Abstract:

Objective To systematically review the psychological and behavioral health benefits and quality of life of adolescent participation in physical activity in a health-promoting school perspective, based on the International Classification of Functioning, Disability and Health (ICF) and PRISMA principles.
Methods PubMed, Web of Science, and CNKI were searched to collect randomized controlled trials related to adolescents' participation in physical activity in schools and health outcomes, published from January, 2011 to June 2023, for a systematic review.
Results Eight studies were included, with 23 652 participants from six countries, mainly from journals related to public health, nursing, child and adolescent mental health, and international environmental research. The types of school physical activity interventions included physical fitness (warm-up and stretching, recreation center activities, shuttle runs, jumping jacks and jump ropes, squats and push-ups, running, wrist and arm training), skills (dribbling, passing, throwing, and catching) and sports (Kripalu yoga, basketball, volleyball, soccer sports, Ringo alternative sports, tennis and jump rope). The frequency of activities was one to six times a week, the intensity ranged from low to high, and the duration was mainly from two to 40 weeks. The psychological and behavioral health benefits of school-based physical activity involved three aspects. In terms of mental health, their social-emotional competence improved, negative emotions reduced, self-efficacy increased, subjective emotional feelings, behavioral control and intelligence improved, cognition and mental health improved; the stress coping strategies were developed, and the cognitive structures for emotion regulation, positive thinking and stress coping were learned. In terms of behavioral health aspects related to physical activity, their physical health and physical activity levels increased, the sense of health responsibility and awareness increased, knowledge of nutrition and health was enriched, behavioral control improved, executive functioning improved, academic achievement and participation in school activities increased, and absence from duty decreased. In terms of quality of life, academic performance, exercise habits and healthy lifestyles, positive attitudes, and interpersonal and stress management skills all improved.
Conclusion In the health-promoting school perspective, physical activity is integrated into the school health promotion system, and physical activity interventions in fitness, skills and sports are implemented to improve adolescents' psychological and behavioral health and quality of life, namely improving cognitive and executive functioning; improving social skills, emotional control, positive thinking, positive physical activity behaviors and health literacy, positive mindset; improving academic performance, good health habits and positive attitude towards life, interpersonal and stress management skills; and increasing overall well-being.

Key words: adolescents, health-promoting school, school physical activity, psychological and behavioral health, systematic review