Gardening Intervention Research Articles

Process Evaluation Across Four Markets Informs Revisions for Implementation of Unique In-School Garden and Nutrition Intervention at Scale

Process Evaluation Across Four Markets Informs Revisions for Implementation of Unique In-School Garden and Nutrition Intervention at Scale

Vegetable Diversity, Productivity, and Weekly Nutrient Supply from Improved Home Gardens Managed by Ethnic Families - a Pilot Study in Northwest Vietnam

Assess to quality diets is a basic human right. Geographical challenges and cultural traditions have contributed to the widespread malnutrition present among ethnic minorities of mountainous areas in Northwest Vietnam. Home gardens can play a role in increased diet diversity and micronutrient intakes. However, low production yields and plant diversity in ethnic home gardens have limited their contributions to household food security and nutrition. The pilot study tested a home garden intervention in weekly vegetable harvests and increasing household production and consumption of diverse vegetables year-round. Food ethics issues encountered included limited access to quality food by resource-poor groups, conflicts arising from low preference and value given to some nutritious foods, limited access to information and technology for food production and consumption, each of which were addressed in the study design. The intervention includes: (1) nutrition-focused home garden training and (2) locally-adapted home garden packages consisting of garden planning, technical assistance, and high-yielding seed varieties. Twenty households from two ethnic villages in Son La province participated in the study and were randomly assigned into two groups (intervention and non-intervention). The total vegetable supply from weekly harvests of home garden produce was significantly higher in the intervention households (226 kg) compared to the non-intervention households (39 kg). The intervention group yielded 5.8 and 1.7 times more vegetables by weight and weight per area than those without the intervention. The vegetables were mainly consumed at home for both groups, but the intervention households gave more vegetables as gifts to neighbors. The intervention group cultivated a higher diversity of vegetables with a total of 42 different vegetables compared to 24 in the non-intervention group, which is reflected in an overall higher nutritional yield of vitamin A, iron, other micronutrients and phytochemicals. The home garden training significantly improved the amount, diversity and continuity of household food and nutrient supply. The home garden model is effective and could be scaled up to improve household vegetable supply and consumption, particularly in Northwest Vietnam.

The Relationship Between Dietary Intake and Parental Support with Child Cooking Involvement in a Youth Population (FS16-03-19)

ObjectivesThis study assessed how child cooking involvement (CCI) and parental support in food preparation (PS) are related to vegetable preference (VP), vegetable intake (VI), and fruit intake (FI) in children participating in the Texas, Grow! Eat! Go! (TGEG) randomized controlled trial. MethodsBaseline data from the TGEG intervention, conducted in 28 low-income, primarily Hispanic schools across Texas, was used for this study, and included 1325 3rd grade students and their parents. Schools were assigned to: (1) control group; (2) school garden intervention [Learn, Grow, Eat & Go! (LGEG)]; (3) physical activity intervention [Walk Across Texas (WAT)]; or (4) combined group (LGEG plus WAT). Height (via stadiometer), weight (via Tanita scale), dietary intake and CCI (via child questionnaire), and PS (via parent questionnaire) were collected. General Linear Models examined variations in baseline VP, VI, and FI with baseline CCI and PS. A priori covariates for all analyses included: TGEG treatment group, age, sex, and ethnicity. ResultsStudents were 49.2% male and 42.4% Hispanic with a mean age of 8.3 ± 0.6; 78.3% of the population had overweight/obesity. Children who never cooked with their families preferred fewer vegetables than children who sometimes/always cooked with their parents (7.0 ± 0.6 vs. 8.7 ± 0.5 and 9.4 ± 0.5 vegetables, respectively; P < 0.001). Children who never cooked with their families ate less vegetables than children who sometimes/always cooked with their parents (1.9 ± 0.4 vs. 2.6 ± 0.3 and 3.5 ± 0.3 servings/day, respectively; P = 0.003 and P = 0.000, respectively). Children who never cooked with their families ate less fruit than children who sometimes/always cooked with their parents (1.2 ± 0.2 vs. 1.5 ± 0.1 and 2.09 ± 0.1 servings/day, respectively; P < 0.001). ConclusionsInterventions including family cooking activities with children may be an effective way to increase vegetable preference and intake, and fruit intake, especially in high-risk, minority children. Funding SourcesThe research was supported by funding from the USDA Agriculture and Food Research Initiative, (grant 2011-68001-30138).

