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Sports settings have been identified as an ideal place to conduct complex multi-level health-promotion interventions, with the potential to engage a broad audience. Whilst the benefits of delivering health-promotion interventions in sports settings are well documented, such interventions' real-world implementation and success must be better understood. Process evaluations can be conducted to provide information related to an intervention's fidelity, replication, scaling, adoption, and the underlying mechanisms driving outcomes. This systematic review summarizes how process evaluations of health-promotion interventions are conducted in sports settings and highlight facilitators and barriers to health-promotion intervention delivery using narrative synthesis. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, searches included original peer-reviewed articles from inception-January 2023. We searched eight electronic databases: Academic Search Complete; MEDLINE, PsycARTICLES; PsycINFO; SPORTSDiscus with Full Text; MEDLINE; SCOPUS; Pub Med, and Pro Quest Central. Thirty-two studies were included. Findings suggest that most process evaluations of health-promotion interventions have acknowledged the inherent complexity of sports settings, and investigated factors that explain their intervention's success (e.g. trust building, engagement). However, poor use of process evaluation frameworks or guidelines resulted in wide variations of how process evaluations are conducted and reported, which made findings difficult to integrate and standardize with consistency. Accordingly, this review provides a guide on how future process evaluations can be conducted to improve health-promotion interventions' transparency, replicability and reliability in real-world settings., (© The Author(s) 2023. Published by Oxford University Press.)

Widespread adolescent involvement in organized sport means that sport contexts are well-suited to 'actively' integrate prevention programs that may promote population-level change. This mixed methods study aimed to evaluate the feasibility and acceptability of a peer-based mental health literacy intervention. The intervention (i.e., Team Talk) was presented to eleven adolescent sport teams in the United States, with a total of 174 participants. Athlete participants completed surveys immediately before and after the intervention-including measures of workshop acceptability, social identity, and help-seeking behaviors. Semi-structured interviews were also conducted with a subset of five athletes, nine parents, and two coaches. With respect to recruitment as an indicator of feasibility, club-level adoption of the intervention was low, with difficulty recruiting clubs for intervention delivery. This signals that feasibility of the intervention-as it is currently designed and implemented by the research team-is low when considering similar competitive adolescent sport clubs and delivered as team-level workshops. Meanwhile, participants reported high acceptability of the intervention, and acceptability levels across participants was predicted by contextual factors related to implementation such as session duration. Regarding limited efficacy testing with measures completed before and after the intervention session: (a) social identity scores increased following the intervention, and (b) significant differences were not identified regarding efficacy to recognize symptoms of mental disorders. Athlete, coach, and parent interview responses also described potential adaptations to mental health programs. This research demonstrates the potential utility of peer-based mental health literacy interventions, while also revealing that further implementation research is necessary to adapt mental health literacy interventions to suit diverse adolescent sport contexts., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Panza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The focus on mental health outcomes in sport, including the ways in which mental health can be protected and promoted, has become a major international priority for all sports, including the recreational sports system. The aim of this paper is to outline a systems theory of mental health care and promotion that is specific to needs of the recreational sport system so that context-specific, effective policies, interventions, and models of care can be articulated and tested. Based on general systems theory, we offer a preliminary theory and accompanying postulates that outline the general principles that explain mental health in recreational sports. Namely: one of the purposes of the recreational sport system is to protect and promote the mental health of all involved; the recreational sport system is comprised of components (individuals, groups, organisations, communities, society); the role and function of those components vary by context; the purpose of the system is achieved through coordinated and reciprocal relationships between its components; and, the system should be regulated from within to ensure that mental health is protected and promoted. We have also outlined the ways in which the subcomponents of the system interact, their potential influence on mental health in recreational sports, and the ways in which they may be regulated. This information provides a theoretical foundation upon which research, programming, and policy can be based to protect and promote the mental health of all involved in recreational sports.

This research sought to test whether sport participation relates to the development of trait extraversion across three life phases. Sport participation and extraversion were measured in children aged 10.5 ± 0.5 years ( n = 3600), in adolescents aged 14.5 ± 0.5 years ( n = 3463), and in adults with a mean age of 49.4 ± 18.0 years ( n = 12,280), with corresponding data collected four years earlier. There were small mean-level decreases in extraversion during childhood and adulthood, and a large decrease in extraversion during adolescence. Four-year rank-order stability in extraversion was .58 in childhood, .61 in adolescence and .76 in adulthood. Sport participation was associated with higher extraversion in all three samples. After controlling for sociodemographic factors, children and adolescents who dropped out of sport showed greater decreases in extraversion than those who continued participation in sport. Sport participation was unrelated to mean-level change in extraversion during adulthood. Sport participation was also associated with greater intra-individual stability in extraversion for children, adolescents and adults. There were no significant sex moderation effects for mean-level change or individual-level stability. These findings provide evidence that sport participation might have an important role in trait extraversion stability and change across the lifespan.

