louise mansfield, tess kay, catherine meads, lily grigsby ... · alistair john,2 norma daykin,5...

Louise Mansfield, Tess Kay, Catherine Meads, Lily Grigsby-Duffy, Jack Lane, Alistair John, Norma Daykin, Paul Dolan, Stefano Testoni, Guy Julier, Annette Payne, Alan Tomlinson and Christina Victor

Sport and dance interventions for healthy young people (15–24 years) to promote subjective well-being: a systematic review Article (Published version) (Refereed)

Original citation: Mansfield, Louise and Kay, Tess and Meads, Catherine and Grigsby-Duffy, Lily and Lane, Jack and John, Alistair and Daykin, Norma and Dolan, Paul and Testoni, Stefano and Julier, Guy and Payne, Annette and Tomlinson, Alan and Victor, Christina (2018) Sport and dance interventions for healthy young people (15–24 years) to promote subjective well-being: a systematic review. BMJ Open, 8 (7). e020959. ISSN 2044-6055 DOI: 10.1136/bmjopen-2017-020959 © 2018 the Author(s) CC BY 4.0 This version available at: http://eprints.lse.ac.uk/89711/ Available in LSE Research Online: August 2018 LSE has developed LSE Research Online so that users may access research output of the School. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LSE Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain. You may freely distribute the URL (http://eprints.lse.ac.uk) of the LSE Research Online website.

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1Mansfield L, et al. BMJ Open 2018;8:e020959. doi:10.1136/bmjopen-2017-020959

Open access

Sport and dance interventions for healthy young people (15–24 years) to promote subjective well-being: a systematic review

Louise Mansfield,1 Tess Kay,2 Catherine Meads,3 Lily Grigsby-Duffy,2 Jack Lane,4 Alistair John,2 Norma Daykin,5 Paul Dolan,6 Stefano Testoni,6 Guy Julier,4 Annette Payne,2 Alan Tomlinson,4 Christina Victor7

To cite: Mansfield L, Kay T, Meads C, et al. Sport and dance interventions for healthy young people (15–24 years) to promote subjective well-being: a systematic review. BMJ Open 2018;8:e020959. doi:10.1136/bmjopen-2017-020959

► Prepublication history and additional material for this paper are available online. To view these files, please visit the journal online (http:// dx. doi. org/ 10. 1136/ bmjopen- 2017- 020959).

Received 6 December 2017Revised 26 March 2018Accepted 11 May 2018

1Department of Life Sciences, Division of Sport Health and Exercise Sciences, Brunel University London, Uxbridge, UK2Life Sciences, Brunel University London, Uxbridge, UK3Health, Social Care and Education, Anglia Ruskin University, Cambridge, UK4Arts and Humanities, University of Brighton, Brighton, UK5Health and Wellbeing, University of Winchester, Winchester, UK6Social Policy, The London School of Economics and Political Science, London, UK7Clinical Sciences, Brunel University London, Uxbridge, UK

Correspondence toProfessor Louise Mansfield; louise. mansfield@ brunel. ac. uk

Research

AbstrACtObjective To review and assess effectiveness of sport and dance participation on subjective well-being outcomes among healthy young people aged 15–24 years.Design Systematic review.Methods We searched for studies published in any language between January 2006 and September 2016 on PsychINFO, Ovid MEDLINE, Eric, Web of Science (Arts and Humanities Citation Index, Social Science and Science Citation Index), Scopus, PILOTS, CINAHL, SPORTDiscus and International Index to Performing Arts. Additionally, we searched for unpublished (grey) literature via an online call for evidence, expert contribution, searches of key organisation websites and the British Library EThOS database, and a keyword Google search. Published studies of sport or dance interventions for healthy young people aged 15–24 years where subjective well-being was measured were included. Studies were excluded if participants were paid professionals or elite athletes, or if the intervention was clinical sport/dance therapy. Two researchers extracted data and assessed strength and quality of evidence using criteria in the What Works Centre for Wellbeing methods guide and GRADE, and using standardised reporting forms. Due to clinical heterogeneity between studies, meta-analysis was not appropriate. Grey literature in the form of final evaluation reports on empirical data relating to sport or dance interventions were included.results Eleven out of 6587 articles were included (7 randomised controlled trials and 1 cohort study, and 3 unpublished grey evaluation reports). Published literature suggests meditative physical activity (yoga and Baduanjin Qigong) and group-based or peer-supported sport and dance has some potential to improve subjective well-being. Grey literature suggests sport and dance improve subjective well-being but identify negative feelings of competency and capability. The amount and quality of published evidence on sport and dance interventions to enhance subjective well-being is low.Conclusions Meditative activities, group and peer-supported sport and dance may promote subjective well-being enhancement in youth. Evidence is limited. Better designed studies are needed.trial registration number CRD42016048745; Results.

IntrODuCtIOnGovernments and international organisa-tions acknowledge subjective well-being (SWB) as a policy goal.1–3 The international focus on measuring SWB is gaining recogni-tion in some aspects of UK sport,4 5 dance6 and physical activity policy.7 SWB describes well-being in terms of the good and bad feel-ings arising from what people do and how they think.8 Good feelings include happi-ness, joy, contentment and excitement while sadness, worry, stress and anxiety are exam-ples of more negative feelings. People’s experiences also involve a sense of purpose (eg, worthwhileness, meaningfulness) and pointlessness (eg, futility, boredom). Since 2011, SWB measured as satisfaction with life, worthwhileness, happiness and anxiety has been included in UK population surveys conducted by the Office of National Statistics.9 Links between sports and cultural activities

strengths and limitations of this study

► Prepublication of our protocol on the International Prospective Register of Systematic Reviews ensures methodological transparency and mitigates against potential post hoc decision making.

► A comprehensive research, policy and practice-rele-vant search strategy was used including searches of published and unpublished data, and study selection was carried out by two reviewers independently.

► Data extraction and quality assessments were con-ducted using standardised forms, independently by two reviewers.