Improving the income status of smallholder vegetable farmers through a homestead food garden intervention

In this article, we assess how a homestead food garden intervention influences the income of participating vegetable farmers in South Africa. The findings show that there is a significant improvement in the income of these farmers. Specifically, the participating vegetable farmers observed an increment in their gross margins of between 39.28% and 44.49%. Our findings further indicate that households with larger farm plots have higher gross margins in a production season. The underlying impact of the participating households with farmland larger than one acre is a surge in growth margin of 35.33–44.61% relative to those owning less than1 acre. Given the benefits of the intervention, stakeholders and policymakers should expand the programme and design strategies that will foster participation. Policies to consider include the availability of farm plots and the readiness of the household to participate in vegetable production. Other Southern African Development Communities as an important food policy intervention, which can improve household income, can adopt the programme.

Neighbour home gardening predicts dietary diversity among rural Tanzanian women.

The present study's aim was to assess the impact of a nutrition-sensitive intervention on dietary diversity and home gardening among non-participants residing within intervention communities. The study was a cross-sectional risk factor analysis using linear and logistic multivariate models. In Tanzania, women and children often consume monotonous diets of poor nutritional value primarily because of physical or financial inaccessibility or low awareness of healthy foods.ParticipantsParticipants were women of reproductive age (18-49 years) in rural Tanzania. Mean dietary diversity was low with women consuming three out of ten possible food groups. Only 23·4 % of respondents achieved the recommended minimum dietary diversity of five or more food groups out of ten per day. Compared with those who did not, respondents who had a neighbour who grew crops in their home garden were 2·71 times more likely to achieve minimum dietary diversity (95 % CI 1·60, 4·59; P=0·0004) and 1·91 times more likely to grow a home garden themselves (95 % CI 1·10, 3·33; P=0·02). Other significant predictors of higher dietary diversity were respondent age, education and wealth, and number of crops grown. These results suggest that there are substantial positive externalities of home garden interventions beyond those attained by the people who own and grow the vegetables. Cost-effectiveness assessments of nutrition-sensitive agriculture, including home garden interventions, should factor in the effects on the community, and not just on the individual households receiving the intervention.

School gardening increases knowledge of primary school children on edible plants and preference for vegetables.

At least 10% of children worldwide are diagnosed with overweight. Part of this problem is attributed to low vegetable intake, for which preference at a younger age is an indicator. Few studies examined long‐term effects of school garden interventions on the knowledge about and preference for vegetables. Therefore, in this study, an intervention period of 7 months (17 lessons) was organized for primary school students (n = 150) of age 10–12 years in the Municipality of Nijmegen (the Netherlands). Surveys were conducted before and after the intervention period to test the ability of students to identify vegetables, to measure their self‐reported preference for vegetables, and to analyze students’ attitudes toward statements about gardening, cooking, and outdoor activity. The long‐term effects were measured by repeating the survey 1 year after the intervention (n = 52). Results were compared with a control group of students (n = 65) with similar background and tested for significance with α = 0.05. School gardening significantly increases the knowledge of primary schoolchildren on 10 vegetables as well as their ability to self‐report preference for the vegetables. The short‐term (n = 106) and long‐term (n = 52) preference for vegetables increased (p < 0.05) in comparison with the control group. The latter did not show a significant learning effect (p > 0.05). This implies that the exposure to vegetables generated by school gardening programs may increase willingness to taste and daily intake of vegetables on the long term. Students’ attitudes toward gardening, cooking, and outdoor activity were unaffected by the intervention.

