Comparison of the 24-Style Tai Chi intervention based on various promotion approaches on college students' mental health: A randomized controlled trial.
24-Style Tai Chi effectively improves college students' mental health, with on-site and mixed approaches excelling in reducing anxiety and depression, and online and mixed approaches enhancing self-efficacy, suggesting a hybrid promotion strategy is optimal.
Key Findings
Results
On-site and mixed promotion groups showed significant reductions in anxiety by week 8 of the 8-week Tai Chi intervention.
Offline-PG achieved SAS score of 34.8 ± 6.3 and MPG achieved 36.2 ± 7.0 by week 8 (P < 0.01)
Offline-PG had 90% attendance and MPG had 84% attendance
ANOVA revealed significant inter-group differences in anxiety (SAS F = 6.45, P = 0.004)
Repeated measures ANOVA confirmed significant time effects across the intervention period
250 college students from Shandong Sport University were randomized across 5 groups over 8 weeks
Results
On-site and mixed promotion groups showed significant reductions in depression by week 8 of the intervention.
Offline-PG achieved SDS score of 33.7 ± 6.9 and MPG achieved 34.9 ± 7.2 by week 8 (P < 0.05)
ANOVA revealed significant inter-group differences in depression (SDS F = 5.32, P = 0.009)
Regression analysis indicated participation strongly correlated with depression reductions in Offline-PG (R = 0.62, P = 0.003) and MPG (R = 0.58, P = 0.004)
The Independent Practice Group (IPG) with 60% attendance showed no significant changes in depression
Results
Online and mixed promotion groups demonstrated significant improvements in general self-efficacy.
Online-PG achieved GSES score of 36.1 ± 5.2 and MPG achieved 35.5 ± 5.6 (P < 0.01)
ANOVA revealed significant inter-group differences in self-efficacy (GSES F = 6.74, P = 0.003)
Regression analysis showed participation correlated with self-efficacy gains in Online-PG and MPG (R = 0.67, P = 0.002)
Online-PG had 72% attendance compared to 90% in the Offline-PG
Results
The Independent Practice Group showed no significant mental health changes, and attendance was lowest in this group.
IPG attendance was 60%, the lowest among all active intervention groups
IPG showed no significant changes in SAS, SDS, or GSES scores
This contrasts with Offline-PG (90% attendance) and MPG (84% attendance) which showed significant improvements
Results suggest that unstructured independent practice without promotion support is insufficient for meaningful mental health outcomes
Results
Participation rate was strongly correlated with mental health outcomes across intervention groups.
Participation correlated with anxiety and depression reductions in Offline-PG (R = 0.62, P = 0.003) and MPG (R = 0.58, P = 0.004)
Participation correlated with self-efficacy gains in Online-PG and MPG (R = 0.67, P = 0.002)
Attendance ranged from 60% (IPG) to 90% (Offline-PG) across groups
Regression analysis was used to evaluate the relationship between participation and outcomes
Methods
The study was an 8-week randomized controlled trial with mental health assessed at baseline, 4 weeks, 8 weeks, and follow-up.
250 college students from Shandong Sport University were enrolled
Participants were randomized into five groups: Offline-PG, Online-PG, MPG, IPG, and Control Group (CG)
Mental health was assessed using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and General Self-Efficacy Scale (GSES)
Data were analyzed using one-way ANOVA, repeated measures ANOVA, and regression analysis
Trial registration number: TCTR20250306005
What This Means
This research suggests that practicing 24-Style Tai Chi over 8 weeks can meaningfully improve mental health in college students, but the way the practice is promoted and supported matters significantly. In a randomized controlled trial of 250 university students divided into five groups, those who received in-person (on-site) instruction or a combination of in-person and online instruction showed the greatest reductions in anxiety and depression after 8 weeks. Students who could only access online instruction showed improvements in self-confidence (self-efficacy), while students who practiced independently without structured support showed no significant mental health benefits.
A key finding was that attendance and participation were strongly linked to better outcomes — groups with higher attendance rates (90% for on-site, 84% for mixed) showed the most improvement, while the independent practice group with only 60% attendance showed no meaningful changes. This suggests that structure and accountability in exercise promotion are important factors in achieving mental health benefits, not just the exercise itself.
This research suggests that universities looking to support student mental health through Tai Chi programs should consider a hybrid approach that combines in-person and online components, as this format appeared to offer benefits across multiple mental health dimensions — reducing anxiety and depression while also boosting self-efficacy. The findings highlight that how an exercise program is delivered and supported can be just as important as the exercise itself in determining whether participants benefit.
Xu K, Sun Z, Dong D, Tan Z, Chen J, Castagna C, et al.. (2026). Comparison of the 24-Style Tai Chi intervention based on various promotion approaches on college students' mental health: A randomized controlled trial.. PloS one. https://doi.org/10.1371/journal.pone.0343808