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

Lisa H. Glassman (), Nicholas P. Otis, Kim T. Kobayashi Elliott, Betty Michalewicz-Kragh and Kristen H. Walter
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Lisa H. Glassman: Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA 92106, USA
Nicholas P. Otis: Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA 92106, USA
Kim T. Kobayashi Elliott: Department of Public Health, Naval Medical Center San Diego, San Diego, CA 92134, USA
Betty Michalewicz-Kragh: Department of Public Health, Naval Medical Center San Diego, San Diego, CA 92134, USA
Kristen H. Walter: Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA 92106, USA

IJERPH, 2024, vol. 21, issue 2, 1-15

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 ( p s = 0.218–0.733). There were no gender differences through follow-up ( p s = 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: exercise; physical activity; depression; outdoor recreation programs; nature exposure; outdoor activity; military (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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