Interventional Strategies for Control of Anemia among Rural Young Women in Coimbatore

Anaemia is the most common micro-nutrient deficiency disorder in the world. The prevalence of anaemia is higher in developing countries than in developed countries. Anaemia affects half a billion women of reproductive age worldwide. India had always been the country with the highest prevalence of anaemia and the home of the largest number of anaemic individuals in the world. A cross sectional community based study was conducted to estimate the prevalence of anaemia among 700 young women in the age group of 19-35 years hailing from different rural areas of Karamadai from Coimbatore district and to assess their iron nutriture. Data on anthropometric measurements, biochemical investigations and dietary details were recorded using a pre-designed, pre-tested proforma. Data were analyzed statistically using mean, standard deviation and ANOVA. Hemoglobin estimation (Cyanmet haemoglobin method) revealed that the prevalence of anaemia among rural women (N = 580) and it was reported that 84.83% of the rural young women were moderately anaemic and 14.83% were mild anaemic. A subsample of 85 moderate anaemic subjects were divided into Group 1 (Nutrition Education + Food supplement intervention), Group 2 (Nutrition Education+Kitchen garden intervention) and Group 3 (Nutrition Education intervention) and subjected to respective intervention for four months. Biochemical analysis revealed significant increase (p≤0.01) in haemoglobin level among the subjects in Group 1, Group 2 and Group 3 after intervention further showing that the majority of rural women improved from moderate to mild level of anaemia and from mild level to normal level of hemoglobin after intervention. Therefore the intervention measures are more effective when they are integrated with other approaches namely better nutritional practices, fortification, dietary modification, infection control, public health measures and income generation programmes. Nutrition education must be made an integral part to all the strategies.

A home-based mentored vegetable gardening intervention demonstrates feasibility and improvements in physical activity and performance among breast cancer survivors.

The current study assessed the feasibility of a mentored home-based vegetable gardening intervention and examined changes in health-related outcomes among breast cancer survivors (BCS). BCS were randomized to either a year-long vegetable gardening intervention to begin immediately or a wait-list control. Master Gardeners mentored participants in planning, planting, and maintaining 3 seasonal gardens over the course of 1 year. Participant accrual, retention, and satisfaction rates of ≥80% served as feasibility (primary outcome) benchmarks. Secondary outcomes (ie, vegetable consumption, physical activity, performance and function, anthropometrics, biomarkers, and health-related quality of life) were collected at baseline and post-intervention (1-year follow-up) using subjective and objective measures. The trial surpassed all feasibility benchmarks at 82% of targeted accrual, 95% retention, and 100% satisfaction (ie, experience ratings of "good to excellent" and willingness to "do it again"). Compared with the controls, intervention participants reported significantly greater improvements in moderate physical activity (+14 vs -17 minutes/week) and demonstrated improvements in the 2-Minute Step Test (+22 vs + 10 steps), and Arm Curl (+2.7 vs + 0.1 repetitions) (P values < .05). A trend toward improved vegetable consumption was observed (+0.9 vs + 0.2 servings/day; P = .06). Approximately 86% of participants were continuing to garden at the 2-year follow-up. The results of the current study suggest that a mentored, home-based vegetable gardening intervention is feasible and offers an integrative and durable approach with which to improve health behaviors and outcomes among BCS. Harvest for Health led to the establishment of a group of trained Master Gardeners and gave rise to local and global community-based programs. Larger studies are needed to confirm the results presented herein and to define applicability across broader populations of survivors.

