Psychological wellbeing in physical education and school sports: A systematic review

International Journal of Environmental Research and Public Health Review Psychological Wellbeing in Physical Education and School Sports: A Systematic Review Javier Piñeiro-Cossio 1, Antonio Fernández-Martínez 1,* , Alberto Nuviala 1and Raquel Pérez-Ordás2   Citation: Piñeiro-Cossio, J.; Fernández-Martínez, A.; Nuviala, A.; Pérez-Ordás, R. Psychological Wellbeing in Physical Education and School Sports: A Systematic Review. Int. J. Environ. Res. Public Health 2021, 18, 864. https://doi.org/10.3390/ ijerph18030864 Academic Editor: Paul B. Tchounwou Received: 30 December 2020 Accepted: 17 January 2021 Published: 20 January 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1Department of Sports and Computer Science, Pablo de Olavide University, 41013 Seville, Spain; [email protected] (J.P.-C.); [email protected] (A.N.) 2 Faculty of Human Sciences and Education, University of Zaragoza, 22003 Huesca, Spain; [email protected] *Correspondence: [email protected]; Tel.: +34-954-977-602 Abstract: Mental health in children and adolescents has become an increasingly important topic in recent years. It is against this backdrop that physical education and school sports play an important role in promoting psychological wellbeing. The aim of this review was to analyse interventions for improving psychological wellbeing in this area. To this end, a literature review was conducted using four databases (WOS, SPORTDiscus, SCOPUS and ERIC) and the following keywords: psychological wellbeing, physical education, and school sports. Twenty-one articles met the inclusion criteria. The results showed that interventions varied greatly in terms of duration and used a wide range of strategies (conventional and non-conventional sports, physical activity, games, etc.) for promoting psychological wellbeing, primarily among secondary school students. There was a lack of consensus as to the conceptualisation of the construct of psychological wellbeing, resulting in a variety of tools and methods for assessing it. Some studies also suggested a link between psychological wellbeing and other variables, such as basic psychological needs and self-determination. Finally, this study provides a definition of psychological wellbeing through physical activity based on our findings. Keywords: mental health; physical activity; educational interventions; emotional education; soft skills 1. Introduction Mental health problems in adulthood originate primarily in childhood and can be related to a variety of causes, such as socioeconomic, genetic or cultural factors [ 1 ]. It is in adolescence that the greatest risks of behaviours affecting wellbeing occur [ 2 , 3 ]. The World Health Organisation (WHO) [ 4 ] describes these problems as the main cause of disability worldwide, with depression extremely prevalent among young people [ 5 ]. School is therefore a suitable location for interventions, allowing students to acquire and develop skills and strategies to face life’s challenges as best they can, with high levels of physical and psychological wellbeing [6,7]. In recent years, the use of physical activity (PA) and sports for personal and social development in children and adolescents has been the subject of an increasing number of studies. Research suggests that physical education (PE) and school sports provide a suitable, effective framework for transferring and teaching skills and strategies to reduce risky behaviour and promote wellbeing [ 8 , 9 ]. Although there is evidence that PA and sports enhance young people’s skills and values at these life stages, there is a gap in research on their impact on psychological wellbeing and a lack of consensus as to the definition of psychological wellbeing in this context [10]. Studies have shown that individuals with high levels of psychological wellbeing are more successful in terms of education, work, friends, stable relationships and physical health [ 11 ]. In education, psychological wellbeing leads to improved attention, creative thinking and holistic thinking [ 5 ]. Psychological wellbeing is usually understood as a construct from the eudaimonic tradition. Unlike subjective wellbeing, which derives from happiness and satisfaction through the pursuit of pleasure and the reduction of pain, Int. J. Environ. Res. Public Health 2021,18, 864. https://doi.org/10.3390/ijerph18030864 https://www.mdpi.com/journal/ijerph Int. J. Environ. Res. Public Health 