► The focus on a specific target age group may have excluded evidence from studies that have aggregat-ed data across younger and older age groups in their analysis.

► Meta-analysis was not possible due to the heteroge-neity of study interventions and outcomes.

on 6 August 2018 by guest. P

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2 Mansfield L, et al. BMJ Open 2018;8:e020959. doi:10.1136/bmjopen-2017-020959

Open access

and SWB have been reported and sport engagement is included in national-level data collection and analysis.10 Significant associations have been found between engage-ment in sport, the arts and enhanced SWB as measured by life satisfaction.11 Yet, it is acknowledged that SWB is a complex concept, with no single agreed definition or measure.12 The term SWB is used synonymously with a wide range of concepts including self-esteem, self-effi-cacy, self-determination, resilience, quality of life, mood enhancement, positive mental health, life satisfaction, worthwhileness and happiness.13 Measures of SWB use various scales that demonstrate well-being as multidimen-sional, for example, The Warwick and Edinburgh Mental Wellbeing Scale,14 Rosenberg’s Self-Esteem Scale and15 The Profile of Mood States.16

The What Works Centre for Well-being initiative,17 funded by the Economic and Social Research Council has commissioned evidence reviews in key areas including Culture, Sport and Well-being. Following consultation with stakeholders,18 four topics were identified for system-atic review between 2015 and 2018 (music and singing, sport and dance, visual arts, and outdoor nature-based physical activity). This paper reports the findings of the second systematic review topic; sport and dance interven-tions for healthy young people (15–24 years) to promote subjective well-being.

The established definition of sport, used throughout the sector, remains that cited from the European Charter (1992) and refers to forms of physical activity either casually or formally organised in which people take part for fitness, health and well-being, social relationships or competition.19 Sport includes a wide range of indi-vidual and group activities including jogging, running, cycling, martial arts, yoga, team games and athletics. Dance is commonly defined differently from sport as a performing art form which refers to the rhythmic move-ments and sequences of steps usually set to music.20 Sport and dance programmes in the UK operate in different delivery, programming and funding environments, yet both sport and dance organisations identify young people as a key target group for engagement in physical activity to enhance well-being. The evidence, however, is theoret-ically and methodologically diverse and less attention has been given to children and adolescents. Existing evidence reviews on sport have tended to focus on physical rather than mental health or well-being outcomes21–23 or they have examined the effect of exercise in populations with specific mental health conditions such as depression24 and anxiety.25 26 Dance-related reviews of evidence have examined the effectiveness of dance therapy on psycho-logical and physical health and well-being outcomes in patients with cancer,27 for schizophrenia28 and on depression.29 A review of reviews on physical activity and mental health in children and adolescents identified an association between physical activity and positive well-being outcomes connected to reduced depression and anxiety, and enhanced self-esteem and cognitive func-tion.30 No systematic review to date has focused on sport

and dance interventions in healthy young people (15–24 years) to promote subjective well-being. Interventions that positively influence the well-being of young people have the potential to promote good physical and mental health.31–33 This review provides evidence that may improve understanding of the effects of sport and dance on a range of SWB measures and contribute to informing policy development, programme delivery and measure-ment and evaluation of sport and dance interventions to enhance well-being.

MethODsThe protocol for this systematic review was registered with the International Prospective Register of System-atic Reviews on 3 October 2016 (registration number CRD42016048745). The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Anal-ysis guidelines.34

Patient and public involvementParticipant observation by one investigator (LM) of public groups taking part in community arts and sports activities contributed to the development of the review question for this study. Patients were not involved in the conduct of the systematic review. The findings of this study will be written in accessible English and disseminated through the What Works Centre for Wellbeing website accessible by the public.

Inclusion criteriaInclusion criteria were any comparative studies investi-gating any form of sport or dance compared with no sport or dance, usual routine or comparing pretest and post-test scores in healthy young people aged 15–24 years and measuring any form of subjective well-being (table 1). We included studies worldwide from countries economically similar to the UK (using OECD–DAC list of country devel-opment; http://www. oecd. org/ dac/ stats/ daclist. htm) or with study populations similar in terms of socioeconomic status. Studies could be fully published with search dates of 2006–2016 to reflect current and long-term work on sport, dance and well-being,or grey literature (with search dates of 2013–2016). Shorter timescales for grey literature search ensured a focus on finding recent rele-vant studies that had not yet been published. Grey liter-ature was included if it was a final evaluation or report on empirical data, had the evaluation of sport-related or dance interventions as the central objective and included details of authors (individuals, groups or organisations).

exclusion criteriaPublished studies were excluded if participants were paid professionals or elite athletes, or if the intervention was sport or dance therapy delivered in a clinical setting for rehabilitation purposes. We did not include studies of walking as there is existing review level evidence on the health and well-being benefits of this activity.35 36 Grey



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literature was excluded if it did not meet the criteria for inclusion on date, format of reporting, type of data and details of authorship. Eligibility criteria are summarised in table 1.

Data sources and search strategyWe searched for empirical studies published between January 2006 and September 2016 on the following data-bases: PsychINFO, Ovid MEDLINE, Eric, Web of Science (Arts and Humanities Citation Index, Social Science and Science Citation Index), Scopus, PILOTS, CINAHL, SPORTDiscus and International Index to Performing Arts. There were no language restrictions.

Electronic databases were searched using a combina-tion of Medical Subject Headings (MeSH) and free text terms. An example of the Ovid MEDLINE search strategy used can be found in online supplementary appendix 1. All database searches were based on this strategy but were appropriately revised to suit each database.