Objectives: The aim of this study was to simultaneously explore multiple pathways through which sports participation during childhood and adolescence may be associated with adiposity over time., Design: Data were drawn from the Kindergarten cohort of the Longitudinal Study of Australian Children. A total of 4286 children provided sports participation data at age 10 years and were followed up 24 and 48 months later., Method: Time spent in organised sports at age 10 years and time spent in physical activity at age 12 years were measured via parental-reported time-use diary. Dietary behaviours were self-reported at age 12 years. Screen time was parent-reported. Body fat was measured at age 14 using bioelectrical impedance analysis. Two parallel multiple mediation models were tested to examine the longitudinal associations between sport participation at age 10 and body fat at age 14 via the mediating variables of physical activity, screen time, and dietary behaviours. One model was run for all participants, and a second model was run only for those participants who reported participating in organised sports., Results: There were no significant indirect relationships between sports participation and body fat via any of the mediating variables in the total sample, or among sport participants., Conclusions: There is a dearth of evidence to support substantial rhetoric and policy to promote organised sports programs as public health initiatives in their current form during childhood and adolescence. Better quality evidence is needed, however, modifications to sport programs may be necessary to elucidate meaningful benefits for adiposity., (Copyright © 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Background: Overweight and obesity among young people is alarmingly high. While hundreds of millions of children participate in organised sports worldwide, it is currently unknown whether time spent in organised sports is associated with levels of adiposity among young people. This study aimed to investigate bidirectional associations between participation in organised sports and adiposity over a two year period., Method: Data were drawn from the Longitudinal Study of Australian Children. In total, 4033 participants (51% male) reported time spent in organised sports and had their body mass index, body fat percentage, and waist circumference measured at age 12, and again two years later. A cross-lagged panel model was used to examine bidirectional relationships over time, as well as interaction effects., Results: Total sport participation at age 12 was not associated with subsequent BMI-z scores (β = 0.01 [95% CI, -0.02, 0.04]), body fat (β = 0.01 [95% CI, -0.02, 0.03]), or waist circumference (β = -0.01 [95% CI, -0.05, 0.02]). Similarly, measure of adiposity at age 12 were not associated with subsequent sports participation (BMI-z score: β = -0.01 [95% CI, -0.02, 0.04]; body fat percentage: β = -0.02 [95% CI, -0.05, 0.02]; waist circumference: β = -0.01 [95% CI, -0.01, 0.03]). There were no differences in the strength or direction of the relationships by type of sport or by sex (p < .05)., Conclusion: Policy and programmatic changes may be needed before organised youth sports are considered a preventative strategy for overweight and obesity. However, a more nuanced understanding of why organised youth sports are not associated with adiposity is needed before evidence-based changes can be made., Competing Interests: The authors have declared that no competing interests exist.

Background: There is a recognised need for targeted community-wide mental health strategies and interventions aimed specifically at prevention and early intervention in promoting mental health. Young males are a high need group who hold particularly negative attitudes towards mental health services, and these views are detrimental for early intervention and help-seeking. Organised sports provide a promising context to deliver community-wide mental health strategies and interventions to adolescent males. The aim of the Ahead of the Game program is to test the effectiveness of a multi-component, community-sport based program targeting prevention, promotion and early intervention for mental health among adolescent males., Methods: The Ahead of the Game program will be implemented within a sample drawn from community sporting clubs and evaluated using a sample drawn from a matched control community. Four programs are proposed, including two targeting adolescents, one for parents, and one for sports coaches. One adolescent program aims to increase mental health literacy, intentions to seek and/or provide help for mental health, and to decrease stigmatising attitudes. The second adolescent program aims to increase resilience. The goal of the parent program is to increase parental mental health literacy and confidence to provide help. The coach program is intended to increase coaches' supportive behaviours (e.g., autonomy supportive behaviours), and in turn facilitate high-quality motivation and wellbeing among adolescents. Programs will be complemented by a messaging campaign aimed at adolescents to enhance mental health literacy. The effects of the program on adolescent males' psychological distress and wellbeing will also be explored., Discussion: Organised sports represent a potentially engaging avenue to promote mental health and prevent the onset of mental health problems among adolescent males. The community-based design, with samples drawn from an intervention and a matched control community, enables evaluation of adolescent males' incremental mental health literacy, help-seeking intentions, stigmatising attitudes, motivation, and resilience impacts from the multi-level, multi-component Ahead of the Game program. Notable risks to the study include self-selection bias, the non-randomised design, and the translational nature of the program. However, strengths include extensive community input, as well as the multi-level and multi-component design., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12617000709347 . Date registered 17 May 2017. Retrospectively registered.

