highly significantP <.001
Results The intervention showed highly significant effects across all domains of the primary outcome measure ( P <.001), with the most notable effects on mental health ( F 2, 118 =425.88; η 2 =0.88), energy and vitality ( F 2, 118 =371.73; η 2 =0.86), and role limitations—emotional ( F 2, 118 =335.45; η 2 =0.85).