Psychosocial well-being in middle schoolers: effects of a school cycling program in the wake of COVID-19.

Introduction: The impact of the Riding for Focus (R4F) school-based cycling program and key risk factors on middle school students' mental health was evaluated following COVID-19 lockdowns. Adolescents face growing mental health challenges that the R4F program aims to address by promoting physical activity and well-being. Methods: The study surveyed students from 31 U.S. schools, assessing mental health via the WHO-5 Well-Being Index and PSC-17-Y checklist. Non-parametric tests (Mann-Whitney U, Kruskal-Wallis ANOVA with Dunn's test) and effect size calculations (Cohen's d) were used; clinical risk assessments employed Fisher's Exact Test and Koopman scores with established cutoff values. Modifiable risk factors analyzed included physical activity, sleep, screen time, and breakfast habits. Linear regression evaluated dose-response relationships between these factors and wellness scores. Results: Participation in R4F was linked to a modest 5% boost in WHO-5 well-being scores; however, PSC-17-Y scores also increased slightly, contrary to previous findings, indicating more reported symptoms. Differences in outcomes were seen across gender and race/ethnicity. Notably, modifiable risk factors such as sleep, screen time, and physical activity showed clear dose-response relationships with mental health metrics. Discussion: Results suggest the R4F program may support adolescent mental health, though outcomes vary by demographic and lifestyle factors, highlighting a need for targeted, individualized interventions in youth populations.