The carry-over effects of school gardens on fruit and vegetable availability at home: A randomized controlled trial with low-income elementary schools

This group-randomized controlled trial examines the effects of a school garden intervention on availability of fruits and vegetables (FV) in elementary school children's homes. Within each region, low income U.S. schools in Arkansas, Iowa, New York, and Washington State were randomly assigned to intervention group (n = 24) or waitlist control group (n = 22). Children were in grades 2, 4, and 5 at baseline (n = 2768). The garden intervention consisted of both raised-bed garden kits and a series of grade-appropriate lessons. FV availability at home was measured with a modified version of the GEMS FJV Availability Questionnaire. The instrument was administered at baseline (Fall 2011) and throughout the intervention (Spring 2012, Fall 2012, Spring 2013). Analyses were completed using general linear mixed models. The garden intervention led to an overall increase in availability of low-fat vegetables at home. Among younger children (2nd grade at baseline), the garden intervention led to greater home availability of vegetables, especially, low-fat vegetables. Moreover, for the younger group, garden intervention fidelity (GIF) or robustness predicted home availability of fruit, vegetables, and low-fat vegetables. School gardens have potential to affect FV availability in the home environment.

Assessing the Feasibility of a Mentored Home-Based Vegetable Gardening Intervention among Breast Cancer Survivors in the Deep South

Abstract To assess the feasibility of a mentored home-based vegetable gardening intervention among Breast Cancer Survivors (BCS) residing in the Birmingham, Alabama metropolitan area. Methods: Using a wait-list control design, BCS were randomized to either a year-long vegetable gardening intervention or a wait-list control. Intervention participants were provided with necessary supplies and paired with a Master Gardener from the Cooperative Extension. Master Gardeners mentored participants in planning, planting, and maintaining 3 seasonal gardens over 12 months, conducted monthly home-visits, and checked in bi-weekly via telephone or email. Feasibility assessment criteria consisted of participant accrual, retention, and satisfaction rates of ≥80%. Target participant accrual was 100. Participant satisfaction data were collected after study completion via structured telephone debriefing. Descriptive statistics were conducted using SPSS V24. Results: 82 BCS (Mage = 60 (39–84); Msurvivorship = 5 years (0.5–23); Mco-morbidities = 3.5 (0–12); ≥2 functional limitations = 86.6%; Caucasian = 73.2%; African-American = 26.8%) enrolled (82% accrual). Of these, four did not complete the study (2 refused to be wait-listed due to not wanting to wait to garden, 1 withdrew due to family obligations, and 1 was lost to follow-up), resulting in an retention rate of 95% over a 1-year period. All BCS who completed the intervention (n = 42) rated their Harvest for Health experience as “Good to Excellent”, reported that they would “do it again”, and planned to “continue to garden.” When asked to rate, on a scale of 1–10 (1 = not at all and 10 = very much), the influence of gardening on motivating behavior change, BCS reported that gardening motivated them to… “eat a healthier diet” (M = 8.38; SD = 2.07), “eat more vegetables” (M = 8.43; SD = 2.08), and “be more physically active” (M = 7.5; SD = 2.73). Conclusions: The vegetable gardening intervention proved to be feasible and provided new knowledge about the influence of gardening on motivating behavior change among BCS. Findings suggest that a mentored home-based vegetable gardening may offer an integrative approach to improve diet, vegetable consumption, and physical activity among BCS. Larger, future studies are warranted.

Pilot Randomized Controlled Trial of a Home Vegetable Gardening Intervention among Older Cancer Survivors Shows Feasibility, Satisfaction, and Promise in Improving Vegetable and Fruit Consumption, Reassurance of Worth, and the Trajectory of Central Adiposity

