Comparison of surf and hike therapy for active duty service members with major depressive disorder: Study protocol for a randomized controlled trial of novel interventions in a naturalistic setting

Abstract

Many active duty service members suffer from major depressive disorder (MDD). Although traditional treatments exist, alternative approaches may also be effective in treating depressive symptoms. Previous research has shown that physical activity has significant positive effects on depression symptoms in individuals with MDD, and that these benefits may be enhanced when physical activity occurs in a natural environment. Even though physical activity (i.e., hiking, walking) in natural environments has been shown to reduce depressive symptoms, water-based activity occurring in a natural environment (e.g., surfing) may produce even greater improvements in depressive symptoms. We detail an ongoing randomized controlled trial (RCT) comparing the efficacy of surf therapy and hike therapy with respect to immediate and longer-term psychological, physical, and functional outcomes in active duty service members with MDD. We describe the methodological development of this RCT evaluating novel treatment approaches and discuss considerations for evaluating physical activity interventions in a naturalistic setting.

A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder

“…All participants received medical clearance from providers at the Naval Hospital prior to participation in the Surf and Hike Therapy programs. Power calculations have been previously published (see [52]). Eligible participants were randomly assigned to either Surf or Hike Therapy, using a blocked randomization design (http:// rando mizat ion.…”

“…Optional yoga was offered to Surf Therapy participants before each session as part of the existing NMCSD program. Information about the Surf and Hike Therapy programs has been published elsewhere [52]. Given the sudden onset and widespread impact of the COVID-19 pandemic, the WII Wellness Program canceled in-person group activities; the last cohort of participants were unable to complete their respective programs that began in March 2020, and study enrollment ended; however, adequate power for analysis was achieved.…”

Comorbidity of depression and posttraumatic stress disorder: Outcomes from a randomized controlled trial of surf and hike therapies among service members.

“…Surf therapy took place at a public beach in San Diego, and hike therapy took place at various locations throughout San Diego County. For further program details, see Walter et al (2019).…”