Author(s): FERREIRA, T., LEÃO, H., ELSANGEDY, H., GUIMARÃES, M., SANTOS, L., SANTOS, T., Institution: UNIVERSIDADE FEDERAL DE PERNAMBUCO, Country: BRAZIL, Abstract-ID: 1720

INTRODUCTION:
Nature-based physical activities are recognized as non-pharmacological strategies for mental health promotion. Surf interventions have emerged within this context; however, evidence remains limited by low methodological quality and poorly controlled designs. To enhance psychological benefits, some studies combine physical activity with structured mindfulness. Existing trials investigating surfing combined with mindfulness have focused mainly on adolescents or military populations, limiting generalizability to adults. Therefore, this study compared surf literacy training with and without mindfulness on depressive and anxiety symptoms and secondary outcomes (e.g., mindfulness, quality of life, balance, and technical performance) in adults.

METHODS:
A five-week randomized controlled trial with parallel groups was conducted. Forty-two adults with symptoms of anxiety and depression and with no previous surfing experience were randomly allocated to a literacy-based technical and proprioceptive surf program (Surf) or to an intervention combining the same protocol with guided mindfulness (SurfMind). Participants completed 21 supervised sessions (18 pool-based, 50 min at 6.3 +/- 1.4 a.u. [RPE 0-10] and 3 ocean-based, 8.4 +/- 1.3 a.u.). The SurfMind group additionally performed 30 min of guided mindfulness after each session. Depression and anxiety were primary outcomes assessed pre and post intervention. Due to non-normal distributions and repeated measures, data were analyzed using Generalized Estimating Equations with a gamma distribution based on QIC, including fixed effects for group, time, and interaction (alpha = 0.05).

RESULTS:
Despite the absence of group and interaction effects, significant main effects of time were observed for depression (Wald chi-square = 99.16; df = 1; p < 0.001; marginal Cohen's d = 6.21) and anxiety (Wald chi-square = 43.75; df = 1; p < 0.001; d = 3.39), with absolute reductions of 17.7 and 11.8 points in Beck Depression Inventory-II and Beck Anxiety Inventory scores, respectively. Secondary outcomes improved over time, including mindfulness (d = -1.65), quality of life (d = -1.79), balance (d = -2.32), and surf-specific technical performance (d = -2.75 to -8.49).
CONCLUSION:
Within the tested parameters, the inclusion of a brief mindfulness component did not yield additional benefits beyond those produced by structured surf literacy training. The latter, grounded in a didactic framework that emphasizes progressive individualized skill acquisition, feasibility, group belonging, and self-efficacy, was sufficient to elicit improvements in depressive and anxiety symptoms as well as physical outcomes in adults. These findings indicate that future interventions should prioritize optimization of the core literacy program while systematically examining the dosage, mechanisms, and theoretical added value of adjunctive strategies, particularly through trials designed to compare different mindfulness dosing protocols.