Effects of Aerobic Exercise and High-Intensity Interval Training on the Mental Health of Adolescents Living in Poverty
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 78
- 试验地点
- 1
- 主要终点
- Satisfaction with Life Scale (SWLS)
研究概览
简要总结
The increasing rate of mental health issues among adolescents has recently been a considerable concern in Hong Kong. In particular, adolescents with low socioeconomic status (SES) are likely to experience poor mental health including low self-esteem and high levels of anxiety, anger, and depression. Previous research has found that physical activities have a positive impact on improving mental health outcomes among adolescents. However, approximately 96% of adolescents in Hong Kong fail to engage in regular exercises, which potentially increase risk of poor mental health. This study aims to (1) examine whether changes in the three indicators (reduced ill-being, enhanced well-being and cognitive functions) of mental health among adolescents with low socioeconomic status are evident before and after exercises. In addition, this study (2) compares the effectiveness of aerobic exercise and high-intensity interval training in these indicators among adolescents with low SES. A range of neuropsychological tests and psychometric scales will be used to measure the executive functions and indicators of psychological well-being and ill-being, which include enjoyment, self-efficacy, mood, depression, anxiety, and stress. It is hoped that the findings will help inform policymakers and practitioners for promoting the importance of physical exercises to enhance mental health.
详细描述
Adolescents' poor mental health provides serious implications for adult morbidity and mortality. Mental health involves the absence of mental illness and life satisfaction. In Hong Kong (HK), the mental health of adolescents has been a subject of considerable concern in recent years. A recent survey of 11,493 local citizens revealed that approximately 74% of adolescents below the age of 25 years exhibit moderate to high levels of depressive symptoms (e.g., depression, anxiety, and stress), 41% suffer moderate to high levels of post-traumatic stress symptoms, and 36% have both diagnoses. Previous research has also demonstrated that poor mental health is unevenly distributed across different socioeconomic groups and is highly clustered in families with socioeconomic status (SES).
Families with low SES are more deprived in multiple ways and suffer from numerous stressors related to finances, social relations, employment opportunities, and physical illness than families from other socioeconomic groups. For instance, adolescents with low SES often have worse access to education and social participation than their peers with an average or high SES. In addition, the results from a meta-analysis study of 34 countries from 2002 to 2010 indicated that adolescents with low SES are affected by physical symptoms and have poor mental health, including low self-esteem and high levels of anxiety, anger, and depression.
Physical exercise is presently considered as an effective intervention for its safe, nonpharmacological, and cost-effective nature that can provide a range of health benefits, including improvements in body composition and physical capacity, among individuals. Recent evidence has confirmed that physical exercise provides a positive effect on mental health outcomes for youth through physiological and psychological pathways.
Studies that are focused on physiological evidence have commonly demonstrated a direct positive effect of physical exercise on the individuals' neurological processes, thereby indicating that cardio activities are directly and immediately beneficial to mental health. Two main research streams that cite physiological evidence, namely, those that focus on monoamines and those that focus on endorphins are present. The first research stream reveals that physical activity upregulates the synaptic transmission of monoamines, including the three major neurotransmitters, namely, norepinephrine, dopamine, and serotonin. A similar effect has been found for antidepressant drugs, while exercise has been proven as effective as antidepressants for alleviating depressive symptoms among patients with major depression. The hypothesis regarding endorphin is also popular for explaining the impacts of aerobic exercise on mental health. Several researchers have believed that endorphins may lead to energy conservation during exercise and consequently exhibits psychological effects such as improved mood states and reduced anxiety. Direct evidence stating that physical activity can elevate the plasma endorphin levels also exists.
Although physiological evidence has established a direct association between physical activity and mental health, researchers are also keen to identify how physical activities may benefit mental health. Several researchers have conducted studies based on the three indicators of mental health that were proposed by Costigan et al. (2016), namely, (1) cognitive function, (2) well-being (e.g., enjoyment), and (3) ill-being (e.g., depression, negative affect).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 12 Years 至 15 Years（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Studying in secondary grades one to three
- •Between 12 and 15 years old
- •Belongs to a family with a household income below half of the median household income reported in HK, which was adjusted by household size
排除标准
- •Hypertension or diabetes mellitus without control
- •A history of brain injury and other neurological disease, epilepsy, or myocardial infarction
- •Musculoskeletal disease
- •Use medication that affects heart rate (e.g., beta-blockers, asthma medications, stimulants, digoxin, antiarrhythmic agents)
- •Cardiovascular disease
结局指标
主要结局
Satisfaction with Life Scale (SWLS)
时间窗: 3 months after intervention
The scale will be used to measure life satisfaction. This scale is a short five-item (e.g., "I am satisfied with my life") scale based on a seven-point rating scale that ranges from 1 (strongly disagree) to 7 (strongly agree).
