Examining the effects of outdoor recreational experiences on military veterans with PTSD: a pilot study

ISRCTN ISRCTN15325073
DOI https://doi.org/10.1186/ISRCTN15325073
Secondary identifying numbers Essex_NC1408_1
Submission date
31/01/2020
Registration date
06/02/2020
Last edited
28/03/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Exposure to the natural environment is increasingly thought to benefit psychological health. Recent reports also suggest that outdoor activities that include recreational pursuits (such as surfing or fishing) coupled with the opportunity to socialize with others in similar circumstances may be helpful to military veterans experiencing Post-Traumatic Stress Disorder (PTSD). This study will evaluate this possibility.

Who can participate?
Military veterans with a diagnosis of post-traumatic stress disorder

What does the study involve?
Three groups of veterans with PTSD will each undertake a group outdoor activity (angling, equine care or archery and falconry). We will measure changes to their symptoms (PTSD, depression, anxiety) 2 weeks before the activity, 2 weeks after the activity, and at 4 month follow up.

What are the possible benefits and risks of participating?
Equine husbandry: There is some risk around horses. We will be working to the garrison stables health and safety guidelines and all participants are covered by the stables’ indemnity insurance, in case of an injury occurring. There will be a first aid trained member of staff in attendance at all times.

The participants for this study are military veterans with PTSD and other anxiety-related issues. They, therefore, have mental health problems but this is a defining aspect of the study and cannot be undertaken with participants without these issues. It is not thought there are any risks in this study above and beyond those normally encountered in everyday life.

It is thought that exposure to an outdoor recreational experience will be beneficial in terms of decreased anxiety, depression and PTSD-symptoms and increased well-being.

Where is the study run from?
Department of Psychology, University of Essex (UK)

When is the study starting and how long is it expected to run for?
June 2014 to June 2015

Who is funding the study?
This study did not receive any funding

Who is the main contact?
Dr. Nicholas Cooper
ncooper@essex.ac.uk

Contact information

Dr Nicholas Cooper
Scientific

Department of Psychology
University of Essex
Wivenhoe Park
Colchester
CO4 3SQ
United Kingdom

ORCiD logoORCID ID 0000-0002-4315-3299
Phone +44 (0)1206 873781
Email ncooper@essex.ac.uk

Study information

Study designSingle-centre interventional design study
Primary study designInterventional
Secondary study designParticipants will be allocated to one of the three levels of the between groups factor
Study setting(s)Community
Study typeTreatment
Participant information sheet Not available in web format, please use contact details to request a participant information sheet.
Scientific titleExamining the effects of outdoor recreational experiences on the mental health and well-being of military veterans with post-traumatic stress disorder (PTSD): a pilot study
Study hypothesisIt is hypothesized that participants will experience a reduction in PTSD-related symptomology and an increase in subjective well-being as a consequence of a short, outdoor, recreational activity.
Ethics approval(s)Approved 01/03/2015, the University of Essex Ethics Committee (Science & Health Ethics Sub-Committee, University of Essex, Wivenhoe Park, CO4 3SQ; reo-governance@essex.ac.uk; +44 (0)1206 87356), ref: MW1502, MW1503
ConditionPost-traumatic stress disorder (PTSD)
InterventionParticipants will be recruited and randomly allocated to one of the three levels of the between-groups factor. They will be sequentially numbered and allocated to condition by means of an online blocked randomization tool.

The three intervention groups are angling, equine husbandry, and falconry and archery. The three different activity interventions will run sequentially and employ the same eligibility criteria, recruitment process, and evaluation. Each activity intervention lasts 1 to 2 days and are designed to deliver professional coaching in an outdoor recreational activity in a peer group context and to facilitate opportunities to socialize and to discuss military experience or PTSD experience if the participant so wishes.

Each participant will complete questionnaires to assess their PTSD, depression, anxiety, and stress. These will be given at 2 weeks before they receive the intervention, at 2 weeks following the intervention and at 4 months follow up.
Intervention typeBehavioural
Primary outcome measure1. PTSD symptoms assessed by the PTSD Checklist Military (PCL-M) at baseline, 2 weeks and 4 months
2. Depression assessed by the Patient Health Questionnaire (PHQ-9) at baseline, 2 weeks and 4 months
3. Anxiety assessed by the General Anxiety Disorder (GAD-7) at baseline, 2 weeks and 4 months
Secondary outcome measuresPerceived stress assessed by the 10-item Perceived Stress Scale (PSS) at baseline, 2 weeks and 4 months
Overall study start date16/06/2014
Overall study end date08/06/2015

Eligibility

Participant type(s)Other
Age groupAll
SexBoth
Target number of participants50
Total final enrolment30
Participant inclusion criteria1. Military veteran
2. Diagnosis of post-traumatic stress disorder (PTSD)
Participant exclusion criteriaCurrently receiving psychological therapy for PTSD
Recruitment start date28/08/2014
Recruitment end date08/03/2015

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Department of Psychology, University of Essex
Wivenhoe Park
Colchester
CO4 3SQ
United Kingdom

Sponsor information

University of Essex
University/education

Wivenhoe Park
Colchester
CO4 3SQ
England
United Kingdom

Phone +44 (0) 1206 873591
Email lglover@essex.ac.uk
Website http://www.essex.ac.uk/
ROR logo "ROR" https://ror.org/02nkf1q06

Funders

Funder type

Not defined

investigator initiated and funded

No information available

Results and Publications

Intention to publish date01/03/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryStored in repository
Publication and dissemination planThe results of the intervention will be published in a peer-reviewed international journal. They will also be presented at relevant national and international conferences and will be disseminated widely through social and conventional media platforms.
IPD sharing planThe datasets generated during and/or analyzed during the current study will be stored in a publically available repository. Our data are stored in an online repository OSF Home.
https://osf.io/63hrb/?view_only=2c8ffabdc8a64e77ba649c47f6df6c75 .
Data are de-identified participant data (IPD) and age and gender removed from the data sets because the small sample size risks identification. The data can be downloaded by anyone with the link. The link will also be provided in the published paper.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 25/11/2020 26/01/2021 Yes No
Protocol (other) 28/03/2023 No No

Editorial Notes

28/03/2023: A link to the protocol file was added.
26/01/2021: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.
05/02/2020: Trial’s existence confirmed by the University of Essex Ethics Committee.