Publications

Filter Publications

Select Research Themes

Select Authors

Select Publication Years

2 publications listed under Veterans

Navigating Constraints and Strategies for Veteran Outdoor Access

2026 / Veterans

Outdoor programs for veterans (OPVs) support the physical and mental health benefits of nature-based experiences, seeking to mitigate the constraints to participation that veterans commonly face. But OPVs themselves often face organizational constraints to service delivery. The COMPACT Act of 2020 required the U.S. Department of Veterans Affairs (VA) to establish an interagency task force to coordinate with public land agencies to enhance outdoor opportunities for veterans. A federal information request in 2022 asked veteran organizations and the public to identify constraints they experience seeking or facilitating outdoor opportunities as well as strategies for overcoming them. We analyzed public comments (n = 120) received in response to the information request. In their service delivery, we found that OPVs faced internal organizational constraints as well as administrative hurdles with both the VA and public land agencies. We described strategies identified by OPVs for negotiating these constraints. OPVs supported capacity-building initiatives to improve coordination, expand access to information, provide training, and identify mechanisms to support OPV programs. They also sought streamlined services to access VA grants and public land reservation and permit systems. Such improvements could reduce constraints to participation and promote improved veteran health.

Nature Versus Urban Hiking for Veterans with Post-Traumatic Stress Disorder: A Pilot Randomized Trial Conducted in the Pacific Northwest USA

2021 / PTSD, Veterans

Figure 1. Conceptual model Objectives To evaluate feasibility and acceptability of a group-based nature recreation intervention (nature hiking) and control condition (urban hiking) for military Veterans with post-traumatic stress disorder (PTSD). Design and setting A pilot randomised controlled trial conducted in the US Pacific Northwest. Participants Veterans with PTSD due to any cause. Interventions Twenty-six participants were randomised to a 12-week intervention involving either six nature hikes (n=13) or six urban hikes (n=13). Primary and Secondary Outcome Measures Feasibility was assessed based on recruitment, retention and attendance. Questionnaires and post-intervention qualitative interviews were conducted to explore intervention acceptability. Questionnaires assessing acceptability and outcomes planned for the future trial (eg, PTSD symptoms) were collected at baseline, 6 weeks, 12 weeks (immediately after the final hike) and 24 weeks follow-up. Results Of 415 people assessed for eligibility/interest, 97 were interested and passed preliminary eligibility screening, and 26 were randomised. Mean completion of all questionnaires was 91% among those in the nature hiking group and 68% in those in the urban hiking group. Over the course of the intervention, participants in the nature and urban groups attended an average of 56% and 58%, respectively, of scheduled hikes. Acceptability of both urban and nature hikes was high; over 70% reported a positive rating (ie, good/excellent) for the study communication, as well as hike locations, distance and pace. Median PTSD symptom scores (PTSD Checklist-5) improved more at 12 weeks and 24 weeks among those in the nature versus urban hiking group. Conclusions This pilot study largely confirmed the feasibility and acceptability of nature hiking as a potential treatment for Veterans with PTSD. Adaptations will be needed to improve recruitment and increase hike attendance for a future randomised controlled trial to effectively test and isolate the ways in which nature contact, physical activity and social support conferred by the group impact outcomes. Trial Registration Number NCT03997344