BackgroundHolistic approaches are sought to improve lifestyle behaviors and health of cancer survivors long term. ObjectiveOur aim was to explore whether a home-based vegetable gardening intervention is feasible and whether it improves diet and other health-related outcomes among older cancer survivors. DesignWe conducted a feasibility trial in which cancer survivors were randomized to receive a year-long gardening intervention immediately or to a wait-list control arm. Home visits at baseline and 1 year assessed physical performance, anthropometric indices, behavioral and psychosocial outcomes, and biomarkers. Participants/settingParticipants included 46 older (aged 60+ years) survivors of locoregionally staged cancers across Alabama from 2014 to 2016. Forty-two completed 1-year follow-up. InterventionCooperative extension master gardeners delivered guidance to establish three seasonal vegetable gardens at survivors’ homes. Plants, seeds, and gardening supplies were provided. OutcomesPrimary outcomes were feasibility targets of 80% accrual and retention, and an absence of serious adverse events; other outcomes were secondary and explored potential benefits. Statistical analysesBaseline to follow-up changes were assessed within and between arms using paired t, McNemar’s, and χ2 tests. ResultsThis trial proved to be safe and demonstrated 91.3% retention; 70% of intervention participants rated their experience as “excellent,” and 85% would “do it again.” Data suggest significantly increased reassurance of worth (+0.49 vs −0.45) and attenuated increases in waist circumference (+2.30 cm vs +7.96 cm) in the gardening vs control arms (P=0.02). Vegetable and fruit consumption increased by approximately 1 serving/day within the gardening arm from baseline to follow-up (mean [standard error]=1.34 [1.2] to 2.25 [1.9] servings/day; P=0.02)] compared to controls (1.22 [1.1] to 1.12 [0.7]; P=0.77; between-arm P=0.06). ConclusionsThe home vegetable gardening intervention among older cancer survivors was feasible and suggested improvements in vegetable and fruit consumption and reassurance of worth; data also suggest attenuated increases in waist circumference. Continued study of vegetable gardening interventions is warranted to improve health, health behaviors, and well-being of older cancer survivors.

Community gardening, community farming and other local community-based gardening interventions to prevent overweight and obesity in high-income and middle-income countries: protocol for a systematic review

IntroductionThe worldwide prevalence of overweight/obesity has continued to rise over the last decades. To reverse this trend, public health authorities are exploring cost-effective interventions, especially in high-income and middle-income countries....

School gardening in Bhutan: Evaluating outcomes and impact

School gardening interventions have been touted as an effective approach to improve children’s eating habits in developed countries, but there is little evidence for their impact in developing countries. We studied the combined effect of school gardens linked to complementary lessons and promotional activities on the eating behavior and nutritional status of 9- to 15-year-old schoolchildren in Bhutan. We also studied the effect on a range of secondary indicators derived from the impact pathway. We used data from 468 schoolchildren in 9 control and 9 treatment schools following a randomized controlled trial design. We found that the school gardening intervention significantly increased children’s awareness about vegetables, their knowledge about sustainable agriculture, and their preferences for healthier foods. We found an 11.7-percentage point increase in the probability that children included vegetables in their meals (p < 0.05), but not in the number of different fruits or vegetables consumed. These results support the idea that comprehensive school garden interventions, combining gardening with education and promotion, can positively influence food preferences and food behavior in developing countries.

Community Gardens as Environmental Health Interventions: Benefits Versus Potential Risks

The purpose of this paper was to summarize current findings on community gardens relevant to three specific areas of interest as follows: (1) health benefits, (2) garden interventions in developing versus developed countries, and (3) the concerns and risks of community gardening. Community gardens are a reemerging phenomenon in many low- and high-income urban neighborhoods to address the common risk factors of modern lifestyle. Community gardens are not limited to developed countries. They also exist in developing low-income countries but usually serve a different purpose of food security. Despite their benefits, community gardens can become a source of environmental toxicants from the soil of mostly empty lands that might have been contaminated by toxicants in the past. Therefore, caution should be taken about gardening practices and the types of foods to be grown on such soil if there was evidence of contamination. We present community gardens as additional solutions to the epidemic of chronic diseases in low-income urban communities and how it can have a positive physical, mental and social impact among participants. On balance, the benefits of engaging in community gardens are likely to outweigh the potential risk that can be remedied. Quantitative population studies are needed to provide evidence of the benefits and health impacts versus potential harms from community gardens.

