Traditional games as a culturally grounded community physical activity intervention: Effects on physical literacy, social cohesion, and selected cardiometabolic outcomes

Background and Purpose Physical inactivity and declining community engagement remain important public health concerns among middle-aged adults. Although conventional exercise programs are widely recognized for supporting health-related outcomes, long-term adherence is often limited by low motivation, poor enjoyment, and insufficient social engagement. Traditional games represent a culturally grounded form of physical activity that integrates movement, cooperation, and emotional familiarity within community settings. Therefore, this study aimed to evaluate the effects of traditional games as a culturally grounded community physical activity intervention on physical literacy, social cohesion, and selected cardiometabolic outcomes among adults aged 35–55 years. Materials and Methods This study employed a parallel-group randomized controlled trial design involving middle-aged community adults aged 35–55 years. Following eligibility refinement procedures, 68 participants were randomly assigned to either a traditional games intervention group (n = 34) or a conventional community physical activity control group (n = 34). Both groups participated in supervised 60-minute sessions three times per week for 12 weeks with matched exercise frequency, duration, and intensity. Primary outcomes included physical literacy and social cohesion, while body mass index (BMI), blood pressure, and fasting glucose were assessed as secondary cardiometabolic outcomes. Final analyses included 64 participants. Data were analyzed using paired-sample t-tests, ANCOVA, and repeated-measures analyses with statistical significance established at p < 0.05. Results Participants in the traditional games group demonstrated significantly greater improvements in physical literacy and social cohesion compared with the control group following the 12-week intervention period (p < 0.05). Favorable reductions were also observed in selected cardiometabolic indicators, including BMI, systolic blood pressure, diastolic blood pressure, and fasting glucose levels. ANCOVA analyses indicated that the largest intervention effects were identified in psychosocial outcomes, particularly physical literacy and social cohesion, whereas physiological improvements were comparatively smaller. No severe adverse events were reported during the intervention period. Conclusions Traditional games may function as a culturally meaningful and socially engaging form of community-based physical activity associated with improvements in physical literacy and social cohesion among middle-aged adults. Although favorable cardiometabolic changes were also observed, the primary benefits of traditional games appear to relate more strongly to psychosocial engagement and sustained participation in physical activity. The findings suggest that culturally familiar and emotionally meaningful physical activity may support sustained community participation through enhanced enjoyment, social engagement, and reduced psychological barriers to exercise adherence. These findings support the potential value of culturally grounded physical activity interventions for promoting community health and social well-being.