Additionally, reference lists of all relevant reviews37–42 from the last 5 years were hand-searched to identify addi-tional relevant empirical evidence. We also carried out a search for up-to-date UK unpublished (grey) literature completed between 2013 and 2016 via: (i) an online call for evidence on the What Works Centre for Wellbeing

website between October and November 2016; (ii) contacting known experts in the field for recommenda-tions of sport or dance sector reviews or repositories to search; (iii) a review of key sector websites; (iv) a search of the British Library EThOS website for unpublished PhD dissertations and (v) reviewing the titles of the first 100 results in a Google search with the use of key terms (‘sport’ AND ‘physical activity’ AND ‘dance’ AND ‘wellbeing’ AND ‘young people’). ‘Physical activity’ was included as a search term because it is used by the sector when reporting on sport and dance activities.

study selectionTwo reviewers independently screened the titles and abstracts of all studies identified by the search strategy for their eligibility. Where it was not clear from the title and abstract whether a study was relevant, the selection criteria were independently applied to the full article to confirm its eligibility. Where two independent reviewers did not agree in their primary judgements they discussed the conflict and attempted to reach a consensus. If they could not agree then a third member of the review team considered the full paper and a majority decision was made. Online supplementary appendix 2 lists excluded studies and reasons for exclusions.

Table 1 Eligibility criteria for selecting studies

PICOS criteria Inclusion Exclusion

Participants ► Participants were to be 15–24 years of age. ► Studies from countries economically similar to the UK (ie, other high-income countries with similar economic systems) or with study populations that have similar socioeconomic status to the UK.

► Participants with a health condition diagnosed by a health professional.

► Participants who were paid professionals or elite athletes.

► Participants in clinically based sport and dance interventions.

Intervention ► Participatory sport and dance interventions including watching and performing.

► Including sport-related and dance therapy offered to enhance well-being in healthy young people.

► Clinical sport-based or dance therapy.

► Sport and dance for clinical procedures such as surgery, medical tests and diagnostics.

► Walking.

Comparison ► No sport or dance, usual routine, ie, inactive comparator or historical/time-based comparator, ie, pre-post study design.

Outcomes ► Subjective well-being using any recognised method or measure.

Study design ► Empirical research: either quantitative, qualitative or mixed methods, outcomes or process evaluations.

► Grey literature: if it was a final evaluation or report on empirical data, had the evaluation of sport-related or dance interventions as the central objective and included details of authors (individuals, groups or organisations).

► Published studies published between 2006 and 2016.

► Grey literature and practice surveys published between 2013 and 2016.

► Discussion articles, commentaries or opinion pieces not presenting empirical or theoretical research.

► Grey literature if it did not have details of authorship.

PCOS, Population Intervention Comparator Outcome Study Design.



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Data extractionTwo review authors independently extracted data using a standardised form (online supplementary appendix 3). Discrepancies were resolved by discussion and consensus. Where agreement could not be reached, a third review author considered the paper and a majority decision was reached. The following data were extracted: (1) evaluation design and objectives (the interventions studied and control conditions used, including detail where available on the intervention content, dose and adherence, ethics); (2) sample (size, representativeness, reporting on dropout, attrition and details of participants including demographics and protected characteristics where reported); (3) the outcome measures (the scales used and the collection time-points, independence, validity, reliability, appropriateness to well-being impact questions); (4) analysis (assessment of methodological quality/limitations); (5) results and conclusions; (6) the presence of possible conflicts of interest for authors. In order to capture project details in the grey literature, we used an adapted version of the Public Health England Arts and Health Evaluation Framework43 and extracted project aims; costs; commissioners, partners and funding sources; intervention details; population and reported outcomes. Where available, evaluation details (aims, objectives, budget, procedures, timeline, data analysis and findings) were also extracted.

Our protocol included for us to contact the authors of articles if the required information could not be extracted and was essential for the interpretation of their results but we did not need to do this.

Quality assessmentTo assess the methodological quality of the included published studies, two review authors independently applied the quality checklist for quantitative studies based on the Early Intervention Foundation checklist and detailed in the What Works Centre for Wellbeing methods guide44 (online supplementary appendix 4). The checklist was used to indicate if a specific study had been well designed, appropriately carried out and prop-erly analysed. A summary of quality scores is presented in table 2.

We then employed the Grading of Recommendations Assessment, Development and Evaluation working group methodology (GRADE) schema for judging strength and quality of evidence on well-being overall from sport and dance interventions. Four categories of evidence are used in GRADE; high, moderate, low or very low. Applying GRADE, randomised controlled trial (RCT) studies were initially judged as high quality and sound observational studies as low quality. Evidence was downgraded for methodological limitations, inconsistent findings, sparse data, indirect evidence and reporting bias. Evidence was graded upwards if there was a large magnitude of effect or a dose-response gradient. The PHE Arts for Health and Wellbeing Evaluation Framework43 was used to judge the quality of the grey literature in terms of the

appropriateness of the evaluation design, the rigour of the data collection and analysis and precision of reporting.

Data synthesisDue to heterogeneity of interventions and well-being outcomes between studies, a meta-analysis was not appro-priate. We report the findings narratively. Summaries of the characteristics of the included studies were organ-ised in a tabular form (table 3) and present informa-tion on the participants (number and characteristics), intervention and comparison conditions, outcomes and measure used, study design, conclusions and study limita-tions. Summaries of the results (number of participants, mean scores and SD) for each outcome measure at each measurement point, are presented in table 4 and synthe-sised in the text according to sport/dance intervention type and well-being outcomes. No studies reported CIs and so these have not been included.

resultssearch resultsAfter the removal of duplicates, the electronic searches returned 5597 records for title and abstract screening. Of these, 143 relevant articles remained for full-text assess-ment as well as 60 additional texts identified through other sources (6 through hand searching the reference lists of included reviews and 54 grey literature submissions were found: 12 received through the call for evidence, 33 via the extended search for grey literature and 9 PhDs found on Ethos). After screening the 203 full texts, 11 studies were included in the systematic review. The search screening process is illustrated in figure 1.

study characteristicsThe systematic review includes seven RCTs45–51 (with a total of 884 participants) and one cohort study52 (93 participants) from the published literature. Three eval-uation reports were included from the grey literature. A summary of the characteristics of the included papers is presented in table 3. Table 4 provides a summary of the numerical results for each published study.