PEDAGOGICAL SCHOOL GARDENS AS A FOOD AND NUTRITION EDUCATION STRATEGY: PERCEPTION OF PARENTS AND EDUCATORS OF THEIR IMPACT ON CHILDREN´S DIETS

Introduction: Schools have been recognized as a favorable setting for food and nutrition education and school-based garden interventions have shown positive results. Objective: The objective of this study was to describe the dietary-related impact of children´s experience with growing foods in school gardens, according to the perception of parents and educators. Methods: In-depth interviews were conducted with principals, teachers and employees, and semistructured in-home interviews with parents of school children from three municipal schools in Greater Sao Paulo. A total of 27 individuals were interviewed, comprising 19 parents and eight educators. Results and discussion: The school garden promoted reflection on the act of eating and on foods through the knowledge gained from direct contact with growing food crops. The experience had an impact on both the children and the families involved with the activities. Contact with food production provided knowledge about food and strengthened connections with the food grown by sensitization to the act of eating. In practice, this resulted in concrete dietary-related changes, greater knowledge of foods and the food system, in addition to greater appreciation of the food produced as well as motivation to try new foods. Conclusion: School gardens are conceived as a food and nutrition education strategy based on involvement and direct contact with food. DOI: 10.12957/demetra.2017.26407

Garden as Canvas: Therapeutic Metaphors in a Children's Garden (Le jardin pour toile : les métaphores thérapeutiques dans un jardin pour enfants)

ABSTRACTThe garden is an inspired place, naturally imbued with metaphors of growth, healing, and renewal. Therapeutic work in the garden can help young clients discover healthy ways to cope with challenging feelings and behaviors such as anxiety and aggression, and learn self-regulation through the senses. Along with supporting literature and clinical examples, this article will present the story of the Children's Therapeutic Garden at a children's mental health center. This garden provides a welcoming, normalized environment for children and families who may otherwise feel stigmatized in a mental health setting.In this article, we share our innovative exploration in expanding the creative media we use to include nature and gardening in our work as art therapists. A variety of spin off topics emerged from our exploration and research, including caring for our environment, outdoor education, nutrition, healthy cooking and eating, and promotion of physical health, which are beyond the scope of this article. Rather we will focus on the innovation of using therapeutic metaphors in our work in the garden while doing art therapy with our clients. We will highlight artful garden interventions that facilitate the cooperative interactions of children and families, building stronger relationships, and improving communication.

Yéego Gardening! A Community Garden Intervention to Promote Health on the Navajo Nation.

Yéego Gardening! is a community garden intervention to increase gardening behavior, increase access to low-cost fruit and vegetables, and ultimately increase consumption in Navajo communities. To design a theory-based, culturally relevant intervention with three components: a community garden, monthly workshops on gardening and healthy eating, and community outreach. Gardens were constructed and maintained in collaboration with community-based organizations in two Navajo communities. Monthly workshops were held throughout the growing season and incorporated aspects of Navajo culture and opportunities to build confidence and skills in gardening and healthy eating behaviors. In addition, program staff attended community events to promote gardening and healthy eating. Community input was essential throughout the planning and implementation of the intervention. If effective, community gardens may be a way to increase fruit and vegetable availability and intake, and ultimately reduce risk of obesity and diabetes.

Impact and cost-effectiveness of women's training in home gardening and nutrition in Bangladesh

ABSTRACTThis study quantifies the impact and cost-effectiveness of training poor rural women in Bangladesh in home gardening and nutrition. We use baseline and follow-up data for 646 intervention and control households and apply a difference-in-difference estimator. We find that the intervention significantly (p < 0.01) increased vegetable production (+16.5 g/person/day), vegetable consumption and the micronutrient supply from the garden. Using the disability-adjusted life years (DALYs) approach, we show that the intervention can be considered cost-effective in abating iron, vitamin A and zinc deficiencies. Home garden interventions can therefore make an effective contribution to addressing micronutrient undernutrition.

