Date of Award


Degree Name

PhD Leadership Studies

Dissertation Committee

Fred J. Galloway, EdD, Chair Antonio Jimenéz-Luque, PhD, Member Paul J. Zak, PhD, Member


technology, therapy, measure, mental health, physical therapy, blue care, exercise as medicine, flow, ocean surf therapy, surfing, quantitative, qualitative, mixed methods


Mental health is quickly becoming a major policy concern, with recent data reporting increasing and disproportionately worse mental health outcomes, including anxiety, depression, increased substance abuse, and elevated suicidal ideation. One specific population that is especially high risk for these issues is the military community because military conflict, deployment stressors, and combat exposure contribute to the risk of mental health problems.

Although several pharmacological approaches have been employed to combat this epidemic, their efficacy is mixed at best, which has led to novel nonpharmacological approaches. One such approach is Operation Surf, a nonprofit that provides nature-based programs advocating the restorative power of the ocean and surfing. Although the limited research in this area has shown a positive impact on the health of veterans, these results were based on self-reported survey instruments that suffer from a series of well-known biases. Fortunately, the recent introduction of wearable technology (e.g., Whoop bands) that unobtrusively gather physiological data such as heart rate variability (HRV), resting heart rate (RHR), and both rapid eye movement (REM) and deep sleep, offers an opportunity to validate or invalidate traditional survey assessment data.

This study used survey data to measure changes in depression, anxiety, and posttraumatic stress disorder (PTSD), together with data generated from Whoop bands, and qualitative data, producing a more robust set of programmatic efficacy inferences for military veterans who participated in Operation Surf between 2021–2022. Paired samples t tests were used to analyze the data gathered before the intervention, immediately after, and 1 month later. Survey scores before the therapy, as measured by the psychometrically sound PHQ-8 (depression), PCL-5 (PTSD), and GAD-7 (anxiety), were significantly higher than both time points after therapy, revealing statistically significant and clinically significant decreases in anxiety, depression, and PTSD symptoms. Physiological data indicated varying degrees of statistically significant change in HRV, RHR, REM sleep, and deep sleep, while the qualitative data provided supported the quantitative findings.

Taken together, the introduction of physiological data gathered from wearable technology can hopefully further understanding toward a low-cost, scalable treatment modality while eliminating stigmas and barriers to care for military veterans and informing public policy care decisions.

Document Type

Dissertation: Open Access


Leadership Studies