2021,18, 864 2 of 16 psychological wellbeing seeks to allow people to attain their maximum potential by developing virtues [ 12 ], focusing on capabilities and personal growth, and understanding that happiness is achieved through individual self-realisation [ 13 , 14 ]. Psychological wellbeing focuses on the process and on pursuing values leading to personal growth rather than on pleasurable, pain-avoiding activities, thus making the individual feel alive and authentic [ 15 ]. Ryff [ 16 ] proposed a multidimensional model for understanding psychological wellbeing called the Integrated Model of Personal Development (IMPD), consisting of six dimensions: self-acceptance, autonomy, personal growth, purpose in life, environmental mastery and positive relations with others. Although information on interventions in the context of PE and school sports using the IMPD is limited, the model is widely recognised as a coherent, logical, valid construct [ 12 ], and PA and sports represent useful tools for its implementation [ 17 ]. Two systematic reviews by Malm, Jacobsson and Nicholson [ 18 ] and Mnich, Weyland, Jekauc and Schipperijn [ 19 ] list the benefits of PA and sports, including, on a physical level, reduced risk of developing metabolic syndromes, reduced side effects of cancer, improved cardiovascular health, stronger bones and improved physical condition; and, on a psychological level, improved cognition, better school performance, increased cognitive function and improved mental health, which generates psychological wellbeing. However, there is limited information on the effects of PA on the development and psychological wellbeing of children and adolescents in the context of PE and school sports. It is therefore necessary to identify different strategies and interventions for developing psychological wellbeing in the literature. The primary objective of this paper is to explore studies that seek to promote psychological wellbeing among schoolchildren through PE and school sports and to identify conceptualisations of psychological wellbeing in this specific context. This review has two objectives. Firstly, it seeks to address the following questions. What are the characteristics of studies on psychological wellbeing interventions in PE and school sports? What are their objectives? What does the literature report on the outcomes of interventions aiming to improve psychological wellbeing? Secondly, this review attempts to analyse how psychological wellbeing is conceptualised in this context and to provide a definition of the concept based on the findings. 2. Materials and Methods 2.1. Search Strategy This review was carried out following the protocol outlined in the PRISMA statement. A comprehensive search was conducted in four databases: WOS, SPORTDiscus (EBSCO), SCOPUS and ERIC (Proquest). A number of articles were selected considering bibliography of reference research (6). Individual searches of all studies published up to September 2019 were performed in each database following the PICO protocol as used by Opstoel et al. [ 9 ] (P = Population, I = Intervention, C = Comparison, O = Outcomes). •P = child, children, boys, girls, adolescents •I = physical education •C = no comparison group was added to the search •O = psychological wellbeing, eudaimonic wellbeing. The search terms used were “psychological wellbeing” and “eudaimonic wellbeing”, in combination with “AND” and the search terms “physical education” and “child”, “children”, “boys”, “girls”, and “adolescents”. Searches were conducted in English and Spanish. Only original articles were included in the study. 2.2. Selection Criteria Potentially relevant studies for this review were checked against the following selection criteria: (a) the study had been published in an international peer-reviewed journal; (b) Int. J. Environ. Res. Public Health 2021,18, 864 3 of 16 the study covered interventions with children and adolescents aged between 6 and 18 years old; (c) the study explored the relationship between PE or school sports and psychological wellbeing; and (d) a full-text version was available in English and/or Spanish. Regarding the first criterion, interventions implemented in the school setting (PE classes and in-school and extracurricular sports activities) were eligible. Regarding the second criterion, interventions with children and adolescents at all stages of formal schooling within the aforementioned age range were also considered for inclusion. In the event that