Impact of school-based vegetable garden and physical activity coordinated health interventions on weight status and weight-related behaviors of ethnically diverse, low-income students: Study design and baseline data of the Texas, Grow! Eat! Go! (TGEG) cluster-randomized controlled trial.

BackgroundCoordinated, multi-component school-based interventions can improve health behaviors in children, as well as parents, and impact the weight status of students. By leveraging a unique collaboration between Texas AgriLife Extension (a federal, state and county funded educational outreach organization) and the University of Texas School of Public Health, the Texas Grow! Eat! Go! Study (TGEG) modeled the effectiveness of utilizing existing programs and volunteer infrastructure to disseminate an enhanced Coordinated School Health program. The five-year TGEG study was developed to assess the independent and combined impact of gardening, nutrition and physical activity intervention(s) on the prevalence of healthy eating, physical activity and weight status among low-income elementary students. The purpose of this paper is to report on study design, baseline characteristics, intervention approaches, data collection and baseline data.MethodsThe study design for the TGEG study consisted of a factorial group randomized controlled trial (RCT) in which 28 schools were randomly assigned to one of 4 treatment groups: (1) Coordinated Approach to Child Health (CATCH) only (Comparison), (2) CATCH plus school garden intervention [Learn, Grow, Eat & Go! (LGEG)], (3) CATCH plus physical activity intervention [Walk Across Texas (WAT)], and (4) CATCH plus LGEG plus WAT (Combined). The outcome variables include student’s weight status, vegetable and sugar sweetened beverage consumption, physical activity, and sedentary behavior. Parents were assessed for home environmental variables including availability of certain foods, social support of student health behaviors, parent engagement and behavior modeling.ResultsDescriptive data are presented for students (n = 1369) and parents (n = 1206) at baseline. The sample consisted primarily of Hispanic and African American (53 % and 18 %, respectively) and low-income (i.e., 78 % eligible for Free and Reduced Price School Meals program and 43 % food insecure) students. On average, students did not meet national guidelines for vegetable consumption or physical activity. At baseline, no statistical differences for demographic or key outcome variables among the 4 treatment groups were observed.ConclusionsThe TGEG study targets a population of students and parents at high risk of obesity and related chronic conditions, utilizing a novel and collaborative approach to program formulation and delivery, and a rigorous, randomized study design.

Detailed methods of two home-based vegetable gardening intervention trials to improve diet, physical activity, and quality of life in two different populations of cancer survivors

BackgroundCancer survivors suffer from long-term adverse effects that reduce health-related quality of life (QOL) and physical functioning, creating an urgent need to develop effective, durable, and disseminable interventions. Harvest for Health, a home-based vegetable gardening intervention, holds promise for these domains. MethodsThis report describes the methods and recruitment experiences from two randomized controlled feasibility trials that employ a waitlist-controlled design. Delivered in partnership with Cooperative Extension Master Gardeners, this intervention provides one-on-one mentorship of cancer survivors in planning and maintaining three seasonal vegetable gardens over 12months. The primary aim is to determine intervention feasibility and acceptability; secondary aims are to explore effects on objective and subjective measures of diet, physical activity and function, and QOL and examine participant factors associated with potential effects. One trial is conducted exclusively among 82 female breast cancer survivors residing in the Birmingham, AL metropolitan area (BBCS); another broadly throughout Alabama among 46 older cancer survivors aged >60 (ASCS). ResultsResponse rates were 32.6% (BBCS) and 52.3% (ASCS). Both trials exceeded 80% of their accrual target. Leading reasons for ineligibility were removal of >10 lymph nodes (lymphedema risk factor), lack of physician approval, and unwillingness to be randomized to the waitlist. ConclusionTo date, recruitment and implementation of Harvest for Health appears feasible. DiscussionAlthough both studies encountered recruitment challenges, lessons learned can inform future larger-scale studies. Vegetable gardening interventions are of interest to cancer survivors and may provide opportunities to gain life skills leading to improvements in overall health and QOL.