Does an Occupational Therapy Program Enhance Mental Health Outcomes for Veterans Who Scuba Dive

Not Applicable

Completed

Conditions: Anxiety
Post Traumatic Stress Disorder
Depression
Stress, Psychological

Interventions: Behavioral: SCUBA with Occupational Therapy (OT)
Behavioral: Self-Contained Underwater Breathing Apparatus (SCUBA) without OT

Registration Number: NCT03928392

Lead Sponsor: Loma Linda University

Brief Summary: The purpose of the study is to investigate whether an occupational therapy program could enhance mental health outcomes for veterans who SCUBA dive. SCUBA diving requires modified breathing techniques and has been found to provide calming effects to individuals who engage in this activity. Occupational therapy interventions such as mindfulness, journaling, and deep breathing techniques can also provide similar calming effects. Therefore, this study will explore whether occupational therapy can provide additional benefits to overall mental health of veterans who SCUBA dive.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 15

Inclusion Criteria

18 to 95 years of age
Participation in WAVES Project for at least 3 months
Completion of 3 open water dives
Proficient in written and verbal English

Exclusion Criteria

Younger than 18 years of age or older than 95 years of age
Not a member of WAVES Project within 3 months of study recruitment
Has not completed 3 open water dives
Not proficient in written and verbal English

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
SCUBA Dive with OT	SCUBA with Occupational Therapy (OT)	Two SCUBA dives in conjunction with occupational therapy intervention. The occupational therapy intervention will take place on the beach or on the boat before/after the SCUBA dive. The intervention will consist of learning 3 different breathing techniques. Participants will also be educated about mindfulness principals. Additionally, participants will complete journaling activities between dives.
SCUBA Dive without OT	Self-Contained Underwater Breathing Apparatus (SCUBA) without OT	The group will engage in two SCUBA dives.

Primary Outcome Measures

Name	Time	Method
Satisfaction With Occupational Performance	Change between baseline and three weeks.	Study participants will complete the assessment, Canadian Occupational Performance Measure (COPM) which is an individualized composite measurement of factors designed to assess clients' perception of their occupational performance and satisfaction with that performance. The participants will identify up to 5 goals. For each goal the participant will rate their perceived performance on a scale of 1 to 10, with 1 representing the lowest level of performance and 10 representing the highest level of performance. The average of the scores will be recorded. Participants will also rate their satisfaction with performance on a scale of 1 to 10, with 1 representing the lowest level of satisfaction and 10 representing the highest level of satisfaction. The average of these scores will represent the satisfaction with performance score.

Secondary Outcome Measures

Name	Time	Method
The PTSD Checklist for DSM-5 (PCL-5)	Change between baseline and three weeks	The PTSD Checklist for DSM-5 (PCL-5) assesses the 20 DSM-5 symptoms of PTSD through a 20-item self-report measure. In the PCL-5, individuals are presented with a list of problems people may have as a result of a stressful situation. Individuals are asked to indicate how much they have been bothered by this problem in the past month. Problems can be rated as "not at all, a little bit (1), moderately (2), quite a bit (3), or extremely" (4). A total symptom severity score (range - 0-80) can be obtained by summing the scores for each of the 20 items. Higher scores reflect more PTSD symptoms. Initial research suggests that a PCL-5 cutoff score between 31-33 is indicative of probable PTSD across samples.
The Depression Anxiety and Stress Scales (DASS)	Change between baseline and three weeks	The Depression Anxiety and Stress Scales (DASS) is a individualized composite measurement used to assess symptoms of depression, anxiety, and stress in community settings. The DASS-21 asks 21 questions and is comprised of three subscales: The Depression sub-scale which measures hopelessness, low self-esteem, and low positive affect; the Anxiety scale which assesses autonomic arousal, musculoskeletal symptoms, situational anxiety and subjective experience of anxious arousal; and the Stress scale which assesses tension, agitation, and negative affect. There are 21 questions and responses are provided on a 4-point Likert scale, Where 0 = Did not apply to me, 1 = applied to me some degree, or some of the time, 2 = applied to me a considerable degree or good part of time, and 3 = applied to me very much or most of the time. The three subscales can be totaled for an overall DASS score, ranging from 0 to 63, with higher scores indicating higher levels of symptoms.