Background: Dropout from organized youth sport has significant adverse health implications. Enjoyment and behavioral intentions have consistently been linked with participation and dropout; however, few studies have investigated these links using a prospective design. This study explored whether enjoyment and intentions to continue predicted dropout behavior at 1-year follow-up., Methods: Questionnaires were completed by 327 regular sport participants (mean age = 13.01 y at baseline). After 1 year, 247 individuals (75.5%) continued participating in their main sport and 26 individuals (8%) dropped out. A hierarchical logistic regression model estimated the probability of dropout. In step 1, the following covariates were included: age, sex, competition level, perceived competence, parental support, coach-athlete relationship, friendship quality, and peer acceptance. In step 2, enjoyment and intentions to continue were included., Results: Step 1 indicated that age, parental support, coach-athlete relationship quality, and peer acceptance were significantly associated with dropout. Step 2 explained further variance in dropout, with both enjoyment and intentions inversely associated with dropout. Peer acceptance was the only covariate to remain significantly associated with dropout in step 2., Conclusions: Findings support the use of enjoyment and behavioral intentions as indicators of sport participation/dropout behavior and may aid the development of interventions aimed at preventing future dropout.

Youth participation in organised sport and physical activity is important for healthy development, growth and wellbeing. In 2014, Active Healthy Kids Australia released its inaugural Report Card on Physical Activity for Children and Young People, which synthesised the best available national- and state-level data for children and young people (<18 years). This paper provides a more detailed examination of the evidence informing the grade for Organised Sport from the 2014 Report Card, compares Australia's Organised Sport grade with other countries, identifies future directions for research and surveillance, and explores possible beneficial strategies. The Report Card highlighted that between 64% and 85% of Australians aged 5-17 years participate in organised sports, a rate higher than alternate forms of physical activity such as active transportation, active play and school based physical activity. This finding reflects Australia's position as one of the global leaders for participating in organised sport. Future research and surveillance methodologies however, need to incorporate standardised metrics that aim to capture more detailed data regarding organised sport participation. Facilitating access for all children and preventing dropout from organised sports are important initiatives to improve current levels of sport participation. However, given that 80% of Australians aged 5-17 years are not sufficiently physically active to achieve the daily recommendation, participation in sport alone is not enough to ensure that children can accrue the health benefits associated with being physically active. As such, there is a pressing need to develop strategies that engage children in other forms of physical activity such as active transportation and active play., (Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

This investigation explored the contribution of extracurricular sport and screen time viewing (television viewing and electronic gaming) to personality trait stability and change during childhood. Two independent samples of 3,956 young children (age 6) and 3,862 older children (age 10) were taken from the Longitudinal Study of Australian Children. Parent-reported child sport participation, screen time, and personality traits were measured at baseline and again 24 months later. Young children who were more active recorded more of a decrease in introversion, less of a decrease in persistence, and less of an increase in reactivity, than those who were less active. Older children who were more active recorded less of an increase in introversion and more of an increase in persistence than those who were less active. In addition, young children who continued participation in extracurricular sport had greater intra-individual stability of personality for introversion. These finding suggest that an active lifestyle might help to facilitate desirable personality trait stability and change during childhood., (© 2015 The British Psychological Society.)