The included studies investigated the effects of a range of sport and dance interventions; the most common form of intervention reported were based on meditative prac-tices including yoga46 50 and Baduanjin Qigong.48 Other interventions reported included body conditioning, aerobic exercise,47 dance forms delivered through dance training,45 hip-hop dance,47 an empowerment-based exercise intervention programme49 and specifically identified sports including, body conditioning, and ice skating47 and Nintendo Wii Active Games.51 Descriptions of interventions tended to be brief. All studies identi-fied the frequency and type of intervention activity, the duration and content of activity sessions, the delivery site and the number of times per week participants took part. All differed in these characteristics as detailed in table 3. Interventions in six of the RCT studies45–51 and



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Tab

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Tab

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ames

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ort

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ple

bia

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este

rn U

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sp

ort.

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fem

ales

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tly C

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tDid

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ass

ess

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extu

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ctor

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oach

ing

beh

avio

ur

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ojia

et

al46

Ind

ian=

50G

end

er: f

emal

eA

ge: 1

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yea

rsE

thni

city

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stud

y co

nduc

ted

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he

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artm

ent

of P

hysi

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y H

ard

inge

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ical

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olle

ge a

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mt.

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ripla

ni H

osp

ital,

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hi,

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ia

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in 6

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eek

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atio

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ree

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stru

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omp

aris

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o in

terv

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n

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er (1

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gnifi

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jopen.bmj.com

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Pub

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hang

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ocia

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riers

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elf-

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stio

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rt o

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mal

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ple

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igh

dro

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te

Nog

gle

et a

l50

US

An=

51G

end

er: 6

1% fe

mal

e in

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a gr

oup

, 47%

fem

ale

in c

ontr

olA

ge: a

vera

ge a

ge 1

7 ye

ars

(gra

des

11

and

12)

Eth

nici

ty: 9

2.2%

whi

te, 3

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fric

an-

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hild

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ositi

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sych

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vent

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esili

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ould

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eing

in a

sch

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ettin

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qui

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cla

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om le

vel

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erat

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tend

ance

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yoga

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An=

54G

end

er: 5

5.6%

fem

ale

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: 15–

19 y

ears

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nici

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fric

an-A

mer

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AI:

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wei

ght

and

ob

ese

stud

ents

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an

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gh s

choo

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rgam

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nter

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cour

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pla

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e N

inte

ndo

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ive

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orke

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ith a

pee

r to

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end

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orie

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d e

arn

poi

nts

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ther

; com

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itive

EG

par

ticip

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gram

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cale

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ceQ

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wat

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R

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com

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rgan

isat

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p

artic

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ance

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st 2

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easu

re t

he s

ucce

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st

2014

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5 ag

ains

t th

e p

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s an

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obje

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15 d

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ntat

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sson

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r ef

fect

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pra

ctic

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r fu

ture

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pro

ject

s d

eliv

ered

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ldre

n &

the

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litat

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inte

rvie

ws,

ob

serv

atio

ns a

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hoto

grap

hs

thro

ugho

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s on

the

pos

itive

wel

l-b

eing

ou

tcom

es

►Fa

ce v

alue

rep

ortin

g us

ed

Tab

le 3

C

ontin

ued

Con

tinue

d



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MJ O


ownloaded from



Open access

in the cohort study52 involved delivery by qualified sport or dance instructors in formal group sessions. One RCT used the Nintendo Wii Active Games Programme incorpo-rating a cooperative or competitive peer-to-peer method of participation.51 A wide range of well-being measures were used and are summarised in online supplementary appendix 5.

Projects reported in the grey literature included the following interventions: martial arts, dance, gym-based exercise, exercise classes, swimming, netball, cycling and football,53 circus-based skills (eg, juggling, balancing, diabolo)54 and a range of dance forms.55 Interventions were led by instructors in group settings. Well-being was evaluated using descriptive statistics and/or thematic analysis from surveys, focus groups, interviews and struc-tured observations.

All of the included studies were carried out in countries categorised in the same group as the UK in the OECD Development Assistance Committee (DAC) categories apart from two (one took place in India,46 and the other was based in Korea47). The sample participants in these two studies were university students, whose educational status indicates their relatively high socioeconomic status, making them broadly comparable with the categorisation of the DAC group in which the UK is located.

study qualityThe scores for the included studies from the What Works Centre for Wellbeing quality checklist for quantitative data are presented in table 2. The most frequent meth-odological weaknesses within the studies (with four or fewer studies meeting the criteria) were the absence of an intent-to-treat design, not having a clear process for determining and reporting dropout and dose, not having an appropriate method for the treatment of missing data, not controlling for confounding factors, not being able to blind participants or measurements and not including assessment information independent of the participants. Common (all studies meeting the criteria) strengths included using appropriate measures, independent of treatment measures, giving measures before and after the intervention/control and using appropriate methods to analyse the data. The results of the quality checklist varied across studies, with Amorose et al52 52 scoring the worst (9 criteria met) and Li et al48 48 scoring the highest (21 criteria met).

The use of the GRADE schema for judging quality of evidence means that despite the predominance of RCT designs, overall the quality of the published evidence on sport and dance interventions to enhance well-being is low in respect of there being very little evidence in total, methodological limitations noted above, small sample sizes in studies and some sample bias.

Using the PHE Arts for Health and Wellbeing Evalu-ation Framework, the evidence from the grey literature were judged to have a high degree of credibility. The strongest reports included descriptive and theoretical detail about evaluation methods and acknowledged the G

rey

liter

atur

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pro

gram

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hat

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ticip

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nce

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hem

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hat

diff

eren

ce d

id p

artic

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ing

mak

e?