Resting Heart Rate
时间窗: At the end of training
The resting heart rate will be measured through a wireless heart rate monitor that will be worn by the participants (Polar Electro OY, Finland) for one minute after their 10-minute rest. The unit of measurement for heart rate is bpm (beats per minute).
Waist-to-Hip Ratio
时间窗: At the end of training
The waist circumference and hip circumference will be measured twice using an anthropometric tape while the participants stand erect and relaxed with their arms at their sides and feet positioned close together. The waist circumference will be measured between the upper border of the iliac crest and the lowest border of the rib cage at the end of normal expiration. The hip circumference will be measured at the widest part of the hip at the level of the greatest trochanter. The tape will be positioned at a level that is parallel to the floor. The unit of measure will be in centimeters (cm) to the nearest 0.1 cm. The waist-to-hip ratio will be calculated as the ratio of the waist-to-hip circumference.
Body Mass Index
时间窗: At the end of training
The body weight and height will be measured using an electronic digital scale and a stadiometer, respectively. The body mass index (BMI) will be calculated by dividing body weight (kg) by height (m\^2).
Blood Pressure
时间窗: At the end of training
Blood pressure will be measured with an automated blood pressure monitoring device. The participants will be given 10-minute rest before the measurement. The systolic and diastolic blood pressure will be measured thrice, with a one-minute interval between readings. If the blood pressure differed by more than 5 mm Hg, then additional readings will be obtained. A mean of the three consecutive readings will be used as the examination value. The unit of measurement for blood pressure is mmHg.
General Self-Efficacy Scale (GSES)
时间窗: 3 months after intervention
This scale will be administered to measure the adolescents' self-efficacy. The GSES contains 10 items (e.g., "I can constantly manage to solve difficult problems if I try hard enough"), with responses ranging from 1 (not at all true) to 4 (exactly true).
Physical Activity Enjoyment Scale (S-PACES)
时间窗: 3 months after intervention
This scale will be utilized to measure enjoyment. The S-PACES includes seven negatively worded items (e.g., "It is not at all interesting"), anchored on a five-point Likert scale that ranges from 1 (disagree a lot) to 5 (agree a lot).
21-item Depression Anxiety Stress Scale (DASS-21)
时间窗: 3 months after intervention
The DASS-21 scale will be used to measure depression (e.g., "I felt that I lack something to look forward to"), anxiety (e.g., "I felt that I was close to panic"), and stress (e.g., "I found it difficult to relax") among adolescents. The respondents will be asked to rate the items through a four-point combined severity/frequency scale that ranges from 0 (not applicable to me at all) to 3 (extremely applicable to me) based on their experiences that are related to each item over the past week.
Brunel Mood Scale (BRUMS-C)
时间窗: 3 months after intervention
The BRUMS-C will be created based on the work of Terry, Lane, Lane, and Keohane (1999) to assess the mood among Chinese students and adults. The BRUMS-C is a 23-item inventory with five negative mood dimensions, namely, anger, confusion, depression, fatigue, and tension. Respondents will be asked to indicate their feelings (e.g., angry, unhappy, or nervous) through a five-point Likert scale that ranges from 0 (not at all) to 4 (extremely).
Wisconsin Card Sorting Test
时间窗: 3 months after intervention
The Wisconsin Card Sorting Test will be administered with Inquisit 6 by Millisecond Software to measure cognitive flexibility. Participants are presented with four stimulus cards and a deck of response cards that vary in three dimensions (i.e., color, shape, and number). They are asked to match a fifth card from the sequentially presented response cards to one of the four key cards. The rules that underpin the classification are matching by color, shape, or number. Participants need to follow the correct card classification rule in accordance with the feedback they receive after each trial. After participants correctly respond to ten consecutive trials, the classification rule changes, requiring flexible set-shifting.
Stroop Color-Word Test
时间窗: 3 months after intervention
Inhibition will be measured using the non-computerized Stroop Color and Word Test (under the word condition, color condition, and color-word condition in three separate 1-minute rounds. In the word condition (W), participants are instructed to read the Chinese words and name the Chinese colors printed in black. In the color condition (C), participants are required to name the colors of printed patches. Finally, in the color-word condition (CW), the name of a color (e.g., BLUE) is presented using either a congruent color (e.g., blue) or an incongruent color (e.g., yellow) in Chinese. Participants have to name the color, instead of reading the word as quickly and accurately as possible.
Digit Span Test
时间窗: 3 months after intervention
Working memory will be measured using the Backward Digit Span subtest of the Wechsler Intelligence Scale for Children, Third Edition \[WISC-III\]. Participants are orally presented with 18 sequences of single-digit numbers of increasing length, from two to nine (two sequences per length), and must repeat the numbers in backwards order. One point is given for each completely recalled sequence, and the test is terminated after two consecutive unsuccessful recalls.
次要结局
未报告次要终点