Youngjun Lee, Simone Ciaccioni, David Stodden, Janet Hauck, Rodrigo A. Lima, Caterina Pesce
{"title":"Physical activity and adolescent mental health across 45 countries: Exploring the role of country-level perceived health","authors":"Youngjun Lee, Simone Ciaccioni, David Stodden, Janet Hauck, Rodrigo A. Lima, Caterina Pesce","doi":"10.1016/j.mhpa.2026.100826","DOIUrl":"10.1016/j.mhpa.2026.100826","url":null,"abstract":"<div><h3>Purpose</h3><div>Physical activity (PA) has been linked to better adolescent mental health, yet most evidence comes from single-country studies. Although a recent meta-analysis established that this association varies significantly by country, the specific country-level factors underlying this variability remain untested. This study examined whether cross-national variability in the PA–mental health association is related to country-level differences in adolescents' perceived health. We examined the PA–mental health association in a large cross-national sample and tested country-level perceived health as a moderator to provide a more holistic perspective on the interplay between physical activity, its context and outcomes.</div></div><div><h3>Methods</h3><div>This cross-sectional study used data from the 2018 Health Behaviour in School-aged Children survey of adolescents aged 11, 13, and 15 from 45 countries (N = 217,384). Mental health was measured using self-reported life satisfaction and psychological health complaints. PA was assessed as the number of days per week with at least 60 min of moderate-to-vigorous activity. Multilevel linear regression models were estimated, with adolescents nested within countries. Random intercepts and slopes were included to capture cross-national variability, and cross-level interactions were tested to assess moderation by country-level perceived health.</div></div><div><h3>Results</h3><div>Higher PA was consistently associated with better mental health across all outcomes (all ps < 0.001). Marginal R<sup>2</sup> ranged from 0.012 to 0.051, and conditional R<sup>2</sup> from 0.040 to 0.095, indicating meaningful country-level variance. A non-significant trend toward moderation by country-level perceived health was observed for life satisfaction (b = 0.15, p = .076) and sleep difficulty (b = 0.08, p = .092), though neither reached the pre-specified significance threshold (p < .05).</div></div><div><h3>Conclusions</h3><div>Findings suggest that country-level context may play a role in the PA–mental health association, though this requires confirmation in future research. Programs promoting mental health through PA should encompass the role of the broad context, considering cross-national differences and adapting strategies to local health perceptions.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"31 ","pages":"Article 100826"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149251381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reciprocal effects of physical activity and depression in older Europeans: A counterfactual longitudinal study using SHARE-ERIC data","authors":"Gulbahar Celik, Fabrizio Pecoraro","doi":"10.1016/j.mhpa.2026.100828","DOIUrl":"10.1016/j.mhpa.2026.100828","url":null,"abstract":"<div><h3>Background</h3><div>While low physical activity and depressive symptoms in older adults form a vicious cycle, their exact causal nature remains unclear due to a reliance on associational models. This study quantifies the reciprocal causal effects causal effects between physical activity levels and depressive symptoms among older European adults.</div></div><div><h3>Methods</h3><div>We analyzed multi-wave longitudinal data from the SHARE-ERIC database. To evaluate this reciprocal relationship, we applied advanced causal inference methods using Longitudinal Modified Treatment Policies (LMTP). This allowed us to estimate the causal impact of hypothetical static (i.e., all individuals are set to the same exposure level in a binary contrast) and dynamic shift scenarios (e.g., increasing physical activity levels or reducing depressive symptoms) while rigorously accounting for time-varying confounding.