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litat

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sem

i-st

ruct

ured

in

terv

iew

s w

ith p

artic

ipan

ts a

nd

volu

ntee

rs

►

Focu

s on

the

pos

itive

wel

l-b

eing

ou

tcom

es

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ce v

alue

rep

ortin

g us

ed

Man

sfiel

d e

t al

53

UK

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ulat

ion

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et: i

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ive

peo

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por

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t in

co

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unity

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ing

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, pila

tes,

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ing,

net

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l, fo

otb

all,

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ted

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abili

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eekl

y 1

hour

ses

sion

s,

12-m

onth

del

iver

y p

hase

Con

duc

t a

long

itud

inal

pro

cess

eva

luat

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exam

inin

g th

e ke

y in

gred

ient

s of

suc

cess

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AS

E

com

mun

ity p

rogr

amm

es a

nd id

entif

y ch

alle

nges

in

des

igni

ng, d

eliv

erin

g an

d e

valu

atin

g th

e H

AS

E

pro

ject

s

Qua

litat

ive—

focu

s gr

oup

s,

stru

ctur

ed o

bse

rvat

ions

, in-

dep

th in

terv

iew

met

hod

s

►

Att

emp

ted

to

sear

ch fo

r d

isco

nfirm

ing

case

s an

d c

onsi

der

th

e ne

gativ

e w

ell-

bei

ng im

pac

t of

sp

ort

par

ticip

atio

n

AI,

add

ition

al in

form

atio

n; n

, num

ber

of p

artic

ipan

ts; N

R, n

ot r

epor

ted

; M, m

ean;

RC

T, r

and

omis

ed c

ontr

olle

d t

rial.

Tab

le 3

C

ontin

ued



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Open access

Tab

le 4

S

umm

ary

of n

umer

ical

res

ults

of i

nclu

ded

stu

die

s

Aut

hors

Out

com

e (m

easu

re)

Bas

elin

eFo

llow

-up

1Fo

llow

-up

2

Inte

rven

tio

nN

umb

ers

Mea

n (S

D)

Co

ntro

l num

ber

sM

ean

(SD

)

Inte

rven

tio

nN

umb

ers

Mea

n (S

D)

Co

ntro

lN

umb

ers

Mea

n (S

D)

Inte

rven

tio

nN

umb

ers

Mea

n (S

D)

Co

ntro

lN

umb

ers

Mea

n (S

D)

Aka

nder

e an

d D

emir4

5D

epre

ssio

n(B

eck

Dep

ress

ion

Sca

le)

n=60

15.7

2 (7

.004

)n=

6016

.53

(5.9

22)

n=60

13.9

0 (5

.568

)*†

n=60

17.4

8 (7

.740

)N

/AN

/A

Am

oros

e et

al5

2N

eed

sat

isfa

ctio

n; s

por

t co

mp

eten

ce, n

eed

for

auto

nom

y, n

eed

for

rela

ted

enes

s

n=93

Sp

ort

com

pet

ence

: 5.7

1 (0

.84)

Nee

d fo

r au

tono

my:

3.7

9 (0

.79)

Nee

d fo

r re

late

dne

ss: 5

.47

(1.1

5)

n=93

Sp

ort

com

pet

ence

: 5.5

0 (1

.07)

Nee

d fo

r au

tono

my:

3.7

6 (0

.59)

Nee

d fo

r re

late

dne

ss: 5

.50

(1.2

1)

N/A

N/A

Sel

f-es

teem

(10-

item

R

osen

ber

g’s

Sel

f-es

teem

S

cale

)

n=93

3.21

(0.4

5)n=

933.

21 (0

.47)

Bur

nout

(15-

item

Ath

lete

B

urno

ut Q

uest

ionn

aire

)n=

932.

05 (0

.71)

n=93

2.15

(0.6

4)

Kan

ojia

et

al46

Ang

er (1

6-ite

m

que

stio

nnai

re)

n=25

Pos

tmen

stru

al p

hase

: in

itial

cyc

le 8

.84

(4.0

1)P

rem

enst

rual

pha

se:

initi

al c

ycle

15.

0 (5

.92)

‡

n=25

Pos

tmen

stru

al p

hase

: in

itial

cyc

le 9

.12

(4.4

1)P

rem

enst

rual

pha

se:

initi

al c

ycle

14.

32 (5

.24)

‡

n=N

RP

ostm

enst

rual

seco

nd c

ycle

7.7

6 (3

.53)

§P

rem

enst

rual

sec

ond

cy

cle

9.52

(4.7

0)§‡

n=N

RP

ostm

enst

rual

seco

nd c

ycle

9.0

4 (4

.33)

Pre

men

stru

al s

econ

d

cycl

e 14

.28

(4.8

9)‡

n=N

RP

ostm

enst

rual

third

cyc

le 7

.92

(4.2

9)P

rem

enst

rual

thi

rd c

ycle

8.

52 (4

.15)

§¶

n=N

RP

ostm

enst

rual

third

cyc

le 8

.96

(4.6

5)P

rem

enst

rual

thi

rd c

ycle

13

.12

(4.8

3)‡

Trai

t an

xiet

y (4

0-ite

m

que

stio

nnai

re)

n=25

Pos

tmen

stru

al p

hase

: in

itial

cyc

le 4

0.64

(6.2

2)P

rem

enst

rual

pha

se:

initi

al c

ycle

46.

96 (5

.87)

‡

n=25

Pos

tmen

stru

al p

hase

: in

itial

cyc

le 4

1.6

(5.4

9)P

rem

enst

rual

pha

se:

initi

al c

ycle

46.

76 (5

.33)

‡

n=N

RP

ostm

enst

rual

seco

nd c

ycle

39.

40 (6

.69)

Pre

men

stru

alse

cond

cyc

le 4

1.48

(5

.77)

§‡

n=N

RP

ostm

enst

rual

seco

nd c

ycle

40.

24 (6

.97)

Pre

men

stru

al s

econ

d

cycl

e 45

.80

(6.4

1)‡

n=N

RP

ostm

enst

rual

third

cyc

le 3

7.24

(9.1

4)§¶

Pre

men

stru

alth

ird c

ycle

40.

80 (5

.75)

§¶

n=N

RP

ostm

enst

rual

third

cyc

le 3

8.64

(12.

76)

Pre

men

stru

al t

hird

cyc

le

43.8

8 (7

.06)

Dep

ress

ion

(10-

item

que

stio

nnai

re)

n=25

Pos

tmen

stru

al p

hase

: in

itial

cyc

le 6

.84

(3.1

0)P

rem

enst

rual

pha

se:

initi

al c

ycle

10.

