Participation in organised sport to improve and prevent adverse developmental trajectories of at‐risk youth: A systematic review

Background Healthy after‐school activities such as participation in organised sport have been shown to serve as important resources for reducing school failure and other problem/high‐risk behaviour. It remains to be established to what extent organised sport participation has positive impacts on young people in unstable life circumstances. Objectives What are the effects of organised sport on risk behaviour, personal, emotional and social skills of young people, who either have experienced or are at‐risk of experiencing an adverse outcome? Search Methods The database searches were carried out in March 2023 and other sources were searched in May 2023. We searched to identify both published and unpublished literature. Selection Criteria The intervention was participation in leisure time organised sport. Young people between 6 and 18 years of age, who either have experienced or are at‐risk of experiencing an adverse outcome were eligible. Primary outcomes were problem/high‐risk behaviour and a secondary outcomes social and emotional outcomes. Studies that used a control group were eligible for. Studies that utilised qualitative approaches were not. Data Collection and Analysis The number of potentially relevant studies was 43,716. Thirteen studies met the inclusion criteria. Only seven studies could be used in the data synthesis. Five studies were judged to have a critical risk of bias and were excluded from the meta‐analysis. One study did not report data that enabled the calculation of effect sizes and standard errors. Meta‐analyses were conducted on each conceptual outcome separately. All analyses were inverse variance weighted using random effects statistical models. Main Results Two studies were from Canada, one from Australia, and the remaining from the USA. The timespan of the interventions was 23 years, from 1995 to 2018. The median number of participants analysed was 316, and the median number of controls was 452. A number of primary outcomes were reported but each in a single study only. Concerning secondary outcomes, two studies reported the effect on overall psychosocial adjustment at post‐intervention. The standardised mean difference was 0.70 (95% CI 0.28–1.11). There was a small amount of heterogeneity. Three studies reported on depressive symptoms at 0–3 years follow‐up. The standardised mean difference was 0.02 (95% CI −0.01 to 0.06). There was no heterogeneity between the three studies. In addition, a number of other secondary outcomes were reported each in a single study only. Authors' Conclusions There were too few studies included in the meta‐analyses in order for us to draw any conclusion. The dominance of Northern America clearly limiting the generalisability of the findings. The majority of the studies were not considered to be of overall high quality and the process of excluding studies with critical risk of bias from the meta‐analysis applied in this review left us with only 7 of a total of 13 possible studies to synthesise. Further, because too few studies reported results on the same type of outcome, at most three studies could be combined in a particular meta‐analysis and no meta‐analysis could be performed on any of the primary outcomes.