Abstract
OBJECTIVES: This study aimed to examine the effects of three intervention modes on social anxiety among rural left-behind children in China, including brief bouts of exercise, defined as short, structured periods of physical activity integrated into daily routines; embodied cognitive training, defined as training that integrates cognitive tasks with goal-directed bodily movements; and a combined intervention incorporating both approaches, with outcomes assessed at baseline, post-intervention, and follow-up. METHODS: A randomized controlled trial (RCT) was conducted to examine the effects of different interventions on social anxiety among rural left-behind children. Participants were recruited purposively from one rural primary school in Shaodong City, Hunan Province, and then randomly allocated to four groups (n = 25 each): brief bouts of exercise (BBEG), embodied cognitive training (ECG), combined intervention (CIG), or control (CG). Demographic information was collected using a researcher-designed questionnaire. The interventions were delivered over a 12-week period, with all intervention groups receiving their respective interventions four times per week, followed by a 6-week follow-up. Social anxiety was assessed using the self-report Social Anxiety Scale for Children at baseline, immediately post-intervention, and follow-up. Outcomes were analyzed using repeated-measures ANOVA to examine group, time, and interaction effects. RESULTS: At baseline, no significant differences were observed among groups in social anxiety (SA), fear of negative evaluation (FNE), or social avoidance and distress (SAD) (all p > 0.05), indicating good baseline comparability. Mixed-design analyzes of variance revealed significant Group × Time interactions across all outcome measures (p < 0.05), indicating that changes over time differed significantly across groups. From pre-test to post-test, participants in the brief bouts of exercise group, embodied cognitive training group, and combined intervention group showed significant reductions in SA, FNE, and SAD (p < 0.001), whereas no significant changes were observed in the control group (p > 0.05). These improvements were maintained at follow-up (p < 0.01). Post hoc comparisons indicated that, at both post-test and follow-up, all intervention groups demonstrated significantly greater symptom reductions than the CG (p < 0.05). Notably, the CIG exhibited significantly greater improvements than both single-intervention groups across all outcomes, and the BBEG achieved greater reductions than the ECG (p < 0.05). CONCLUSION: All three interventions were associated with reductions in social anxiety relative to the control group. Compared with single-modality interventions, the combined intervention demonstrated greater improvements during the intervention period and follow-up.