</div></div><div><h3>Results</h3><div>Increasing physical activity levels was associated with a significant reduction in subsequent depressive symptoms (23% reduction in the static scenario, MR = 0.714; 12% reduction per one-level shift, MR = 0.875). Conversely, reducing depressive symptoms predicted an improvement in physical activity participation (10% in the static scenario, MR = 0.898; 2–7% in the shift scenarios, MRs: 0.977–0.926). Subgroup analyses revealed that the protective effect of physical activity on depressive symptoms was more pronounced among individuals without existing illnesses (p = 0.002) and those not receiving therapies (p < 0.001). Similarly, the reverse effect (depressive symptoms on physical activity) was more pronounced among older adults (≥75 years), and individuals with poor self-reported health, activity limitations, and multimorbidity (≥3 chronic conditions).</div></div><div><h3>Conclusion</h3><div>These findings support a reciprocal relationship between physical activity levels and depressive symptoms in older adults. Under the stated assumptions, the magnitude of these causal effects varies significantly depending on individual health profiles and demographic characteristics. Therefore, rather than adopting a one-size-fits-all approach, interventions targeting physical activity and depressive symptoms should be tailored to the specific profiles of different subgroups.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"31 ","pages":"Article 100828"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149251377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eliana M. Moreno, Antonio Poyato-Sanz, José Manuel Armada-Crespo
{"title":"Physical activity and depression: A systematic review of clinical practice guidelines","authors":"Eliana M. Moreno, Antonio Poyato-Sanz, José Manuel Armada-Crespo","doi":"10.1016/j.mhpa.2026.100827","DOIUrl":"10.1016/j.mhpa.2026.100827","url":null,"abstract":"<div><div>The inclusion of physical exercise in clinical practice guidelines (CPGs) for the treatment of depression in adults has come about due to evidence of the benefits of such exercise on the symptoms of depression. However, its use is not widespread amongst professionals due to a lack of resources and even a lack of specific training in this area. In this regard, the aim of this study is to examine the recommendations regarding the use of physical activity (PA) for the treatment of depression in adults, as set out in clinical practice guidelines published by internationally recognised organisations. To this end, a systematic review was carried out using the PRISMA method, in which 14 CPGs were identified and analysed. The results reveal that 10 of the 14 guidelines contain recommendations in favour of using PA as a complementary or adjunct to psychotherapeutic and/or pharmacological treatment, or as monotherapy for mild depression. Recommendations for PA were also found in all 14 guidelines for the different degrees of depression (mild, moderate or severe). Among the effects of PA on depression, a reduction in depressive symptoms and an improvement in general well-being and quality of life are described. In conclusion, this review supports the use of PA for the treatment of depression in the adult population.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"31 ","pages":"Article 100827"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arnaud Philippot , Marine Coppens , Tine Van Damme , Camille Sluys , Marc Francaux , Vincent Dubois , Davy Vancampfort
{"title":"Combining the behaviour change wheel framework with a co-design approach to develop an outpatient physical activity intervention for adolescents with depression: a blueprint","authors":"Arnaud Philippot , Marine Coppens , Tine Van Damme , Camille Sluys , Marc Francaux , Vincent Dubois , Davy Vancampfort","doi":"10.1016/j.mhpa.2026.100758","DOIUrl":"10.1016/j.mhpa.2026.100758","url":null,"abstract":"<div><h3>Background</h3><div>Physical activity (PA) benefits adolescents with depression, yet current interventions often lack theoretical rigor and tailored development, limiting their effectiveness.</div></div><div><h3>Objective</h3><div>To systematically co-develop a multi-component, theory-driven intervention to increase PA among outpatient adolescents with depression, guided by the eight-step Behaviour Change Wheel (BCW) framework and participatory co-design.</div></div><div><h3>Methods</h3><div>Inpatient adolescents (8♀, 2 ♂, 1 ⚧, 16.8 ± 1.8 years) participated in six BCW-aligned co-design workshops. Content was analysed deductively via BCW steps and inductively for participants’ insights. Themes were mapped to Capability, Opportunity, Motivation – Behaviour (COM-B) constructs to inform intervention components and behaviour change techniques.