Exploration of visual analogue scale versions with the EQ-HWB-9 to measure health, social care, and carer-related quality of life: a VASt landscape.

Depression and anxiety are pervasive and potentially life‐threatening concerns among adolescents and young adults in the United States. In 2024, 2.8 million adolescents (aged 12–17) reported depression that significantly impaired their functioning, and 3 million reported suicidal ideation (Reinert et al., ). Depression rates among adolescents and young adults have substantially increased in the past decade (Brody & Hughes, ). Rates among young adults have more than doubled from 13% in 2017 to nearly 27% in 2025 (Witters, ). Among individuals from low‐socioeconomic households, current reports of depression are close to 35% (Witters, ). Rates of anxiety have also risen dramatically over the last decade, with greatest increases found among young adults, aged 18–25 (Goodwin et al., ). While estimates differ, studies have found between 27% and 40% of 18 to 29‐year‐olds reporting symptoms of anxiety, the highest among all adult age groups (Srygley et al., ; Terlizzi & Zablotsky, ). Depression and anxiety are associated with numerous negative outcomes across the life course, including low academic achievement, substance use, sleep and appetite disturbances, reduced quality of life, and greater mortality and suicidal behaviors (Casares et al., ; Goodwin et al., ; Nzoma & Shaw, ). Despite the high prevalence of these conditions, mental health treatment access and uptake in the United States are alarmingly low. Most adolescents experiencing mental health problems do not pursue or obtain treatment, either in the form of psychotherapy or pharmacological treatment (National Institute of Mental Health (NIH), ). In 2022–2023, over 50% of youth with major depression did not receive any form of clinical intervention or treatment (Reinert et al., ). Among the small proportion who do receive treatment, the efficacy of these treatments varies substantially (National Institute of Mental Health (NIH), ). Additionally, the most commonly prescribed medications—Serotonin‐specific reuptake inhibitors (SSRIs), Benzodiazepines, and Serotonin and norepinephrine reuptake inhibitors (SNRIs)—have many unpleasant side effects (e.g., agitation, headache, diarrhea, nausea, dizziness, sweating, sexual dysfunction, hypomania). Most dangerously, all SSRIs and SNRIs warn of increased risk of suicidal ideation, particularly among youth and young adults (FDA, ; Nzoma & Shaw, ). Therefore, there is an unmet need for accessible supplementary approaches to address mental health problems and improve mental health outcomes for these populations. In this study, we examine the associations of participation in team sports during adolescence with depression and anxiety in adolescence, whether these associations extend into early adulthood, and whether these associations differ by youth sex, race/ethnicity, and socioeconomic status. Bronfenbrenner's Ecological Systems theory provides a useful conceptual framework with which to understand how sports participation might impact mental health. The theory describes a nested system where an individual is at the center surrounded by increasingly broader layers of influence, often depicted as concentric circles (Bronfenbrenner, ). The theory illustrates the interactions and interrelationships that influence an individual. Building on this framework, Eime et al. () developed the conceptual model of Health through Sport, which explicitly describes the relationships between factors that drive sport participation and the psychological and social health benefits associated with this participation. Their model illustrates the interactions and interrelationships between physical, social, and psychological factors.