Sport-based interventions for post-disaster mental health and psychosocial recovery: a multi-level systematic review...

Disasters and humanitarian crises affect both individual mental health and broader psychosocial functioning, but these outcome domains are not interchangeable. This systematic review and meta-analysis examined structured sport-, exercise-, play-, yoga/body-awareness-, physical-education-, and sport-for-protection-based interventions within a mental health and psychosocial support (MHPSS) framework. Web of Science Core Collection, PubMed, Scopus, SPORTDiscus, PsycINFO, and Google Scholar were searched for studies published from January 1, 2000, through November 1, 2025. Eligible populations were affected by disasters, conflict, forced displacement, refugeehood, humanitarian crises, or crisis-related restrictions. Outcome-specific quantitative analyses were conducted for comparable mental health symptoms, whereas heterogeneous psychosocial and community constructs were synthesized narratively and integrated through a joint interpretation matrix. Twenty-eight studies or programme evaluations were included; 20 contributed data to at least one quantitative analysis, with fewer studies contributing to each controlled outcome model. Random-effects models indicated favorable small-to-moderate average effects for PTSD symptoms (Hedges' g = -0.32, 95% CI [-0.50, -0.14]; I ² = 58%), depression (g = -0.44, 95% CI [-0.60, -0.28]; I ² = 47%), and anxiety (g = -0.41, 95% CI [-0.58, -0.24]; I ² = 52%). Narrative findings identified routine, emotional regulation, belonging, social connectedness, life skills, and community cohesion as possible complementary pathways and outcomes. However, variation in populations, designs, intervention components, comparators, and measures, together with risk-of-bias concerns and small outcome sets, limits certainty and generalizability. Sport-based interventions may function as scalable community or focused non-specialized components of MHPSS when they are trauma-sensitive, culturally adapted, safeguarded, monitored, and linked to referral pathways. They should not be interpreted as substitutes for specialized mental health care, trauma-focused treatment, child protection, or clinical risk management.