Forum Talk: OUTSIDE: OUTdoor Swimming as a nature-based Intervention for DEpression; a feasibility randomised controlled trial
Speaker: Heather Massey, Senior Lecturer, Extreme Environments Laboratory, School of Sport, Health & Exercise Sciences, University of Portsmouth
Speaker: Hannah Denton, Counselling Psychologist, Sussex Partnership NHS Foundation Trust
Background: Many people say outdoor swimming improves their mental health. Research to date indicates benefits people with depression, but it is not conclusive.
Aim: To establish if it is feasible to conduct a full-scale randomised controlled trial (RCT), evaluating if outdoor swimming helps people with depression and is good value for money.
Methods: 87 adults living with mild to moderate symptoms of depression provided written informed consent to participate in this ethically approved study (NRES 22/LO/0268). Participants were allocated randomly to an introductory outdoor swimming course (8 one-hour sessions), as well as their usual care, or to receive their usual care only. Online survey data were collected; at baseline, immediately post intervention and at follow-up 8 weeks later, assessing depression, anxiety, wellbeing, health related quality of life and use of health care resources. Participants completed surveys. Focus groups were also conducted to provide feedback about the participant journey through the study.
Results: 79% of participants completed four or more sessions of the swim course. Although not powered to detect differences there were medium effects indicating reductions in symptoms of depression (Mean ± standard deviation, Baseline Swim 11 ± 5.3, Usual care 10 ± 5.2, post intervention swim 6.7 ± 4.8, usual care 9.7 ± 4.7 d=0.71) and anxiety (Baseline Swim 8.4 ± 4.6, Usual care 9.1 ± 5.6, post intervention swim 4.5 ± 3.4, usual care 8.5 ± 5.5, d=0.74) in the intervention group compared with control respectively. Reductions in health resource use in the intervention group was also found (reduction of one treatment session and reduced medication use). Focus groups showed that participants found the experience of swimming positive and provided helpful guidance for the design of the full-scale trial.
Conclusion: It is feasible to conduct a full-scale RCT to test if an outdoor swimming course (in addition to usual care) would be helpful for people in recovery from symptoms of depression.