the studies included individuals outside that age range, only articles with the majority of participants within that age range were eligible. Articles were excluded following Opstoel’s criteria [9]: • Studies involving a specific population with any type of physical, cognitive or psychological impairment. • Articles not providing primary data (non-interventions), as they do not ensure methodological and statistical rigour (reviews, conceptual articles, conference proceedings, editorials, doctoral theses, books, opinion articles, etc.). •Instrument validations. Duplicates were discarded. The study selection process consisted of screening the titles and abstracts identified during the search. Potentially relevant full-text studies were independently checked for eligibility by two authors, J.P.-C. and R.P.-O. Discrepancies in the selection of the articles were discusses until a consensus was reached. Figure 1shows the sampling process used. After removing duplicates and excluding records by abstract and title, a total of 21 articles were retrieved. 2.3. Data Extraction and Reliability Pilot test forms were used to extract data from the studies. A content analysis of the articles included in this review was also performed. Subsequently, the data were discussed and confirmed by the researchers. The following categories were defined: authors, year, journal (volume and issue), country, objectives, sample size, characteristics of the participants, duration of the study, instruments used to assess psychological wellbeing, and results (Table 1). The criteria for assessing the quality of the studies included were adapted from the Consolidated Standards of Reporting Trials (CONSORT) Statement [ 41 ] as used by Pozo et al. [42] . The quality assessment criteria were: (a) description of the programme, (b) number of participants, (c) inclusion of the journal of publication in the Journal Citation Reports, (d) duration of the programme, (e) description of the methodology; (f) definition of psychological wellbeing. Each item was rated from 0 to 2 based on the criteria outlined in Figure 1. A total score was calculated for each study depending on the number of positive items it contained. Studies with a total score of 9 or higher were considered to be of high quality (HQ); studies with a total score of 5–8 were considered to be of average quality (AQ); studies with a total score lower than 4 were considered to be of low quality (LQ). Details are shown in Table 2. The risk of bias is difficult to ascertain in qualitative, social science studies. Version 5.1.0 of the Cochrane handbook emphasises that, in many situations, it is not practical or possible to blind participants or study staff in the intervention group. Int. J. Environ. Res. Public Health 2021,18, 864 4 of 16 Int. J. Environ. Res. Public Health 2021, 18, x FOR PEER REVIEW 4 of 18 Figure 1. Flow chart of the sampling process. 2.3. Data Extraction and Reliability Pilot test forms were used to extract data from the studies. A content analysis of the articles included in this review was also performed. Subsequently, the data were discussed and confirmed by the researchers. The following categories were defined: authors, year, journal (volume and issue), country, objectives, sample size, characteristics of the participants, duration of the study, instruments used to assess psychological wellbeing, and results (Table 1). Records identified through database searching = 502 WOS = 200 SCOPUS = 204 ERIC = 57 SPORTDiscus = 35 Other sources = 6 Records after screening abstracts and titles (n = 118) Records after removing duplicates (n = 77) Duplicate records (n = 41) Studies included in the analysis (n = 21) Studies involving physical education and sports interventions (n = 21) Articles excluded after reading their titles and abstracts (n = 384) Full-text articles excluded for the following reasons (n = 56): Being conceptual papers (n = 11), not in a school or physical activity setting (n = 8), not assessing psychological wellbeing (n = 5), involving populations with physical or cognitive impairments (n = 1), not involving interventions (n = 31) (n = 56) Figure 1. Flow chart of the sampling process. Int. J. Environ. Res. Public Health 2021,18, 864 5 of 16 Table 1. General overview of the articles included. Study Year Journal (Volume and Issue) Country Objectives Characteristics of the Population Sample Size Duration (Weeks) Instruments Used to Assess Wellbeing Results Bakır & Kangalgil [20]2017 Journal of Education and Training Studies, 5(11) Turkey To explore the effectiveness of sports on mental wellbeing and positivity. 