</div></div><div><h3>Results</h3><div>COM-B mapping revealed key needs related to psychological capability (e.g., building confidence and skills), social opportunity (e.g., fostering connection and trust), and reflective motivation (e.g., cultivating intention and value around physical activity). The identified intervention strategy operationalized by the selected behavior change techniques include physiotherapist-led counselling, structured in-house confidence-building PA sessions, optional peer support groups, a voluntary peer-buddy system, and guidance into psychologically safe, inclusive community clubs. Visual analogue scale ratings (8.5–9.7) demonstrated high acceptability and feasibility. The proposed delivery model aligns with the Belgian reimbursement system for physiotherapy.</div></div><div><h3>Conclusions</h3><div>This study provides a transparent, replicable BCW- and co-design–based framework for PA promotion in adolescents with depression. To enhance sustainability and impact, future research should engage early with policymakers, community partners, and sports organizations and pilot hybrid models to assess behavioural, organizational, and policy-level outcomes.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"30 ","pages":"Article 100758"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah M. Kaja , Greyson Arnold , Amy L. Gower , Kay A. Simon , Hana-May Eadeh
{"title":"Physical activity is associated with less emotional distress among transgender and gender diverse adolescents","authors":"Sarah M. Kaja , Greyson Arnold , Amy L. Gower , Kay A. Simon , Hana-May Eadeh","doi":"10.1016/j.mhpa.2026.100773","DOIUrl":"10.1016/j.mhpa.2026.100773","url":null,"abstract":"","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"30 ","pages":"Article 100773"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147740002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bethany Fleck Dillen , Michael Rhoads , Isabel Kool
{"title":"Maternal well-being for working mothers in the U.S. who participate in Peloton™ exercise","authors":"Bethany Fleck Dillen , Michael Rhoads , Isabel Kool","doi":"10.1016/j.mhpa.2025.100743","DOIUrl":"10.1016/j.mhpa.2025.100743","url":null,"abstract":"<div><h3>Statement of purpose</h3><div>This study addresses the mental and physical well-being of working mothers from the United States who used Peloton™ during the COVID-19 pandemic. The objective is to investigate the relationship between exercise behavior and maternal well-being, focusing on parenting stress, parental self-efficacy, and guilt. Research questions explore whether Peloton use moderates these factors.</div></div><div><h3>Method</h3><div>This study involved 144 working mothers whose children's ages ranged from birth to 18. Mothers participated in an online survey.</div></div><div><h3>Results</h3><div>Parenting stress was linked to lower quality of life, self-efficacy, and happiness, and higher shame. High-intensity Peloton use related positively to psychological and social quality of life, but negatively to self-efficacy.</div></div><div><h3>Conclusions</h3><div>Encouraging regular physical activity may support maternal well-being, especially under high stress. Online platforms like Peloton offer accessible options for busy mothers.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"30 ","pages":"Article 100743"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
James Mugisha , Philip B. Ward , Japheth Nkiriyehe Kwiringira , Davy Vancampfort
{"title":"An Act-Belong-Commit-based school intervention reduces suicidal ideation in adolescents: a pilot cluster-randomized trial from Uganda","authors":"James Mugisha , Philip B. Ward , Japheth Nkiriyehe Kwiringira , Davy Vancampfort","doi":"10.1016/j.mhpa.2026.100764","DOIUrl":"10.1016/j.mhpa.2026.100764","url":null,"abstract":"<div><h3>Objective</h3><div>Schools are essential in addressing mental health challenges, particularly in low-income settings like Uganda. However, there is a lack of randomized trials that are culturally tailored for these contexts. This secondary analysis of a group-randomized trial evaluates the effectiveness of a culturally sensitive Act-Belong-Commit (ABC) intervention, combined with physical activity, in reducing suicidal ideation among Ugandan adolescents aged 14 to 17 years.