Growing Healthy Hearts: Gardening Program Feasibility in a Hospital-Based Community Garden

Veldheer, Susan; Winkels, Renate M.; Cooper, J.B.; Groff, Calesta; Lepley, Jordan; Bordner, Candace; Wagner, Alexandra; George, Daniel R.; Sciamanna, Christopher N.

doi:10.1016/j.jneb.2020.07.006

Cited by 13 publications

(12 citation statements)

References 22 publications

(21 reference statements)

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“…It is also in alignment with social cognitive theory which posits that knowledge is an important element for behavior change [ 50 ]. Both NG and EG were fairly consistent in suggesting the need for gardening-related knowledge and skills and the topics they identified were broadly consistent with other programs that have offered gardening-based education [ 18 , 23 , 44 , 45 ].…”

Section: Discussionsupporting

confidence: 69%

“…Importantly, while the majority of gardening that occurs in the US is home-based (92%), there are many practical options for outdoor gardening in small spaces and urban settings. This includes growing in pots or containers on apartment balconies, in small front or back yards [ 53 ], or by accessing community gardens which are located in all 50 states [ 54 , 55 ], at schools [ 56 ], and on medical center campuses [ 23 , 57 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…The vast majority of published studies that teach gardening skills to adults have relied on synchronous, in-person delivery models [ 12 , 19 , 23 - 25 ]. In-person intervention delivery methods have inherent participation barriers due to logistical considerations such as labor availability, scheduling, transportation, and participant child care needs [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

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Participant Preferences for the Development of a Digitally Delivered Gardening Intervention to Improve Diet, Physical Activity, and Cardiovascular Health: Cross-sectional Study

Veldheer¹,

Whitehead-Zimmers²,

Bordner³

et al. 2023

JMIR Form Res

Self Cite

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Background Low dietary intake of fruits and vegetables and physical inactivity are 2 modifiable risk factors for cardiovascular disease. Fruit and vegetable gardening can provide access to fresh produce, and many gardening activities are considered moderate physical activity. This makes gardening interventions a potential strategy for cardiovascular disease risk reduction. Previously developed gardening interventions have relied on in-person delivery models, which limit scalability and reach. Objective The purpose of this study was to ascertain participant insight on intervention components and topics of interest to inform a digitally delivered, gardening-focused, multiple health behavior change intervention. Methods A web-based survey was delivered via Amazon Mechanical Turk (MTurk), including quantitative and open-ended questions. Eligible participants were aged ≥20 years, could read and write in English, were US residents, and had at least a 98% MTurk task approval rating. A multilevel screening process was used to identify and exclude respondents with response inattention, poor language fluency, or suspected automated web robots (bots). Participants were asked about their interest in gardening programming, their preferences for intervention delivery modalities (1-hour expert lectures, a series of brief <5-minute videos, or in-person meetings), and what information is needed to teach new gardeners. Comparisons were made between never gardeners (NG) and ever gardeners (EG) in order to examine differences in perceptions based on prior experience. Quantitative data were summarized, and differences between groups were tested using chi-square tests. Qualitative data were coded and organized into intervention functions based on the Behavior Change Wheel. Results A total of 465 participants were included (n=212, 45.6% NG and n=253, 54.4% EG). There was a high level of program interest overall (n=355, 76.3%), though interest was higher in EG (142/212, 67% NG; 213/253, 84.2% EG; P<.001). The majority of participants (n=282, 60.7%) preferred a series of brief <5-minute videos (136/212, 64.2% NG; 146/253, 57.7% EG; P=.16) over 1-hour lectures (29/212, 13.7% NG; 50/253, 19.8% EG; P=.08) or in-person delivery modes (47/212, 22.2% NG; 57/253, 22.5% EG; P=.93). Intervention functions identified were education and training (performing fundamental gardening and cooking activities), environmental restructuring (eg, social support), enablement (provision of tools or seeds), persuasion (offering encouragement and highlighting the benefits of gardening), and modeling (using content experts and participant testimonials). Content areas identified included the full lifecycle of gardening activities, from the fundamentals of preparing a garden site, planting and maintenance to harvesting and cooking. Conclusions In a sample of potential web-based learners, participants were interested in a digitally delivered gardening program. They preferred brief videos for content delivery and suggested content topics that encompassed how to garden from planting to harvesting and cooking. The next step in this line of work is to identify target behavior change techniques and pilot test the intervention to assess participant acceptability and preliminary efficacy.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Participant Preferences for the Development of a Digitally Delivered Gardening Intervention to Improve Diet, Physical Activity, and Cardiovascular Health: Cross-sectional Study

Veldheer¹,

Whitehead-Zimmers²,

Bordner³

et al. 2023

JMIR Form Res

Self Cite

View full text Add to dashboard Cite

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“…These include providing patients with community-supported agriculture boxes, 39 providing patients with fruit and vegetable vouchers to reduce costs (eg, prescription produce programs), 40,41 and hosting hospital-based farmers' markets 42,43 or community gardens where patients can access high-quality, low-cost produce. 44,45 Some of these programs not only provide local fruits and vegetables to patients at clinical points-of-care, but also multiply community benefit by lending economic support and visibility to local food growers. This support increases reach for community actors who are producing and distributing products that, in turn, improve human health, lower the overall GHG footprint, and strengthen regional economies.…”

