The 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.

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.

Background Cancer survivors are at increased risk for second malignancies, cardiovascular disease, diabetes, and functional decline. Evidence suggests that a healthful diet and physical activity may reduce the risk of chronic disease and improve health in this population. Methods We conducted a feasibility study to evaluate a vegetable gardening intervention that paired 12 adult and child cancer survivors with Master Gardeners to explore effects on fruit and vegetable intake, physical activity, quality-of-life, and physical function. Throughout the year-long study period, the survivor-Master Gardener dyads worked together to plan/plant 3 gardens, harvest/rotate plantings, and troubleshoot/correct problems. Data on diet, physical activity, and quality-of-life were collected via surveys; anthropometrics and physical function were objectively measured. Acceptability of the intervention was assessed with a structured debriefing survey. Results The gardening intervention was feasible (robust enrollment; minimal attrition) and well-received by cancer survivors and Master Gardeners. Improvement in 3 of 4 objective measures of strength, agility, and endurance was observed in 90% of survivors, with the following change scores (median [interquartile range]) noted between baseline and 1-year follow-up: hand grip test (+4.8 [3.0, 6.7] kg), 8 foot Get-Up-and-Go (−1.0 [−1.8, −0.2] seconds), 30-second chair stand (+3.0 [−1.0, 5.0] stands), and 6-minute walk (+38 [20, 160] feet). Increases of ≥1 fruit and vegetable serving/ day and ≥30 minutes/week of physical activity were observed in 40% and 60%, respectively. Conclusion These preliminary results support the feasibility and acceptability of a mentored gardening intervention and suggest that it may offer a novel and promising strategy to improve fruit and vegetable consumption, physical activity, and physical function in cancer survivors. A larger randomized controlled trial is needed to confirm our results.

Background Cancer 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. Methods This 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 12 months. 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). Results Response 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. Conclusion To date, recruitment and implementation of Harvest for Health appears feasible. Discussion Although 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.

Good dental health enables a person to eat, speak, and socialise. It contributes to nutrition, general health, and quality of life. The dental health of people living in the UK has improved in the last 40 years, and older people are retaining their natural teeth throughout their life; nontheless, a significant proportion of people over 75 years still rely on partial and full dentures. Dental disease in all age groups is readily prevented by daily oral hygiene and adherence to a healthy diet, avoidance of smoking, and sensible alcohol intake. Some older people may simply need reminding and encouragement to carry out oral hygiene, while more dependent adults may need support and active help to do so. Nursing teams and health professionals play a key role in promoting oral health by supporting oral hygiene and adequate nutrition, preventing discomfort, and detecting dental diseases early. This article gives a brief overview of how nursing teams and health professionals can promote oral health and provides details of resources from which further detailed information may be obtained.

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Background Health behavior interventions, especially those that promote improved diet and physical activity, are increasingly directed toward cancer survivors given their burgeoning numbers and high risk for comorbidity and functional decline. However, for health behavior interventions to achieve maximal public health impact, sustainability at both the individual and organizational levels is crucial. The current study aimed to assess the individual and organizational sustainability of the Harvest for Health mentored vegetable gardening intervention among cancer survivors. Methods Telephone surveys were conducted among 100 cancer survivors (mean age 63 years; primarily breast cancer) completing one-of-two Harvest for Health feasibility trials. Surveys ascertained whether participants continued gardening, and if so, whether they had expanded their gardens. Additionally, surveys were emailed to 23 stakeholders (Cooperative Extension county agents, cancer support group leaders, and healthcare representatives) who were asked to rate the intervention’s ability to generate sustained service and produce benefits over time using the eight-domain Program Sustainability Assessment Tool (PSAT). Results The survey among cancer survivors (91.9% response rate) indicated that 85.7% continued gardening throughout the 12 months following intervention completion; 47.3% expanded their gardens beyond the space of the original intervention. Moreover, 5.5% of cancer survivors enrolled in the certification program to become Extension Master Gardeners. The survey among stakeholders generated a similar response rate (i.e., 91.3%) and favorable scores. Of the possible maximum of 7 points on the PSAT, the gardening intervention’s “Overall Capacity for Sustainability” scored 5.7 (81.4% of the maximum score), with subscales for “Funding Stability” scoring the lowest though still favorably (5.0) and “Program Evaluation” scoring the highest (6.3). Conclusions Data support the sustainability capacity of the Harvest for Health vegetable gardening intervention for cancer survivors. Indeed, few interventions have proven as durable in terms of individual sustainability. Furthermore, Harvest for Health’s overall organizational score of 5.7 on the PSAT is considered strong when compared to a previous review of over 250 programs, where the mean overall organizational PSAT score was 4.84. Thus, solutions for long-term funding are currently being explored to support this strong, holistic program that is directed toward this vulnerable and growing population. Trial registration ClinicalTrials.gov Identifier: NCT02150148

Extension Master Gardener (EMG) volunteers are key to effective dissemination of horticultural information to the public. The goal of this workshop was to identify techniques to increase the capacity and effectiveness of EMG volunteers. The workshop focused on projects and tools that reduce the administrative burden of managing volunteers, increase the scope of issues that volunteers are prepared to address, and pool volunteer efforts and resources across county lines. Two online systems for managing and reporting EMG volunteer activities were described. Both systems are intuitive, user-friendly, and updated without the assistance of web managers. Regional web-based, advanced training on specific topics was used to expand educational messages of EMG volunteers and eliminate the costs associated with face-to-face training. Presentations were made using distance learning technologies and resources were shared online. Hosting agents tailored hands-on supporting activities to meet local needs. Volunteers expanded extension outreach by answering noncommercial landscape and garden telephone questions. Many of the administrative, logistical, and resource burdens associated with the EMG helpline phone service were overcome by working across county lines, standardizing training, centralizing supporting resources, and clustering volunteers into regional telephone helpline offices. Other projects and tools presented in the workshop focused on the need to affirm and/or foster the volunteers' connection with the university and the outreach mission of Cooperative Extension.