retention. Trial registration: The present clinical trial is pre-registered in German Clinical Trials Register (DRKS) on 29 July 2020; DRKS ID: DRKS00022145).

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“…Results showed that residents' top neighborhood priorities, just after reducing crime and disorder, was to rebuild cross-walk and playground areas. Finally, physical activity and sport programs could also help social integration in the context of forced climatic migrations in the next years (see for an example [125]). This last point is crucial.…”

Section: Adaptation Role Of Health Behaviorsmentioning

confidence: 99%

Thinking health-related behaviors in a climate change context: A narrative review

Chevance¹,

Fresán²,

Hekler³

et al. 2021

Preprint

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Background: Human activities have changed the biosphere so profoundly over the past two centuries that human-induced climate change is now posing serious health-related treats to the current and future generations. Rapid actions from all scientific fields are needed to contribute to both the mitigation and adaption to climate change. Purpose: This article aims to identify bi-directional associations between climate change effects (i.e., rising average temperatures, natural disasters, air pollution, rising sea level) and health-related behaviors, as well as a set of key actions for the behavioral medicine community. Methods: We synthetized the existing literature about (i) the effects of rising average temperature, natural disasters, air pollution, and rising sea level on the food system and eating behaviors, physical activity, sleep, substance use, access to safe water, and preventive behaviors; and (ii) the concurrent positive and negative roles that health-related behaviors can play in mitigation and adaptation to climate change. Results: Based on this literature review, we propose one of the first model of the complex, occasionally bi-directional, associations between climate change and health-related behaviors. Key actions are proposed with particular consideration for health equity (i.e., between and within-countries, at the intergenerational level, as well as between men and women) of future behavioral interventions. Synergies are also proposed between the field of behavioral medicine, the study of complex systems and planetary health science. Conclusions: We contend that climate change is among the most urgent issue facing all scientists, and should become a central priority for the behavioral medicine community.

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Efficacy of physical activity interventions on psychological outcomes in refugee, asylum seeker and migrant populations: A systematic review and meta-analysis

Cited by 18 publications

References 66 publications

Physical activity, post-traumatic stress disorder, and exposure to torture among asylum seekers in Sweden: a cross-sectional study

Physical activity, post-traumatic stress disorder, and exposure to torture among asylum seekers in Sweden: a cross-sectional study

Moderate-intensity Aerobic Exercise Training as an Adjunct to Trauma-focused Psychotherapy in Traumatized Refugees and Asylum Seekers: Study Protocol of a Randomized Controlled Trial

Thinking health-related behaviors in a climate change context: A narrative review

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