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Randomized Controlled Trial
. 2024 Feb 19;21(2):241.
doi: 10.3390/ijerph21020241.

Gender Differences in Psychological Outcomes Following Surf versus Hike Therapy among U.S. Service Members

Lisa H Glassman  1   2 , Nicholas P Otis  1   2 , Kim T Kobayashi Elliott  3 , Betty Michalewicz-Kragh  3 , Kristen H Walter  1
Affiliations
Randomized Controlled Trial

Gender Differences in Psychological Outcomes Following Surf versus Hike Therapy among U.S. Service Members

Lisa H Glassman et al. Int J Environ Res Public Health. .

Abstract

Background: Surf and hike therapies have demonstrated effectiveness as adjunct interventions for service members with major depressive disorder (MDD). This study explores gender differences in intervention outcomes following a pragmatic, randomized controlled trial of Surf and Hike Therapy for service members with MDD (N = 96; men, n = 46; women, n = 50).

Methods: Clinician-administered and self-report measures (depression, anxiety, positive affect, negative affect, resilience, and pain) were completed at preprogram, postprogram, and 3-month follow-up; brief measures (depression/anxiety and positive affect) were completed before and after each session.

Results: Multilevel modeling results showed that anxiety decreased from pre- to postprogram and significantly differed by gender (B = -2.26, p = 0.029), with women reporting greater reductions. The remaining outcomes from pre- to postprogram demonstrated significant improvements that did not differ by gender (ps = 0.218-0.733). There were no gender differences through follow-up (ps = 0.119-0.780). However, within sessions, women reported greater improvements in depression/anxiety (B = -0.93, p = 0.005) and positive affect (B = 3.73, p = 0.001). The change in positive affect scores within sessions was greater for women in Hike Therapy compared to men (p = 0.016).

Conclusions: Overall, results demonstrate that both genders benefit from adjunctive Surf and Hike Therapies, but women exhibit a better response in terms of longer-term anxiety and immediate psychological outcomes.

Keywords: depression; exercise; military; nature exposure; outdoor activity; outdoor recreation programs; physical activity.

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Conflict of interest statement

L.H.G. and N.P.O. have no conflicts of interest to report. However, both work for the company Leidos, Inc., in San Diego, CA, USA. The spouse of K.H.W. is an employee of Google LLC and has stock options as part of his compensation package. Google LLC owns Fitbit products, which were used in the study for secondary data collection. Fitbit data are not reported in the current manuscript. When published, results are not expected to affect the value of the company’s stock.

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