72 (4

.19)

‡

n=25

Pos

tmen

stru

al p

hase

: in

itial

cyc

le 6

.36

(4.1

3),

Pre

men

stru

al p

hase

: in

itial

cyc

le 9

.72

(3.8

9)‡

n=N

RP

ostm

enst

rual

seco

nd c

ycle

3.9

6 (2

.59)

§P

rem

enst

rual

seco

nd c

ycle

5.9

2 (3

.76)

§‡

n=N

RP

ostm

enst

rual

seco

nd c

ycle

6.2

4 (4

.98)

Pre

men

stru

al s

econ

d

cycl

e 9.

56 (3

.22)

‡

n=N

RP

ostm

enst

rual

third

cyc

le 3

.12

(2.7

1)§¶

Pre

men

stru

alth

ird c

ycle

4.7

6 (2

.82)

§¶‡

n=N

RP

ostm

enst

rual

third

cyc

le 6

.07

(2.8

1)P

rem

enst

rual

third

cyc

le 9

.36

(2.9

6)‡

Sub

ject

ive

wel

l-b

eing

(50-

item

que

stio

nnai

re)

n=25

Pos

tmen

stru

al p

hase

: in

itial

cyc

le 4

1.72

(16.

05)

Pre

men

stru

al p

hase

: in

itial

cyc

le 5

3.92

(20.

35)‡

n=25

Pos

tmen

stru

al p

hase

: in

itial

cyc

le 4

5.6

(14.

05)

Pre

men

stru

al p

hase

: in

itial

cyc

le 5

1.04

(14.

89)

n=N

RP

ostm

enst

rual

seco

nd c

ycle

39.

64

(16.

07)§

Pre

men

stru

al s

econ

d

cycl

e 44

.48

(17.

87)§

‡

n=N

RP

ostm

enst

rual

seco

nd c

ycle

44.

68 (1

6.5)

Pre

men

stru

al s

econ

d

cycl

e 50

.40

(18.

67)

n=N

RP

ostm

enst

rual

third

cyc

le 3

7.20

(1

5.17

)§¶

Pre

men

stru

al t

hird

cyc

le

40.2

4 (1

6.22

)§¶

n=N

RP

ostm

enst

rual

third

cyc

le 4

3.96

(14.

01)

Pre

men

stru

al t

hird

cyc

le

49.7

6 (1

7.02

)‡ Con

tinue

d



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Aut

hors

Out

com

e (m

easu

re)

Bas

elin

eFo

llow

-up

1Fo

llow

-up

2

Inte

rven

tio

nN

umb

ers

Mea

n (S

D)

Co

ntro

l num

ber

sM

ean

(SD

)

Inte

rven

tio

nN

umb

ers

Mea

n (S

D)

Co

ntro

lN

umb

ers

Mea

n (S

D)

Inte

rven

tio

nN

umb

ers

Mea

n (S

D)

Co

ntro

lN

umb

ers

Mea

n (S

D)

Kim

and

Kim

47P

ositi

ve w

ell-

bei

ng(S

ubje

ctiv

e E

xerc

ise

Exp

erie

nces

Sca

le)

Ice

skat

ing

(n=

84):

19 (3

.9)

Hip

-hop

dan

ce (n

=45

): 16

.3 (4

.2)

Bod

y co

nditi

onin

g (n

=64

): 15

.3 (2

.9)

Aer

obic

dan

ce (n

=84

): 16

.8 (4

.0)

Ice

skat

ing

(n=

84):

20.4

(3.4

)H

ip-h

op d

ance

(n=

45):

19.7

(3.4

)*B

ody

cond

ition

ing

(n=

64):

18 (2

.8)

Aer

obic

dan

ce (n

=84

): 19

.9 (3

.9)*

N/A

N

/A

Psy

chol

ogic

al d

istr

ess

(Sub

ject

ive

Exe

rcis

eE

xper

ienc

esS

cale

)

Ice

skat

ing:

8.3

(3.9

)H

ip-h

op d

ance

: 9.8

(4.6

)B

ody

cond

ition

ing:

10.

7 (4

.1)

Aer

obic

dan

ce: 9

.4 (4

.2)

Ice

skat

ing:

8.1

(3.9

)H

ip-h

op d

ance

: 7.3

(4.2

)*B

ody

cond

ition

ing:

9.6

(3.2

)A

erob

ic d

ance

: 6.7

(2.9

)*

N/A

N

/A

Fatig

ue(S

ubje

ctiv

eE

xerc

ise

Exp

erie

nces

Sca

le)

Ice

skat

ing:

10.

9 (5

.4)

Hip

-hop

dan

ce: 1

6.2

(4.4

)B

ody

cond

ition

ing:

15.

9 (4

.4)

Aer

obic

dan

ce: 1

4.4

(5.0

)

Ice

skat

ing:

13.

9 (5

.3)

Hip

-hop

dan

ce: 1

2.9

(4.7

)*B

ody

cond

ition

ing:

13.

9 (4

.1)

Aer

obic

dan

ce: 1

1.2

(4.3

)*

N/A

N

/A

Li e

t al

48S

elf-

este

em(S

elf-

este

em S

cale

)n=

101

31.1

7 (3

.69)

n=10

531

.41

(3.2

9)n=

96 (1

01 in

clud

ed in

ITT

anal

ysis

)31

.56

(3.3

0)

n=10

5 (1

05 in

clud

ed in

IT

T an

alys

is) 3

1.31

(3.2

7)n=

93 (I

TT a

naly

sis)

30.8

1 (3

.45)

n=10

1 (IT

T an

alys

is)

31.0

(3.7

1)

Moo

d/m

ind

fuln

ess

(Pro

file

of M

ood

Sta

tes

(PO

MS

) sca

le)

n=10

110

2.3

(16.

14)

n=10

510

3.5

(17.