10th grade high school students 60 20 Psychological wellbeing: Ryff’s Psychological Wellbeing Scale Based on the study results, significant differences between pre-test and post-test positivity were identified. There were significant differences in mental wellbeing between the sports activities group and the control group. Beaulac et al. [21]2011 Journal of Youth Studies, 14(8) Canada To explore whether a hip-hop dance programme was associated with improved wellbeing for adolescents living in a multicultural, socio-economically disadvantaged urban community in Ottawa. Youths between 11 and 16 years of age living in a multicultural, socio-economically disadvantaged urban community 63 13 Eudaimonic wellbeing: The Personally Expressive Activities Questionnaire; Hedonic wellbeing: The Positive Affect and Negative Affect Schedule for Children The findings suggested that the community-based intervention was a promising programme for the promotion of youth psychological, social, and physical wellbeing. Bunketorp et al. [22]2015 Journal of School Health, 85(10) Sweden To explore whether a curriculum-based physical activity intervention correlates positively with children’s academic achievement, psychological well-being, health-related quality of life (HRQoL), fitness, and structural development of the brain. Primary school students 428 Not reported Wellbeing: The British Panel Household Survey (BPHS-Y) assesses 5 domains: school, work, family, appearance, and friends at school. Girls attending the intervention school were more likely to pass national tests in Swedish and Mathematics. The fourth to sixth graders in the intervention school reported lower levels of conduct problems, and the girls were also less likely to report hyperactivity. Girls reported higher levels of emotional problems than boys. Boys in the intervention group had significantly higher levels of estimated maximal oxygen uptake than controls. No difference in hippocampal structure was seen. Connolly et al. [23]2011 Research in Dance Education, 12(1) United Kingdom To assess the physiological and psychological impact of contemporary dance classes on adolescent females. Females aged 14 recruited from secondary schools 55 Not reported Health-related quality of life: KIDSCREEN-27; 5 dimensions: physical wellbeing, psychological wellbeing, autonomy & parents, peers & social support, school environment. There was a statistical increase in areas of physical fitness. Aerobic capacity and upper body strength increased significantly. No significant change occurred in flexibility. Self Esteem statistically increased. No change occurred in Intrinsic Motivation, however motivation scores were higher than average at pre-test stage. Attitudes towards dance were very positive both preand post-intervention. This study showed that dance can statistically improve components of physical fitness, and psychological well-being. Costigan et al. [24]2016 Medicine and Science in Sports and Exercise, 8 Australia To evaluate the efficacy of two high-intensity interval training (HIIT) protocols for improving cognitive and mental health outcomes (executive function, psychological wellbeing, psychological distress, and physical self-concept) in adolescents. Secondary school students aged 14–16 years old. 65 24 Does not mention instruments for assessing wellbeing While results were not significant, small improvements in executive function and psychological wellbeing were evident in the aerobic exercise programme (AEP) group; and moderate improvements in executive function, and small improvements in wellbeing and perceived appearance were observed for the resistance and aerobic programme group. Mean feeling state scores improved from preworkout to postworkout in both HIIT conditions, with significant results for the AEP. Int. J. Environ. Res. Public Health 2021,18, 864 6 of 16 Table 1. Cont. Study Year Journal (Volume and Issue) Country Objectives Characteristics of the Population Sample Size Duration (Weeks) Instruments Used to Assess Wellbeing Results Grace et al. [25]2015 African Journal for Physical, Health Education, Recreation and Dance, 21(4) South Africa To determine the effects of a pedometer-based physical activity intervention on the psychological wellbeing and selected physical and physiological indices in overweight/obese adolescents. Overweight/obese adolescents aged 12-18 years from two secondary schools. 