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Background: While evidence consistently demonstrates that physical activity is beneficial to mental health, it remains relatively unknown how physical activity benefits mental health, and which factors influence the effect of physical activity on mental health. This understanding could vastly increase our capacity to design, recommend, and prescribe physical activity in more optimal ways. The purpose of this study was to systematically review and synthesise evidence of all mediators and moderators of the relationship between physical activity and mental health. Methods: Systematic searches of four databases (i.e., Scopus, PsycINFO, PubMed, and SPORTDiscus) identified 11,633 initial studies. Empirical studies that quantitatively assessed physical activity, or conducted a physical activity intervention, measured a mental health outcome, and tested one or more mediator or moderator of the relationship between physical activity and mental health were included. A total of 247 met the inclusion criteria; 173 studies examined mediation and 82 examined moderation. Results: Results of the best-evidence synthesis revealed strong evidence for 12 mediators including affect, mental health and wellbeing, self-esteem, self-efficacy, physical self-worth, body image satisfaction, resilience, social support, social connection, physical health, pain, and fatigue. Moderate evidence was identified for a further 15 mediators and eight moderators. Conclusions: Findings should inform the design of future physical activity interventions to ensure optimal effects on mental health related outcomes. Additionally, if health professionals were to take these mediators and moderators into consideration when prescribing or recommending physical activity, physical activity would likely have a greater impact on population mental health. [ABSTRACT FROM AUTHOR]

School‐based physical education (PE) provides opportunities to accumulate moderate‐to‐vigorous physical activity (MVPA), but many students are insufficiently active during PE lessons. Providing teachers with feedback regarding their students' physical activity may increase the effectiveness of PE for achieving MVPA goals, but existing physical activity monitoring technologies have limitations in class environments. Therefore, the purpose of this study was to develop and validate a system capable of providing feedback on PE lesson MVPA. Equations for translating step counts to %MVPA were derived from measures in 492 students who concurrently wore an ActiGraph GT3X+ (ActiGraph) and Yamax pedometer (Yamax) during a PE lesson. To enhance feedback availability during PE lessons, we then developed a bespoke monitoring system using wireless tri‐axial pedometers (HMM) and a smart device app. After developing and testing the monitoring system, we assessed its validity and reliability in 100 students during a PE lesson. There was a strong correlation of 0.896 between step counts and accelerometer‐determined %MVPA and quantile regression equations showed good validity for translating step counts to %MVPA with a mean absolute difference of 5.3 (95% CI, 4.4‐6.2). The physical activity monitoring system was effective at providing %MVPA during PE lessons with a mean difference of 1.6 ± 7.1 compared with accelerometer‐determined %MVPA (7% difference between the two measurement methods). Teachers and students can use a smart device app and wireless pedometers to conveniently obtain feedback during PE lessons. Future studies should determine whether such technologies help teachers to increase physical activity during PE lessons. [ABSTRACT FROM AUTHOR]

Physical activity (PA) is beneficial for the prevention and management of psychological distress. However, no studies have investigated which combination/s of PA prescribed in the current global guidelines (i.e. aerobic moderate-to-vigorous PA [MVPA] and muscle-strengthening exercise [MSE]) are most strongly linked to reduced psychological distress. This study aimed to examine how PA guidelines adherence is associated with psychological distress. Using cross-sectional data of adults (n = 14,050) who participated in the 2012-2016 Health Survey for England, four categories of self-reported PA guidelines adherence were created: meeting none, only MSE, only aerobic MVPA, meeting both (exposure variables). Psychological distress (outcome) was measured using the General Health Questionnaire-12. The likelihood of experiencing high levels of psychological distress (cut-point of ≥4) across guidelines adherence categories was examined using logistic regression models adjusted for sociodemographic and lifestyle factors. About 17% of adults experienced high levels of psychological distress; 37.5% did not adhere to any PA guidelines (category 1), 1.3% met only MSE (category 2), 35.5% met only aerobic MVPA (category 3), and 25.7% met both guidelines (category 4). Compared to category 1, the likelihood of experiencing high psychological distress was lowest in category 4 (OR = 0.65, 95% CI: 0.54-0.77) followed by category 3 (OR = 0.78, 95% CI: 0.67-0.90), while it did not differ in category 2 (OR = 1.24, 95% CI: 0.75-2.05). This is the first study to identify the association between PA guidelines adherence and psychological distress in a large population sample. Findings suggest that meeting both aerobic MVPA and MSE guidelines might be most beneficial for mental health. [ABSTRACT FROM AUTHOR]

