Promoting mental health in children and adolescents with disabilities through school-based physical activity intervention during the COVID-19 pandemic

Abstract

BackgroundChildren and adolescents with disabilities had lower levels of physical activity (PA) and mental health than their typically developing peers during the COVID-19 pandemic. ObjectivesThis study aimed to examine the effects of school-based PA intervention on quality of life (QoL) and self-concept (SC) in children and adolescents with intellectual disabilities (IDs), physical disabilities (PDs), and hearing impairments (HIs). MethodsFifty-eight participants with disabilities (Mage = 15.0 ± 2.2 years) were recruited from five Hong Kong special schools during the COVID-19 pandemic. School-based PA intervention included (un)structured PA, teacher training, and parental involvement. PA levels, QoL, and SC were measured by the Physical Activity Questionnaire for Older Children, Pediatric Quality of Life Inventory, and Physical Self-Description Questionnaire Short Form, respectively. PROCESS macro, linear mixed model, two-way ANOVAs, and linear regression were used in the data analyses. ResultsThere were positive intervention effects on PA levels (Mean Difference [MD] = 0.33, 95% CI [0.06, 0.60]) and SC (MD = 0.38, 95% CI [0.03, 0.73]) in participants with disabilities; and social QoL (MD = 14.10, 95% CI [0.43, 27.78]) only in participants with IDs. SC improvement significantly mediated the relationship between PA and QoL improvements in participants with disabilities (β = 0.304, R2 = 26%) and males (β = 0.463, R2 = 10%). Contextual factors significantly moderated PA levels and mental health. ConclusionSchool-based PA intervention improved QoL through positive changes in SC in children and adolescents with disabilities during the COVID-19 pandemic. Future studies should consider stress, anxiety, and depression to explore the effectiveness of school-based PA intervention in children and adolescents with disabilities.