Section: Strategiesmentioning

confidence: 99%

Strategies to Help Health Care Organizations Execute Their Food System Leadership Responsibilities

Veldheer

George

2022

AMA Journal of Ethics

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Food systems influence environmental sustainability and health. The fact that our current food production and distribution practices neither support nor promote planetary or human health raises ethical concerns. Since health organizations offer food to patients, community members, and employees, they are situated at key intersections among food systems, agricultural policies and practices, and public health. This article considers the nature and scope of health care organizations' local food system leadership responsibilities and describes how health care organizations' food practices can help improve health outcomes and motivate equity. Food Production EmissionsModern agricultural food systems exert a major impact on both the environment and human health. Food production accounts for an estimated 19% to 29% of greenhouse gas (GHG) emissions and an estimated 70% of global freshwater withdrawals. 1,2 The production of animal-based protein (eg, beef, pork, and chicken) makes the largest contribution to GHG and imposes the greatest burden on water and land resources. 3,4 In contrast, plants (eg, fruits, vegetables, legumes, and grains) have the lowest environmental impact. 3,4 At the same time, there is compelling evidence demonstrating that plant-based diets high in fruits and vegetables can be used for primary prevention or treatment of many of the most prevalent chronic diseases in the United States, including cardiovascular disease, type-2 diabetes, obesity, and some cancers. 5,6,7,8,9 Thus, the imbalance of our current food production practices not only degrades environmental health, but also has implications for human health. However, at a time of historic wealth and income inequality, when life expectancy in the United States has reversed for the first time in a century and 6 of 10 Americans are living with at least one diet-related chronic disease (eg, heart disease, obesity, diabetes), 10,11 fostering healthier diets remains a persistent challenge. 12 Food production and consumption patterns that are misaligned with healthy dietary patterns are in part driving these troubling public health trends. For instance, population-level red meat intake is higher than recommended in North America and in most regions of the world, while intake of fruits and vegetables, legumes, whole grains, and nuts is well

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“…They are productive landscapes where people and place, mind and body, social and physical, and past and present intermingle [4]. UCGs offer many ecosystem services (ES) [5] such as the provision of food and medicinal plants [6], local climate regulation [7], biodiversity [8], habitat for species [9], the facilitation of active and healthy lifestyles [10], neighborhood relationships [11], opportunities for relaxation and recreation [12], increased social cohesion [13], and environmental education [14]. However, UCGs are also associated with various ecosystem disservices (EDS) [15] such as sheltering harmful animals and vectors of diseases, contaminating soil, destroying landscape aesthetics, and increasing interpersonal tension [3,16].…”

Section: Introductionmentioning

confidence: 99%

Chinese Residents’ Perceived Ecosystem Services and Disservices Impacts Behavioral Intention for Urban Community Garden: An Extension of the Theory of Planned Behavior

Tian

et al. 2022

Agronomy

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Urban community gardens (UCGs), greenspace cultivated and managed for vegetables by local communities, provide substantial ecosystem services (ES) and are warmly welcomed by residents. However, they also have many ecosystem disservices (EDS) and are almost always refused by the decision-makers of the government, especially in China. Better understanding the residents’ perceived ES and EDS and the impact on the behavioral intention (BI) toward UCGs is of great value to solve the conflicts between residents and the government concerning UCGs and to develop sustainable UCGs. Following the theory of planned behavior (TPB), we measured perceived ES/EDS, attitudes (ATT), perceived behavioral control (PBC), subjective norm (SN), and BI of 1142 residents in Changsha, China, and investigated their direct and indirect causal relationships using structural equation modeling (SEM). The results showed that: (1) ATT, PBC, and SN significantly and positively impact the BI of UCGs and together explained 54% of the variation of BI. (2) The extended TPB model with additional components of perceived ED/EDS improved the explanatory ability of the model, explaining 65% of the variance of BI. Perceived ES and perceived EDS showed significant direct positive and negative impacts on UCGs, respectively. They also indirectly impacted BI by influencing ATT, PBC, and SN. The findings of this study can extend our understanding of residents’ attitudes, behavior, and driving mechanism toward UCGs, and can help decision makers to design better policies for UCG planning and management.

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Growing Healthy Hearts: Gardening Program Feasibility in a Hospital-Based Community Garden

Cited by 13 publications

References 22 publications

Participant Preferences for the Development of a Digitally Delivered Gardening Intervention to Improve Diet, Physical Activity, and Cardiovascular Health: Cross-sectional Study

Participant Preferences for the Development of a Digitally Delivered Gardening Intervention to Improve Diet, Physical Activity, and Cardiovascular Health: Cross-sectional Study

Strategies to Help Health Care Organizations Execute Their Food System Leadership Responsibilities

Chinese Residents’ Perceived Ecosystem Services and Disservices Impacts Behavioral Intention for Urban Community Garden: An Extension of the Theory of Planned Behavior

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