34)

n=96

(101

incl

uded

in IT

T an

alys

is)

106

(15.

68)

n=10

5 (1

05 in

clud

ed in

IT

T an

alys

is) 1

07.4

(17.

95)

n=93

(ITT

ana

lysi

s)10

3.8

(16.

78)

n=10

1 (IT

T an

alys

is)

104.

6 (1

6.89

)

QoL

(WH

OQ

OL-

BR

EF)

n=10

155

.84

(6.6

5)n=

105

54.9

4 (6

.45)

n=96

(101

incl

uded

in IT

T an

alys

is)

55.0

9 (6

.93)

n=10

5 (1

05 in

clud

ed in

IT

T an

alys

is) 5

4.26

(7.0

2)n=

93 (I

TT a

naly

sis)

56.2

9 (7

.45)

n=10

1 (IT

T an

alys

is)

55.6

1 (7

.45)

Att

entio

n (S

chul

te G

rid)

n=10

121

3.9

(58.

84)

n=10

522

4.6

(47.

52)

n=96

(101

incl

uded

in IT

T an

alys

is)

192.

4 (4

7.14

)

n=10

5 (1

05 in

clud

ed in

IT

T an

alys

is)

210.

4 (5

4.15

)†

n=93

(ITT

ana

lysi

s)19

3.9

(54.

31)

n=10

1 (IT

T an

alys

is)

202.

8 (5

8.34

)

Str

ess

(Chi

nese

Per

ceiv

ed

Str

ess

Sca

le)

n=10

124

.22

(5.1

8)n=

105

23.9

1 (5

.50)

n=96

(101

incl

uded

in IT

T an

alys

is)

23.5

3 (5

.40)

n=10

5 (1

05 in

clud

ed in

IT

T an

alys

is)

22.6

0 (5

.43)

n=93

(ITT

ana

lysi

s)22

.72

(5.7

2)n=

101

(ITT

anal

ysis

)23

.22

(5.7

2)

Sel

f-sy

mp

tom

inte

nsity

(S

CL-

90 s

cale

)n=

101

142.

9 (3

3.58

)n=

105

142.

1 (3

2.77

)n=

96 (1

01 in

clud

ed in

ITT

anal

ysis

)13

5.6

(31.

3)

n=10

5 (1

05 in

clud

ed in

IT

T an

alys

is)

136.

2 (3

2.4)

n=93

(ITT

ana

lysi

s)13

0.6

(34.

83)

n=10

1 (IT

T an

alys

is)

130.

4 (3

1.94

)

Lind

gren

et

al49

Gen

eral

sel

f-ef

ficac

y (G

ener

al S

elf-

effic

acy

Sca

le)

n=55

Med

ian

(IQR

)32

.0 (1

1.0–

54.0

)

n=53

Med

ian

(IQR

)32

.0 (1

4.0–

47.0

)

n=27

Med

ian

(IQR

)28

.0 (1

5.0–

48.0

)*†

n=36

Med

ian

(IQR

)35

.0 (1

6.0–

48.0

0)

N/A

N

/A

Sp

ecifi

c se

lf-ef

ficac

y (S

ocia

l Bar

riers

to

Exe

rcis

e S

elf-

effic

acy

Que

stio

nnai

re)

n=56

Med

ian

(IQR

)S

upp

ort:

9.0

(3.0

–18.

0)S

ocia

l: 22

.0 (7

.0–3

5.0)

n=54

Med

ian

(IQR

)S

upp

ort:

8.0

(3.0

–16.

0)S

ocia

l: 18

.5 (7

.0–3

7.0)

n=27

Med

ian

(IQR

)S

upp

ort:

8.0

(3.0

–17.

0)S

ocia

l: 19

.0 (7

.0–3

6.0)

n=36

Med

ian

(IQR

)S

upp

ort:

7.0

(3.0

–18.

0)S

ocia

l: 19

.0 (8

.0–3

1.0)

Tab

le 4

C

ontin

ued

Con

tinue

d



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Aut

hors

Out

com

e (m

easu

re)

Bas

elin

eFo

llow

-up

1Fo

llow

-up

2

Inte

rven

tio

nN

umb

ers

Mea

n (S

D)

Co

ntro

l num

ber

sM

ean

(SD

)

Inte

rven

tio

nN

umb

ers

Mea

n (S

D)

Co

ntro

lN

umb

ers

Mea

n (S

D)

Inte

rven

tio

nN

umb

ers

Mea

n (S

D)

Co

ntro

lN

umb

ers

Mea

n (S

D)

Nog

gle

et a

l50

Moo

d (P

OM

S-S

hort

Fo

rm)

n=36

Moo

d d

istu

rban

ce (−

): 42

.8 (1

9.3)

Tens

ion

anxi

ety

(−):

6.4

(4.7

)D

epre

ssio

n-d

ejec

tion

(−):

5.1

(5.0

)A

nger

hos

tility

(−):

6.5

(4.7

)V

igou

r ac

tivity

(+):

9.8

(4.4

)Fa

tigue

iner

tia (−

): 8.

3 (5

.7)

Con

fusi

on b

ewild

erm

ent

(−):

6.8

(3.5

)

n=15

Moo

d d

istu

rban

ce (−

): 44

.5 (1

0.2)

Tens

ion

anxi

ety

(−):

6.7

(2.8

)D

epre

ssio

n-d

ejec

tion

(−):

4.9

(3.0

)A

nger

hos

tility

(−):

6.3

(2.7

)V

igou

r ac

tivity

(+):

10.2

(3

.8)

Fatig

ue in

ertia

(−):9

.8 (4

.5)

Con

fusi

on b

ewild

erm

ent

(−):

6.6

(2.7

)

n=35

Moo

d d

istu

rban

ce (−

): 38

.4 (1

6.9)

# m

ediu

m-

larg

e ef

fect

siz

e=0.

689

(Coh

en’s

d)

Tens

ion

anxi

ety

(−):

5.1

(3.6

)#

Larg

e ef

fect

siz

e=0.