31 Not reported Mental wellbeing: Warwick-Edinburgh Mental Wellbeing Scale Our results indicate that a relatively small change in activity caused a statistically significant improvement in cardio respiratory fitness with no significant impact on psychological wellbeing. Gül et al. [26]2017 Journal of Education and Training Studies, 5(5) Turkey To examine the effect of sports education on psychological wellbeing among high school students at the individual, environmental, and self-determination levels. Secondary school students aged 14–18 years old. 187 16 Does not mention instruments for assessing wellbeing Regarding the individual development dimensions of the psychological wellbeing scale, there were statistically significant differences between the experimental groups and the control groups, especially post-test. Ha et al. [27]2017 BMC Public Health, 18(11) China To examine the effects of the SELF-FIT intervention on students’ moderate-to-vigorous physical activity (MVPA) MVPA during school physical education. Secondary school students with an average age of 14 years. 773 Not reported Does not mention instruments for assessing wellbeing The SELF-FIT intervention has been designed to improve students’ health and wellbeing by using high-intensity activities in classes delivered by teachers who have been trained to be autonomy-needs supportive. If successful, scalable interventions based on SELF-FIT could be applied in physical education at large. Hankonen et al. [28]2016 BMC Public Health, 16(1) Finland To describe the study protocol for a cluster RCT designed to evaluate the effectiveness, cost-effectiveness, and processes of the Let’s Move It programme compared with the usual curriculum among vocational school students. Students between the ages of 15 and 17 years from 6 vocational schools. 1123 30 Psychological wellbeing: The Flourishing Scale Does not report on results. Hignett et al. [29]2018 Journal of Adventure Education and Outdoor Learning, 18(1) United Kingdom To explore the impact of a 12-week surfing programme on a group of children/young people excluded, or at risk of exclusion, from mainstream schooling in the UK. Young people between the ages of 12 and 16 years, who have either been excluded from mainstream schooling and therefore attend Short Stay Schools, or attend mainstream schools, but are considered at risk of exclusion. 58 12 Does not mention instruments for assessing wellbeing Results found significant drops in heart rate (suggesting improved fitness), increased satisfaction with appearance, more positive attitudes towards school and friendships, greater environmental awareness and more positive teacher evaluations, post-intervention. A lack of findings in other domains suggests these results were not due to participants simply conforming to demand characteristics. Ho et al. [30]2017 Pediatrics, 140(4) China To assess the effectiveness of a positive youth development (PYD)-based sports mentorship programme on the physical and mental wellbeing of adolescents recruited in a community setting. Students from 12 secondary schools 664 Not reported Perceived self-control in physical activity: The Perceived Behavioral Control Questionnaire; Self-efficacy: The Self-Efficacy Questionnaire; Self-concept: The Physical Self-Description Questionnaire The PYD-based sports mentorship intervention improved healthy adolescents’ mental wellbeing, psychological assets, physical fitness, and physical activity levels. Int. J. Environ. Res. Public Health 2021,18, 864 7 of 16 Table 1. Cont. Study Year Journal (Volume and Issue) Country Objectives Characteristics of the Population Sample Size Duration (Weeks) Instruments Used to Assess Wellbeing Results Karasimopoulou et al. [31]2012 Health Education Research, 27(5) Greece To examine the effect of the Health Education Programme ‘Skills for primary school children’ on children’s perceptions about certain dimensions of their quality of life: physical wellbeing, mental wellbeing, moods and emotions, self-concept, leisure–autonomy, family life, financial resources, friends, school environment and social acceptance (bullying). Students aged 10–12 years from 12 primary schools. 