Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trial

Abstract

Regular physical activity is associated with a reduced risk of all-cause mortality, and mortality due to cardiovascular disease and cancer. Among adolescents, physical activity is associated with benefits in the prevention and control of emotional distress, and improvement of self-esteem. Countries in transitional epidemiological scenarios, such as Chile, need to develop effective strategies to improve physical activity as a way to face the epidemic of chronic diseases. The objective of this study was to evaluate the effects of a school-based physical activity program on physical fitness and mental health status of adolescents living in a low socioeconomic status area in Santiago, Chile. A quasi-experimental design was used to evaluate the effects of the program over one academic year. The study included 198 students aged 15 years old. Two ninth grade classes were randomly selected as the intervention group, with two classes of the same grade as controls. A social planning approach was used to develop the intervention. The program was designed and implemented based on student preferences, teachers' expertise and local resources. Changes in physiological and mental health status were assessed. After the intervention, maximum oxygen capacity achieved a significant increase of 8.5% in the intervention versus 1.8% in the control group (p < 0.0001). Speed and jump performance scores improved significantly more in the intervention versus the control group (p > 0.01). Anxiety score decreased 13.7% in the intervention group versus 2.8% in the control group (p < 0.01), and self-esteem score increased 2.3% in the intervention group and decreased 0.1% in the control group after the end of the program (p < 0.0001). No significant change was observed in the depressive score. Student participation and compliance with the program was > 80%. To conclude, a school-based program to improve physical activity in adolescents of low socioeconomic status, obtained a high level of participation and achieved significant benefits in terms of physical fitness and mental health status.

A Systematic Review of Online Youth Mental Health Promotion and Prevention Interventions

“…Such interventions may have great potential in addressing the increased risk of depression, peer relationship problems, post-traumatic stress and conduct problems among AIDS orphans [74][75][76]. There is also some encouraging evidence that interventions which combine lifeskills with reproductive and sexual health education [37,38] and physical health and fitness [36] can have a significant positive effect on pupils' risk-taking and prosocial behaviour. These findings are consistent with the substantive evidence from multiple reviews of school-based interventions in HICs which report the greater effectiveness of multi-component interventions (i.e.…”

“…In addition, the resilience intervention in South Africa also reported long-term findings with improved selfappraisal scores maintained at three months follow up [41]. Additional outcomes from these studies include improved behaviour [35], school adjustment [35], fitness [36], attitudes about reproductive and sexual health [37] and a reduction in the level of substance misuse [37]. The art intervention for AIDS orphan children reported the least positive findings with a significant improvement reported in the intervention groups' self-efficacy score but no change in participants' depression, self-esteem and emotional and behavioural scores [44].…”

“…Regarding the universal lifeskills and resilience schoolbased interventions, all six studies reported significant positive effects on students' mental health and wellbeing in terms of improved self-esteem [35,36,42], motivation [38] and self-efficacy [44]. The peer-group support intervention implemented with AIDS orphan children resulted in significant improvements in participants' depression, anger and anxiety scores but not for self-concept [45].…”

“…The quality of evidence from the majority of studies was strong. A total of eight studies received a strong quality rating [42,45,47,48,50,[54][55][56], five studies received a moderate quality assessment rating as a result of selection bias [36,44] and not reporting the percentage of withdrawals/dropouts [35,38,49]. One study received a weak quality assessment rating due to selection bias, not reporting confounders and not reporting level of withdrawals [41].…”

“…Three interventions were implemented with children in the senior end of primary school (>10 years of age) [45,49,50]. Eight interventions were implemented by the class teacher [35][36][37][38]42,44,49,54,55], with the remaining interventions implemented by mental health professionals [41,48,50], locally trained paraprofessionals [47] and local youth workers [44,56]. The majority of session ranged in length from 11 -16 sessions implemented weekly.…”