The effects of different types of leisure-time physical activity on positive mental health among adolescents: a mixed-methods systematic review and meta-analysis

Abstract Background Despite the well-researched general effect of physical activity on mental health, less is known about specific effects, such as qualitative and contextual aspects of physical activity. Thus, this review aimed to systematically synthesise evidence on the effects and experiences of different types of leisure-time physical activity (LTPA; e.g., running, fitness, yoga) on distinct positive mental health (PMH) outcomes among adolescents. Methods We searched in seven databases (MEDLINE, Embase, PsycINFO, Cochrane, SPORTDiscus, CINAHL, and Web of Science) without language restrictions for records from January 2009 to 16 June 2025. Inclusion criteria were defined according to the PICOS framework: population (adolescents from non-clinical studies); intervention (specific LTPA type); comparisons (with and without comparator); outcomes (measures or experiences of PMH); study designs (longitudinal quantitative and qualitative studies). We appraised included studies using the mixed-methods appraisal tool. Results 44 articles from initial 8,149 records were included. Following a convergent segregated approach, the meta-analyses for synthesising the quantitative studies showed different effects depending on the LTPA type. Additionally, the effects depend on the PMH outcome in focus. We identified four facilitators to promote PMH outcomes from the synthesis of qualitative studies: social facilitators for all types of LTPA and various configurations of other facilitators (mastery-related, setting-related, affective-related) for specific LTPA types. The mixed-methods synthesis shows the interplay between LTPA and PMH outcomes depending on the LTPA type. Conclusions The effects of LTPA on PMH in adolescents depend on the LTPA type and PMH outcome in focus. Perceived facilitators highlight possible explanations for the effects found. By investigating specific LTPA types and different PMH outcomes, ecologically valid implications for specific contexts to foster adolescent mental health may be derived. The limited number of studies per LTPA type, PMH aspect, and study design emphasises the need for more research to derive more specific and robust implications for tailored mental health promotion.