286 23 Does not mention instruments for assessing wellbeing Children in the experimental group significantly improved their perceptions of physical wellbeing, family life, financial aspects, friends, school life, and social acceptance. On the other hand, children in the control group significantly improved their perceptions for physical wellbeing, whereas they deteriorated them significantly for family life, mood and feelings and social acceptance. Also, children as a whole improved their self-concept. Furthermore, analysis of covariance showed that the experimental group had better perceptions of autonomy than the control group in the final measurement. Lubans et al. [32]2016 Journal of Adolescent Health, 58(2) Australia To explore the effect of the ‘Active Teen Leaders Avoiding Screen-time’ (ATLAS) intervention on psychological wellbeing in adolescent boys and to examine the potential mediating mechanisms that might explain this effect. Adolescent boys with a mean age of 12.7 years from schools located in low-income communities. 361 Not reported Positive thoughts and emotions: The Warwick-Edinburgh Mental Wellbeing Scale The intervention effect on wellbeing was small but statistically significant. Within a multiple mediator model, changes in autonomy needs satisfaction, recreational screen-time and muscular fitness significantly mediated the effect of the intervention on psychological wellbeing. Luna et al. [33]2019 International Journal of Environmental Research and Public Health, 16(1821) Spain To evaluate the impact of a physical-sport education pilot programme on adolescents’ subjective wellbeing (health-related quality of life, positive affect and negative affect), trait emotional intelligence and social anxiety. Compulsory secondary education students aged 12–15 years 113 16 Psychosocial wellbeing: Harter’s Self-Perception Profile for Children; General wellbeing and wellbeing at school: 13 questions from the Danish national survey of wellbeing in the school-aged population; Health-related quality of life: KIDSCREEN-27 The physical-sport education pilot programme promoted significant improvements in a specific indicator of subjective wellbeing and trait emotional intelligence in the experimental group. McNamee et al. [34]2016 European Physical Education Review, 23(4) USA To demonstrate the efficacy and feasibility of an innovative physical education programme, referred to as a health club (HC) approach, in a high school setting. Adolescent girls in a high school setting, aged 14–15 years. 1970 35 Psychosocial wellbeing: Mood states: The Profile of Mood States-Short Form; Affects: The Positive Affect and Negative Affect Schedule for Children; Perceived stress: The Perceived Stress Scale; Positive psychology: The Inventory of Positive Psychological Attitudes-32R. The HC approach produced high levels of moderate-to-vigorous physical activity (MVPA). Significant differences were found in participants’ flexibility and cardiovascular fitness at the conclusion of the 14-week programme. Participants reported greater perceived control over their PA, improvements in their physical self-concept across several domains, more positive feelings about appearance and strength and more positive global statements about their physical selves at post-test. Noggle et al. [35]2012 Journal of Developmental & Behavioral Pediatrics, 33(2) USA To test feasibility of yoga within a high school curriculum and evaluate preventive efficacy for psychosocial wellbeing. Grade 11 or 12 students with a mean age of 17 years. 51 28 KIDSCREEN-52 Although PE-as-usual students showed decreases in primary outcomes, yoga students maintained or improved. Int. J. Environ. Res. Public Health 2021,18, 864 8 of 16 Table 1. Cont. Study Year Journal (Volume and Issue) Country Objectives Characteristics of the Population Sample Size Duration (Weeks) Instruments Used to Assess Wellbeing Results Sifers & Shea [36]2013 Journal of Clinical Sport Psychology, 7 USA To measure broader emotional and behavioural functioning along with the self-esteem and body image of the participants in the GOTR/T programme at the beginning and upon completion of the programme to further evaluate the programme’s effect on self-esteem, body image, and emotional and behavioural functioning. Girls, ages 8 to 13 111 4 Psychological wellbeing: The Flourishing Scale Results suggest GOTR/T may help improve self-esteem in relation to physical appearance and body image. Improvements in other domains were not found. Slee & Allan [37]2019 Sports, 7(134) United Kingdom To investigate the efficacy of three contrasting induction programmes for facilitating improvements in children’s psychological wellbeing and self-determination during their transition into secondary school. Primary school children aged 11. 