870

(Coh

en’s

d)

Dep

ress

ion-

dej

ectio

n (−

): 4.

7 (4

.9)

Ang

er h

ostil

ity (−

): 5.

7 (5

.0)

Vig

our

activ

ity (+

): 9.

3 (4

.0)

Fatig

ue in

ertia

(−):

7.2

(5.2

)C

onfu

sion

bew

ilder

men

t (−

): 6.

3 (3

.5)

n=15

Moo

d d

istu

rban

ce (−

): 51

.2 (2

0.1)

Tens

ion

anxi

ety

(−):

9.3

(5.8

)D

epre

ssio

n-d

ejec

tion

(−):

6.3

(4.2

)A

nger

hos

tility

(−):

7.1

(4.5

)V

igou

r ac

tivity

(+):

10.9

(3

.5)

Fatig

ue in

ertia

(−):

9.3

(4.6

)C

onfu

sion

bew

ilder

men

t (−

): 8.

3 (4

.1)

N/A

N

/A

Str

ess

(Per

ceiv

edS

tres

s S

cale

)n=

3619

.2 (7

.4)

n=15

19.1

(3.8

)n=

3518

.6 (6

.2)

n=15

20.3

(5.4

)N

/A

N/A

Pos

itive

psy

chol

ogy

(Inve

ntor

y of

Pos

itive

P

sych

olog

ical

Att

itud

es)

n=36

Pos

itive

psy

ch a

ttrib

utes

(+

): 4.

5 (1

.0)

Life

pur

pos

e/sa

tisfa

ctio

n (+

): 4.

7 (1

.0)

Sel

f-co

nfid

ence

dur

ing

stre

ss (+

): 4.

2 (1

.0)

n=15

Pos

itive

psy

ch a

ttrib

utes

(+

): 4.

5 (0

.78)

Life

pur

pos

e/sa

tisfa

ctio

n (+

): 4.

8 (0

.94)

Sel

f-co

nfid

ence

dur

ing

stre

ss (+

): 4.

2 (0

.67)

n=35

Pos

itive

psy

ch a

ttrib

utes

(+

): 4.

5 (1

.2)

Life

pur

pos

e/sa

tisfa

ctio

n (+

): 4.

8 (1

.1)

Sel

f-co

nfid

ence

dur

ing

stre

ss (+

): 4.

3 (0

.98)

n=15

Pos

itive

psy

ch a

ttrib

utes

(+

): 4.

2 (0

.88)

Life

pur

pos

e/sa

tisfa

ctio

n (+

): 4.

6 (0

.88)

Sel

f-co

nfid

ence

dur

ing

stre

ss (+

): 4.

0 (0

.90)

N/A

N

/A

Res

ilien

ce (R

esili

ence

Sca

le)

n=36

132.

9 (1

8.4)

n=15

132.

1 (1

2.4)

n=35

131.

9 (2

4.5)

n=15

127.

9 (2

3.4)

N/A

N

/A

Affe

ct (P

ositi

ve a

ndN

egat

ive

Affe

ctS

ched

ule

for

Chi

ldre

n)

n=36

Pos

itive

affe

ct (+

): 50

.1

(11.

5)N

egat

ive

affe

ct (−

):32

.1 (1

2.5)

n=15

Pos

itive

affe

ct (+

): 47

.7

(9.4

)N

egat

ive

affe

ct (−

):28

.8 (7

.7)

n=35

Pos

itive

affe

ct (+

): 48

.6

(11.

7)N

egat

ive

affe

ct (−

):29

.4 (1

1.5)

#

Med

ium

-lar

ge e

ffect

si

ze=

0.65

9 (C

ohen

’s d

)

n=15

Pos

itive

affe

ct (+

): 49

.2

(11.

3)N

egat

ive

affe

ct (−

):38

.4 (1

5.5)

N/A

N

/A

Min

dfu

lnes

s (C

hild

A

ccep

tanc

eM

ind

fuln

ess

Mea

sure

)

n=36

53.9

(8.6

)n=

1552

.3 (6

.7)

n=35

53.4

(7.8

)n=

1549

.4 (7

.2)

N/A

N

/A

Ang

er (S

tate

Tra

it A

nger

E

xpre

ssio

n In

vent

ory-

2TM

)

n=36

Inw

ard

(−):

16.4

(4.2

)O

utw

ard

(−):

17.2

(5.7

)C

ontr

ol (+

): 22

.8 (5

.5)

n=15

Inw

ard

(−):

15.9

(3.3

)O

utw

ard

(−):

16.5

(4.0

)C

ontr

ol (+

): 22

.7 (5

.3)

n=35

Inw

ard

(−):

16.8

(4.9

)O

utw

ard

(−):

16.9

(5.5

)C

ontr

ol (+

): 22

.4 (6

.1)

n=15

Inw

ard

(−):

17.9

(4.6

)O

utw

ard

(−):

17.1

(3.7

)C

ontr

ol (+

): 20

.9 (3

.7)

N/A

N

/A

Tab

le 4

C

ontin

ued

Con

tinue

d



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limitations of evaluation design. Two studies reported both preproject and postproject data. It was not always clear how themes were identified and developed and it was not always apparent that conclusions emerged from comprehensive data treatment. One report made a clear attempt to search for disconfirming cases and consider the negative well-being impact of sport participation,53 but evaluation reports tended to focus only on the posi-tive impacts of sport and dance. Furthermore, there was a tendency in evaluations on dance and performance to rely on face value reporting of participants’ accounts rather than developing latent forms of thematic analysis informed by identified theory where appropriate.

the effect of meditative sport activity on well-beingThree published RCT studies assessed the effectiveness of meditative practices including yoga46 50 and Baduanjin Qigong48 on well-being in young people. All three studies used several different measures of well-being including mood scales for rating anger, anxiety, positive and negative affect, confusion/bewilderment and stress, anxiety and depression.46 48 50 One stu

louise mansfield, tess kay, catherine meads, lily grigsby ... · alistair john,2 norma daykin,5...

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