Effects of a structured physical activity intervention on mental health and psychological resilience among Chinese college students: a randomized controlled trial with mediation analysis

Background/objectivesMental health challenges among Chinese college students represent a significant public health concern. While physical activity is recognized as beneficial for mental health, high-quality randomized controlled trials (RCTs) examining the efficacy of structured interventions and their underlying mechanisms in this population are limited. This study investigated the effects of an 8-week structured physical activity intervention on depression, anxiety, and psychological resilience among Chinese college students, and tested whether resilience mediates the intervention effects.MethodsA three-arm RCT was conducted with 120 students exhibiting mild-to-moderate depression/anxiety symptoms. Participants were recruited through convenience sampling and randomly allocated to a team-based sports group (n = 40), an individual aerobic exercise group (n = 40), or a waitlist control group (n = 40). The 8-week intervention involved three supervised 60-min sessions per week. Outcomes including depressive symptoms (PHQ-9), anxiety symptoms (GAD-7), and psychological resilience (CD-RISC-10) were assessed at baseline, post-intervention, and 1-month follow-up. Data were analyzed using linear mixed-effects models (LMM) for primary outcomes and the PROCESS macro bootstrap mediation procedure for mechanistic pathways.ResultsBoth exercise groups demonstrated significant, large reductions in depressive and anxiety symptoms compared to the control group at post-intervention (p < 0.001, Cohen’s d = 1.14, 1.38), with effects maintained at follow-up. Psychological resilience increased significantly in both intervention groups (p < 0.001). No significant differences were found between the team-based and individual exercise modalities. Mediation analysis revealed that increases in psychological resilience accounted for approximately 45% of the intervention effects on reducing depression and anxiety symptoms.ConclusionStructured physical activity, whether team-based or individual, appears to be an effective intervention for reducing depression and anxiety and enhancing psychological resilience among Chinese college students. Psychological resilience appears to serve as a significant mediator of these mental health benefits. These findings suggest the integration of structured exercise programs into university mental health promotion strategies. Future research should investigate long-term sustainability through multi-site RCTs, longer follow-up periods, cross-cultural replication, and neurobiological mediating mechanisms.