100 Not reported Psychological wellbeing: Ryff’s Psychological Wellbeing Questionnaire A bespoke outdoor adventure (OA) residential programme achieved the strongest scale of change in children’s psychological wellbeing and self-determination compared to a generic OA residential and a non-OA school-based induction programme. Smedegaard et al. [38]2016 BMC Public Health, 16(1127) Denmark To develop, implement, and evaluate a multi-component, school-based, physical activity intervention to improve psychosocial wellbeing among school-aged children and youths. Children and youths from the 4th to the 6th grade (10–13 years). 3124 Not reported Psychological wellbeing: The Flourishing Scale The intervention focuses on the mental benefits of physical activity at school, which has been a rather neglected theme in health promotion research during recent decades. Standage et al. [39]2013 BMC Public Health, 13(666) United Kingdom To determine the effectiveness of the BtBYCB programme on (i) pupils’ wellbeing, self-perceptions, self-esteem, aspirations and learning strategies; and (ii) changes in modifiable health-risk behaviours (i.e., physical activity, diet, smoking and alcohol consumption). Primary school children aged 11–13. 711 13 Physical and mental wellbeing: the Chinese version of the SF-12v2. The findings of this work provide insight into the effectiveness of an innovative and child-centered programme. The research informs improvements to the BtBYCB programme as well as other interventions targeting child/youth health and wellness. Wright & Burton [40]2008 Journal of Teaching in Physical Education, 27(2) USA To systematically explore the implementation and short-term outcomes of a responsibility-based physical activity programme that was integrated into an intact high school PE class. African American students in an urban high school. 23 20 Subjective wellbeing: KIDSCREEN-10; Affects: The Positive Affect and Negative Affect Schedule for Children Five themes characterised the programme: (a) establishing a relevant curriculum, (b) navigating barriers, (c) practising life skills, (d) seeing the potential for transfer, and (e) creating a valued programme. Int. J. Environ. Res. Public Health 2021,18, 864 9 of 16 Table 2. Quality of the studies. Study Description of the Programme Number of Participants Included in JCR Duration of the Programme Description of the Methodology Definition of Psychological Wellbeing Overall Score Quality Level Bakır & Kangalgil [20]0 0 2 1 0 2 5 AQ Beaulac et al. [21]1 0 2 1 1 2 7 AQ Bunketorp et al. [22]1 1 2 2 1 0 7 AQ Connolly et al. [23]2 0 1 0 2 2 7 AQ Costigan et al. [24]2 0 2 0 2 2 8 AQ Grace et al. [25]1 0 0 0 1 2 4 LQ Gül et al. [26]2 1 2 0 2 2 9 HQ Ha et al. [27]2 2 2 0 2 2 10 HQ Hankonen et al. [28]2 2 2 0 2 0 8 AQ Hignett et al. [29]1 0 1 1 1 2 6 AQ Ho et al. [30]2 2 2 2 2 2 12 HQ Karasimopoulou et al. [31]2 1 2 2 2 2 11 HQ Lubans et al. [32]1 1 2 2 1 2 9 HQ Luna et al. [33]2 1 2 0 2 2 9 HQ McNamee et al. [34]1 2 2 1 1 2 9 HQ Noggle et al. [35]1 0 2 1 1 2 7 AQ Sifers & Shea [36]1 1 1 0 1 0 4 LQ Slee & Allan [37]2 0 1 0 2 2 7 AQ Smedegaard et al. [38]2 2 2 2 2 0 10 HQ Standage et al. [39]2 2 2 0 2 2 10 HQ Wright & Burton [40]2 0 2 1 2 0 7 AQ Parameter 1: Does the study provide a detailed description of the implementation? 0: No, 1: Yes, but it is incomplete or inaccurate, 2: Yes. Parameter 2: The number of participants: 0: fewer than 100 participants, 1: between 100 and 500 participants, 2: more than 500 participants. Parameter 3: Is the journal of publication included in the Journal Citation Reports? 0: No, 1: It is included in the Scimago Journal Rank 2: Yes. Parameter 4: Duration of the intervention: 0: less than 3 months, 1: between 3 and 4 months, 2: more than 4 months. Parameter 5: Does the study provide a detailed description of the methodology? 0: No, 1: Yes, but it is incomplete or inaccurate, 2: Yes. Parameter 6: Does the study provide a definition of wellbeing? 0: No, 1: Yes, but the definition is vague, 2: Yes, and the definition is detailed. Int. J. Environ. Res. Public Health 2021,18, 864 16 of 16 44. Rodriguez-Ayllon, M.; Cadenas-Sánchez, C.; Estévez-López, F.; Muñoz, N.E.; Mora-Gonzalez, J.; Migueles, J.H.; Molina-García, P.; Henriksson, H.; Mena-Molina, A.; Martínez-Vizcaíno, V.; et al. Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic Review and Meta-Analysis. Sports Med. 2019 ,49, 1383–1410. 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