Objectives: This paper assessed the associations between sports participation and the development of psychological strengths and difficulties during childhood., Design: Two-year follow up study of a sample of 4042 Australian children who were followed from age 8 years to 10 years., Methods: Parents reported children's participation in organised sports, and completed the Strengths and Difficulties Questionnaire. Univariate general linear models were used to examine the association between changes in sports participation and psychological strengths and difficulties at 10 years, adjusting for psychological strengths and difficulties at age 8., Results: Children who maintained participation in sport had lower rates of parent-reported psychological difficulties at 10 years compared with children who dropped out of sport. Less internalising problems were also reported for children who participated in organised sports compared to children who dropped out of sports and children who did not participate in sports. These relationships did not differ by BMI, socioeconomic status, or parental education., Conclusions: Greater psychological difficulties are experienced by children who drop out of sports, and greater social and emotional problems are experienced by children who drop out of sports and who do not participate in organised sports. Due consideration should be given to the quality and implementation of sporting programs to ensure that they provide benefits to mental health. Due consideration should also be given to the potential psychological difficulties being experienced by children who drop out of organised sports as a higher level of psychological difficulties may be experienced prior to or subsequent to dropout., (Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objectives: Several important research questions have been addressed: (1) What are the cross-sectional associations between sports club participation, objectively measured physical activity, and adiposity? (2) Do measures of physical activity and adiposity predict subsequent sports club participation? (3) Does sports club participation predict subsequent measures of physical activity and adiposity? and (4) Do changes in sports club participation predict changes in objective measures of physical activity and adiposity?, Design: Longitudinal and cross-sectional., Methods: Data from the Gateshead Millennium Study birth cohort (n=609 at age 7 years) were analysed for associations between adiposity, sports club participation and accelerometer-measured physical activity from ages 7y to 9y to 12y., Results: Seventy-two per cent of 9 year olds and 63% of 12 year olds took part in a sports club. Sports club participation was significantly associated with overall accelerometer-measured physical activity at 12y (coefficient=0.0.09; 95% CI: 0.01-0.16) but not 9y. An inverse relationship between fat mass (estimated from bioelectric impedance) and sport club participation, and between fat mass and accelerometer-measured physical activity was observed at 12y, but not 9y. Sports club participation at 9y was highly predictive of participation at 12y. Sports club participation was significantly associated with socioeconomic status; fewer children from poorer areas took part., Conclusions: Sports club participation in adolescence may be associated with decreased levels of adiposity. Furthermore, the potential benefits of sports club participation for adiposity are likely generated from continuous participation in sports, rather than any long-term protective effects., (Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objective: To investigate the longitudinal association between sports participation and parent-reported health-related quality of life (HRQOL) in children., Study Design: Cohort study that used data drawn from the Longitudinal Study of Australian Children in waves 3 (2008) and 4 (2010). Participants were a nationally representative sample of 4042 Australian children ages 8.25 (SD = 0.44) years at baseline and followed-up 24 months later., Results: After we adjusted for multiple covariates, children who continued to participate in sports between the ages of 8 and 10 years had greater parent-reported HRQOL at age 10 (Eta2 = .02) compared with children who did not participate in sports (P ≤ .001), children who commenced participation after 8 years of age (P = .004), and children who dropped out of sports before reaching 10 years of age (P = .04). Children who participated in both team and individual sports (P = .02) or team sports alone (P = .04) had greater HRQOL compared with children who participated in individual sports alone (Eta2 = .01). The benefits of sports participation were strongest for girls (P < .05; Eta2 = .003)., Conclusions: Children's participation in developmentally appropriate team sports helps to protect HRQOL and should be encouraged at an early age and maintained for as long as possible., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: The purpose of this study was to explore the socio-ecological determinants of participation and dropout in organised sports in a nationally-representative sample of Australian children., Methods: Data were drawn from Waves 3 and 4 of the Longitudinal Study of Australian Children. In total, 4042 children aged 8.25 (SD = 0.44) years at baseline were included, with 24-months between Waves. Socio-ecological predictors were reported by parents and teachers, while cognitive and health measures were assessed by trained professionals. All predictors were assessed at age 8, and used to predict participation and dropout by age 10., Results: Seven variables at age 8 were shown to positively predict participation in organised sports at age 10. These included: sex (boy); fewer people in household; higher household income; main language spoken at home (English); higher parental education; child taken to a sporting event; and, access to a specialist PE teacher during primary school. Four variables predicted dropout from organised sports by age 10: lower household income; main language spoken at home (non-English); lower parental education; and, child not taken to a sporting event., Conclusions: The interplay between child sex, socioeconomic indicators, and parental support is important in predicting children's participation in organised sports. Multilevel and multicomponent interventions to promote participation and prevent dropout should be underpinned by the Socio-Ecological Model and targeted to high risk populations using multiple levels of risk.

Background: The purpose of this study was to examine the relationship between organized sports participation, weight status, physical activity, screen time, and important food habits in a large nationally representative sample of Australian adolescents., Methods: Nationally representative cross-sectional study of 12,188 adolescents from 238 secondary schools aged between 12 and 17 years (14.47 ± 1.25 y, 53% male, 23% overweight/obese). Participation in organized sports, compliance with national physical activity, screen time, and fruit and vegetable consumption guidelines, and consumption of sugar-sweetened beverages and high-fat foods were self-reported. Weight status and adiposity (BMI, waist circumference) were measured., Results: Organized sports participation was higher among males and those residing in rural/remote areas. Underweight adolescents reported the lowest levels of participation. Higher levels of participation were associated with an increased likelihood of complying with national physical activity (OR = 2.07 [1.67-2.58]), screen time (OR = 1.48 [1.19-1.84]), and fruit and vegetable consumption guidelines (OR = 1.32 [1.05-1.67]). There was no association between organized sport participation and weight status, adiposity, consumption of sugar-sweetened beverages or high-fat foods., Conclusions: Participation in organized sports was associated with a greater likelihood to engage in a cluster of health behaviors, including meeting physical activity guidelines, electronic screen time recommendations, and fruit and vegetable consumption guidelines. However, participation in organized sports was not associated with unhealthy dietary behaviors including the consumption of sugar-sweetened beverages and high-fat foods. There is no association between participation in organized sports and likelihood to be overweight or obese. The role of sports in promoting healthy weight and energy balance is unclear.