</div></div><div><h3>Method</h3><div>The study included 927 adolescents (490 in the intervention group, 437 in the control group; 329 boys; mean age 16.3 ± 0.9 years) who reported suicidal ideation at baseline across four schools. Participants were randomized by school to receive either 12-weeks ABC and physical activity, facilitated by teachers and peers, added to standard care or standard care alone, which involved referring severe depression cases. Pre- and post-intervention assessments measured suicidal ideation using Item 9 of the PHQ-9-A and evaluated childhood trauma (CTQ-SF), self-reported health, wealth, and food security. Linear mixed modeling was employed.</div></div><div><h3>Results</h3><div>The intervention led to significant reductions in suicidal ideation (PHQ-9-A item 9 ≥ 1), with a Cohen's h of 0.85. The prevalence of suicidal ideation decreased to 45.3% in the intervention group compared to 83.3% in the control group (odds ratio for no suicidal ideation = 1.83, 95%CI = 1.65-2.04 (χ<sup>2</sup> = 142.2, P < 0.001). Effects were moderated by age, sex, wealth index, food insecurity, health status, and childhood abuse.</div></div><div><h3>Conclusions</h3><div>ABC effectively reduces suicidal risk among adolescents, although there is need for additional mental health support to reduce the burden.</div></div><div><h3>Trial registration</h3><div>NCT06957925.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"30 ","pages":"Article 100764"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arian Daneshpour , Davy Vancampfort , Felipe Schuch , Katarzyna Karolina Machaczek , Joseph Firth , Brendon Stubbs
{"title":"Weekend warrior physical activity engagement and the risk of mental health conditions: A systematic review and narrative synthesis","authors":"Arian Daneshpour , Davy Vancampfort , Felipe Schuch , Katarzyna Karolina Machaczek , Joseph Firth , Brendon Stubbs","doi":"10.1016/j.mhpa.2025.100746","DOIUrl":"10.1016/j.mhpa.2025.100746","url":null,"abstract":"<div><h3>Background and aims</h3><div>Regular moderate-to-vigorous physical activity (MVPA) offers mental health benefits, with guidelines recommending 150 min weekly. However, many struggle to meet this standard. The weekend warrior (WW) approach, which involves reaching this activity level in one or two days, may lower the risk of mental health conditions, but evidence is limited. This study reviews if the WW pattern reduces risks of mental disorders compared to regular physical activity (RPA) and inactivity.</div></div><div><h3>Methods</h3><div>A systematic search was conducted on October 30, 2025, for studies on WW PA and mental health conditions. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Narrative synthesis was employed for data synthesis.</div></div><div><h3>Results</h3><div>Twelve studies (eight cross-sectional, four prospective cohort) were included, mostly focusing on depression (N = 8). A narrative synthesis found that 10 studies confirmed the comparable association of WW and RPA with lower rates of depression and anxiety. All cohort studies (NOS Mean: 9 ± 0) and most cross-sectional studies (5.12 ± 0.64) were high quality. Inconsistent results may be partially explained by varying definitions of WW and populations, suggesting moderating effects of factors such as age and sex. Several studies indicate a U-shaped relationship between MVPA and mental health, but the evidence remains insufficient.</div></div><div><h3>Conclusions</h3><div>WW seems to have a comparable association with a lower risk of depression when compared to RPA. However, there is limited information regarding its impact on other mental health conditions. To gain a deeper understanding of this association, future research, particularly longitudinal studies and trials, is essential.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"30 ","pages":"Article 100746"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Maternal and paternal pathways linking health literacy, physical activity, and BMI to adolescent physical activity and mental health: A structural equation modeling study","authors":"Wei Yu , Yang Deng , Cui Yang , Hamid Amini","doi":"10.1016/j.mhpa.2026.100778","DOIUrl":"10.1016/j.mhpa.2026.100778","url":null,"abstract":"<div><h3>Background</h3><div>The distinct mechanisms through which maternal and paternal health literacy differentially relate to adolescent outcomes remain under-explored. This study examined direct and indirect pathways linking parental health literacy to adolescents’ mental health and moderate-to-vigorous physical activity (MVPA).