Evidence map›Paper›PMID 37443045›Full record

ArticlePilot and feasibility studies2023

OUTdoor Swimming as a nature-based Intervention for DEpression (OUTSIDE): study protocol for a feasibility randomised control trial comparing an outdoor swimming intervention to usual care for adults experiencing mild to moderate symptoms of depression.

Heather Massey, Hannah Denton, Amy Burlingham, Mara Violato, Anna-Marie Bibby-Jones, Rebecca Cunningham, Sandy Ciccognani, Sam Robertson, Clara Strauss

Abstract read
In one paragraph

Article in Pilot and feasibility studies, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Heather MasseyExtreme Environments Laboratory, School of Sport, Health and Exercise Sciences, University of Portsmouth, Spinnaker Building, Portsmouth, PO1 2ER, UK. heather.massey@port.ac.uk.ORCID http://orcid.org/0000-0002-7542-513X
Hannah DentonR&D Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Nevill Avenue, Brighton & Hove, BN3 7HZ, UK.
Amy BurlinghamCoventry and Warwickshire Partnership NHS Trust, Coventry, UK.
Mara ViolatoNuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK.
Anna-Marie Bibby-JonesR&D Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Nevill Avenue, Brighton & Hove, BN3 7HZ, UK.
Rebecca CunninghamBirmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK.
Sandy CiccognaniR&D Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Nevill Avenue, Brighton & Hove, BN3 7HZ, UK.
Sam RobertsonR&D Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Nevill Avenue, Brighton & Hove, BN3 7HZ, UK.
Clara StraussR&D Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Nevill Avenue, Brighton & Hove, BN3 7HZ, UK.

Funding

National Institute for Health and Care Research 203462
6 · The paper itself

Abstract

backgroundDepression is common and the prevalence increasing worldwide; at least 1 in 10 people will experience depression in their lifetime. It is associated with economic costs at the individual, healthcare and societal level. Recommended treatments include medication and psychological therapies. However, given the long waiting times, and sometimes poor concordance and engagement with these treatments, a greater range of approaches are needed. Evidence for the potential of outdoor swimming as an intervention to support recovery from depression is emerging, but randomised controlled trials (RCTs) evaluating clinical and cost-effectiveness are lacking. This study seeks to investigate the feasibility of conducting a definitive superiority RCT, comparing an 8-session outdoor swimming course offered in addition to usual care compared to usual care only, in adults who are experiencing mild to moderate symptoms of depression. Feasibility questions will examine recruitment and retention rates, acceptability of randomisation and measures, and identify the primary outcome measure that will inform the sample size calculation for a definitive full-scale RCT. This study will also explore potential facilitators and barriers of participation through evaluation questionnaires, focus-group discussions and interviews. METHODS/

designTo address these aims and objectives, a feasibility superiority RCT with 1:1 allocation will be undertaken. We will recruit 88 participants with mild to moderate symptoms of depression through social prescribing organisations and social media in three sites in England. Participants will be randomised to either (1) intervention (8-session outdoor swimming course) plus usual care or (2) usual care only. Both groups will be followed up for a further 8 weeks. DISCUSSION: If findings from this feasibility RCT are favourable, a fully powered RCT will be conducted to investigate the clinical- and cost-effectiveness of the intervention. Findings from the definitive trial will provide evidence about outdoor swimming for depression for policymakers and has the potential to lead to greater choice of interventions for adults experiencing symptoms of depression.

trial registrationCurrent controlled trial registration number is ISRCTN 90851983 registered on 19 May 2022.

Indexed as

AnxietyCold waterCold water swimmingDepressionHealth and social care resource useHealth-related quality of lifeLakeNature-based interventionsOpen water swimmingRCTRiver swimmingSeaSocial prescribingWellbeing

Identifiers

PMID37443045
PMCPMC10339599

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.