A systematic review of the mental health impacts of sport and physical activity programmes for adolescents in post-conflict settings

Children and adolescents exposed to violent conflict are at high risk of developing mental health problems. Sport and physical activity is increasingly incorporated in post-conflict assistance for young people. Implementing agencies make a broad array of health claims for which there is currently a fragmented evidence base. The purpose of this review was to summarise the impact evidence for sport and physical activity based programmes on the mental health of adolescents in post-conflict settings, and highlight the limitations of current practice. Methods: A systematic review of 12 electronic databases, 12 journals and leading humanitarian websites was conducted in August 2014. Studies were eligible for inclusion if they described a sports or physical activity based intervention for adolescents between the ages of 12-19 in a post-conflict setting.Results: A total of 11,722 publications were initially identified, of which 3 met the inclusion criteria and were included in a narrative synthesis. Two studies described projects in northern Uganda; one reported a decline in intervention in boys’ mental health when compared to controls, the other a non-significant improvement. The third study reported continual improvement in symptom presentation in ex-child soldiers in Sierra Leone. Common limitations were short study duration and follow-up, poor or unreported adaptation of methods and a lack of treatment mechanisms research.Conclusion:There is a shortage of high-quality and available information, which limits the strength of conclusions that can be drawn. Despite the international furore surrounding the use of sport for assisting conflict-affected populations, there is not yet convincing evidence of its efficacy as a mental health intervention. Future evaluation and research should aim to identify the mechanisms and processes behind the intended impact of interventions.