This study aims to understand the association among sport participation, substance use and mental health of adolescent athletes within a diverse urban youth population. Data included a convenience sample of predominantly Black and Hispanic youth (85.7%) ages 14 to 18 years, who were Mount Sinai Adolescent Health Center (MSAHC) patients who presented for an annual physical exam or pre-participation exam (PPE) and were cleared for high school sport(s) participation. During the encounter, participants self-reported their use of tobacco, alcohol, and marijuana on a 6-point frequency scale, dichotomized to indicate use in the past 30 days. Anxiety and depression were assessed using two self-reported questions. Demographic data (e.g. ethnicity, gender, age) and whether participants had a current mental health provider were also extracted from the Electronic Medical Record (EMR). Results from multivariate logistic regression analyses showed adolescents with one year of sport participation had significantly lower odds of alcohol use in the past 30 days (OR=0.22, 95%CI= [0.12,0.41]) compared to individuals who did not participate in sport(s). Adolescents with two or more years of sport participation had significantly lower odds of alcohol (OR=0.46, 95%CI= [0.23,0.93]) and marijuana use (OR=0.10, 95%CI= [0.01,0.72]) in the past 30 days compared to individuals who did not participate in sport(s). Adolescents with one year of sport participation had lower odds of reported depression (OR=0.56, 95%CI= [0.33,0.94]) compared to individuals who did not participate in sport(s). Adolescents with two or more years of sport participation had significantly lower odds of reported depression (OR=0.35, 95%CI= [0.16,0.75]) and anxiety (OR=0.36, 95%CI= [0.15,0.86]) compared to individuals with no sport participation. These effects were found after adjusting for whether they were currently engaged with a mental health provider. Results of this study suggest that engagement in organized sport(s) may have protective effects against substance use, depression and anxiety. Additionally, the PPE could be used as an opportunity to promote engagement in extracurricular activities in addition to organized sports, to maximize the opportunity for adolescents to experience these benefits.
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