</div></div><div><h3>Methods</h3><div>Structural equation modeling (SEM) was used to estimate separate maternal and paternal models examining pathways between parental health literacy, parental physical activity, parental BMI, adolescent moderate-to-vigorous physical activity (MVPA), adolescent BMI, and adolescent mental health. Adolescent MVPA was assessed using ActiGraph wGT3X-BT accelerometers, parental health literacy using the 12-item Health Literacy Population Survey (HLS19-Q12), parental physical activity using the short form of the International Physical Activity Questionnaire (IPAQ-SF), and adolescent mental health using the Strengths and Difficulties Questionnaire (SDQ).</div></div><div><h3>Results</h3><div>Higher maternal health literacy was associated with greater maternal physical activity (β = 0.21, p < 0.001) and lower BMI (β = −0.12, p = 0.001), and was linked to higher adolescent MVPA (β = 0.10, p = 0.003), lower BMI (β = −0.08, p = 0.008), and fewer mental health difficulties (β = −0.09, p = 0.005), with additional indirect pathways via maternal physical activity. In contrast, paternal health literacy was associated with paternal physical activity (β = 0.14, p = 0.003) and showed a small indirect association with adolescent MVPA (β = 0.013), with no significant direct associations observed for adolescent outcomes.</div></div><div><h3>Conclusions</h3><div>Maternal health literacy was associated with broader direct and indirect relationships with adolescent physical activity, BMI, and mental health, whereas paternal health literacy appeared to relate primarily to adolescent MVPA through fathers’ own physical activity. These findings suggest distinct maternal and paternal pathways in adolescent health outcomes.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"30 ","pages":"Article 100778"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Shields-Zeeman , Michele Schmitter , Joelle Vilé , Annelot van Geffen , Tessa van Doesum , Ben Wijnen , Peter Oostelbos , Jasper A.J. Smits , Jan Spijker , Janna N. Vrijsen
{"title":"Barriers and facilitators of evidence-based exercise therapy as adjunct treatment for major depressive disorder in specialized mental health care","authors":"Laura Shields-Zeeman , Michele Schmitter , Joelle Vilé , Annelot van Geffen , Tessa van Doesum , Ben Wijnen , Peter Oostelbos , Jasper A.J. Smits , Jan Spijker , Janna N. Vrijsen","doi":"10.1016/j.mhpa.2025.100742","DOIUrl":"10.1016/j.mhpa.2025.100742","url":null,"abstract":"<div><h3>Purpose</h3><div>Major Depressive Disorder (MDD) is a pervasive public health challenge, and although exercise therapy shows promise as an adjunct treatment, its integration into routine mental health care remains limited. This study examines the barriers and facilitators to implementing evidence-based exercise therapy for MDD in Dutch specialized mental health care settings.</div></div><div><h3>Methods</h3><div>We explored implementation processes alongside the <em>Exercise Enhances</em> randomized controlled trial. Data were collected through semi-structured interviews with patients (N = 6) and with professionals through focus group discussions (N = 8) and a questionnaire exploring barriers and facilitators to implementation (N = 12).</div></div><div><h3>Results</h3><div>Results indicate that both patients and professionals perceive exercise therapy as beneficial for mood and overall well-being. Key facilitators include the intervention's adaptability, its alignment with existing clinical routines, and the patient-centered support provided by exercise therapists. However, barriers included limited exercise modalities, challenges in adherence to home-based sessions, interprofessional communication gaps, and insufficient organizational resources.</div></div><div><h3>Conclusions</h3><div>While integrating exercise as an adjunct treatment for MDD is feasible and well received, sustained implementation requires enhanced flexibility in program design, improved interdisciplinary collaboration, and dedicated implementation coordination. These insights contribute to the evidence base for scaling exercise interventions within specialized mental health care and underscore the need for structural adjustments and targeted funding.</div></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"30 ","pages":"Article 100742"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}