Postnatal depression (PND) is a leading cause of illness and death among women following childbirth. Physical inactivity, sedentary behaviour, poor sleep, and sub-optimal diet quality are behavioural risk factors for PND. A feasible, sustainable, and scalable intervention to improve healthy behaviours and reduce PND symptoms among women at postpartum is needed. This study aims to examine the effectiveness of a multi-behavioural home-based program Food, Move, Sleep (FOMOS) for Postnatal Mental Health designed to improve PND symptoms in women at postpartum. This randomised clinical trial will recruit 220 Australian women (2–12 months postpartum) experiencing heightened PND symptoms (Edinburgh Postnatal Depression Scale score ≥ 10). Participants will be randomised to FOMOS or wait-list control receiving standard clinical care. FOMOS is a 6-month mobile health (mHealth) intervention targeting diet quality, physical activity, sedentary behaviour, sleep, and mental health. The intervention, informed by the Social Cognitive Theory and incorporating behaviour change techniques defined in the CALO-RE taxonomy and Cognitive Behavioural Treatment of Insomnia, provides exercise equipment, and educational/motivational material and social support via mHealth and social media. Data collection pre-intervention and at 3, 6 and 12 months will assess the primary outcome of PND symptoms and secondary outcomes (diet quality, physical activity, sitting time, sleep quality) using self-report and device measures. Process evaluation will explore acceptability, appropriateness, cost-effectiveness, feasibility, and sustainability via analytic tools, record keeping, interviews, and surveys. If effective, FOMOS could be a feasible and potentially scalable management strategy to support improvement of health behaviours and mental health for women with PND symptoms. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12622001079730p [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Purpose: The primary aim of this study was to test the effect of a school-based physical activity intervention on adolescents' performance in mathematics. A secondary aim was to explore potential mechanisms that might explain the intervention effect. Methods: The Activity and Motivation in Physical EDucation intervention was evaluated using a two-arm cluster randomized controlled trial in 14 secondary schools located in low socioeconomic areas of Western Sydney, Australia. Study participants (n = 1173) were grade 8 students (mean age = 12.94 yr, SD = 0.54). The multicomponent intervention was designed to help teachers maximize students' opportunities for moderate-to-vigorous physical activity (MVPA) during physical education (PE) and enhance students' motivation toward PE. Mathematics performance was assessed as part of national testing in grade 7, which was the year before the trial began and then again in grade 9. Potential mediators were: (i) proportion of PE lesson time that students spent in MVPA and leisure time MVPA (%), measured using Actigraph GT3X+ accelerometers, and (ii) students' self-reported engagement (behavioral, emotional, and cognitive) during mathematics lessons. Mediators were assessed at baseline (grade 8) and follow-up (grade 9, 14–15 months after baseline). Results: The effect of the intervention on mathematics performance was small-to-medium (β = 0.16, P < 0.001). An intervention effect was observed for MVPA% in PE (β = 0.59, P < 0.001), but not for leisure time MVPA or any of the engagement mediators. There were no significant associations between changes in potential mediators and mathematics performance. Conclusions: The Activity and Motivation in Physical EDucation intervention had a significant positive effect on mathematics performance in adolescents. However, findings should be interpreted with caution as the effect was small and not associated with changes in hypothesized mediators. [ABSTRACT FROM AUTHOR]

Background: School-based physical education is an important public health initiative as it has the potential to provide students with regular opportunities to participate in moderate-to-vigorous physical activity (MVPA). Unfortunately, in many physical education lessons students do not engage in sufficient MVPA to achieve health benefits. In this trial we will test the efficacy of a teacher professional development intervention, delivered partially via the Internet, on secondary school students' MVPA during physical education lessons. Teaching strategies covered in this training are designed to (i) maximize opportunities for students to be physically active during lessons and (ii) enhance students' autonomous motivation towards physical activity.Method: A two-arm cluster randomized controlled trial with allocation at the school level (intervention vs. usual care control). Teachers and Year 8 students in government-funded secondary schools in low socio-economic areas of the Western Sydney region of Australia will be eligible to participate. During the main portion of the intervention (6 months), teachers will participate in two workshops and complete two implementation tasks at their school. Implementation tasks will involve video-based self-reflection via the project's Web 2.0 platform and an individualized feedback meeting with a project mentor. Each intervention school will also complete two group peer-mentoring sessions at their school (one per term) in which they will discuss implementation with members of their school physical education staff. In the booster period (3 months), teachers will complete a half-day workshop at their school, plus one online implementation task, and a group mentoring session at their school. Throughout the entire intervention period (main intervention plus booster period), teachers will have access to online resources. Data collection will include baseline, post-intervention (7-8 months after baseline) and maintenance phase (14-15 months after baseline) assessments. Research assistants blinded to group allocation will collect all data. The primary outcome will be the proportion of physical education lesson time that students spend in MVPA. Secondary outcomes will include leisure-time physical activity, subjective well-being, and motivation towards physical activity.Discussion: The provision of an online training platform for teachers could help facilitate more widespread dissemination of evidence-based interventions compared with programs that rely exclusively on face-to-face training.Trial Registration: Australia and New Zealand Clinical Trials Registry- ACTRN12614000184673 . Registration date: February 19, 2014. [ABSTRACT FROM AUTHOR]