A Serious Digital Game (SugarVita) to Support Diabetes Self-Management: Pilot Randomized Controlled Trial.

Men have long been subjected to unique forms of gender role stress, which has contributed to serious mental health crises including elevated suicide rates and low help-seeking behaviors (; ; ). This problem is equally salient among male university students, a specific subgroup of young men (). The gender role stress experienced by adolescent males stems from multiple factors, including the desire for success, competition for power, and the pursuit of self-dominance. Adherence to traditional masculinity norms may exacerbate their psychological conflicts and distress. Although prior research has identified the presence of masculine gender role stress among male university students, targeted psychological interventions to enhance resilience in this population remain scarce (; ; ). Historically, suicide risk has generally increased with age, with older adults once considered the highest-risk group. However, since the global rise in suicide cases toward the end of the 20th century, research attention has progressively shifted toward suicide rates among younger populations (; ). Studies have found that while suicide rates among older adults have declined, rates among younger cohorts have risen, and in most countries, suicide now ranks among the top three to five leading causes of death in young men (). Despite substantial overall declines in global suicide mortality, this issue remains unresolved, posing ongoing challenges for policy-making and health services that require further coordinated efforts to reduce suicide-related deaths (; ). Emerging evidence suggests that masculinity is a significant determinant of depression in men, and that traditional therapeutic approaches may not be broadly acceptable to this group, necessitating the development of alternative, masculinity-congruent interventions (). A substantial body of research indicates that physical activity, as a “male-friendly” intervention modality, may indirectly improve psychological outcomes through physical challenges. Exercise has been shown to exert positive effects on cognitive function, depression severity, sleep quality, alcohol consumption, and psychiatric symptoms (; ). Moreover, exercise can attenuate sympathetic nervous system responses to stress (), and multiple randomized controlled trials (RCTs) have confirmed that both aerobic and anaerobic exercise alleviate depressive symptoms and improve mental health (). Maximal cycling power training, which employs 30-s Wingate all-out sprints interspersed with rest intervals [adapted from the classic sprint interval training (SIT) protocol] (; ), is classified as SIT—a high-intensity, short-duration form of training combining both anaerobic and aerobic components (). This format aligns with the time constraints and low exercise adherence commonly observed among university students (; ). Regarding the definition of resilience, a widely accepted conceptualization describes it as the capacity of a dynamic system to adapt successfully to disruptions that threaten its viability, function, or development (; ). Resilience also encompasses hope and meaning. For individuals facing adversity, the sense of “meaning-making” is crucial; resilience fundamentally relies on the belief that life retains meaning, even in the face of chaos, cruelty, stress, worry, or despair (; ). proposed that mental toughness comprises four core psychological attributes: Confidence, Challenge, Commitment, and Control—that is, the ability to persist in challenging situations, maintain unwavering belief under pressure (including confidence in one’s abilities and interpersonal relationships), regulate emotions, and maintain control over one’s life (). Furthermore, mental toughness is closely associated with stress management, stress recovery, and overall mental health (). In various human activities—including academic pursuits, sport, and work—mental toughness serves as an important prerequisite for consistent performance (). With respect to mental toughness profiles, athletes engaged in long-term sport participation typically exhibit higher levels of mental toughness. Mental toughness has been linked to multidimensional athlete characteristics (; ; ). From a gender perspective, multiple studies have confirmed that male athletes demonstrate higher mental toughness than their female counterparts, potentially attributable to greater confidence in physical (athletic) abilities and higher testosterone levels that may facilitate stronger mental resilience (; ). In addition, total mental toughness scores are significantly positively correlated with academic achievement and academic progression (). It is important to clarify two concepts that are often confused: resilience and mental toughness. Resilience is generally defined as the successful adaptation of individuals to adversity, trauma, or significant stress, with its core emphasis on “bouncing back” and meaning-making capacities. Mental toughness, by contrast, places greater emphasis