Harvest for health gardening intervention feasibility study in cancer survivors

Abstract

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.

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

“…To our knowledge, these two investigations plus the initial pilot study of 12 subjects [7], are the first home-based vegetable gardening intervention trials among cancer survivors or any patient population. Both BBCS and ASCS provide cancer survivors with the opportunity to gain skills that promote lifelong changes in their lifestyle behaviors and may ultimately improve their overall health and quality of life.…”

“…Harvest for Health was first conducted as a single-arm pilot study with 12 adult and child cancer survivors [7]. Results suggested that the vegetable gardening intervention was associated with promising benefit, not only on improving the diet, but also on physical functioning, and physical activity.…”

“…Results suggested that the vegetable gardening intervention was associated with promising benefit, not only on improving the diet, but also on physical functioning, and physical activity. The potential impact on physical activity was not associated solely with the activity of gardening, but rather the garden appeared to serve as a “cue to action,” that drew survivors outside and incited more activity through extra yard work and walking [7]. Two studies are currently underway to build capacity with the ACES and test the feasibility of delivering the yearlong vegetable gardening intervention to adult cancer survivors.…”

“…To have lasting health benefits, permanent lifestyle changes are needed. Gardening interventions have the potential for sustainability since gardening 1) involves a variety of activities which prevent satiation common with other forms of exercise; 2) provides a sense of accomplishment and zest for life that come from nurturing and observing new life and growth [6, 7], and 3) imparts natural prompts since plants require regular care (watering, weeding, pest control) and attention (pruning, harvesting) and serve as continual and dynamic behavioral cues. As the vast majority of cancer survivors are seeking complementary and alternative medical therapies to maintain or improve their health [8], gardening interventions may be widely acceptable and sustainable.…”

Nature-based supportive care opportunities: a conceptual framework

“…Limited available literature relies on qualitative reports from various therapy gardens and single attempts to integrate nature activities into other types of supportive care or therapeutic modalities [21,22]. Although these accounts contribute lower level evidence than clinical trials, they are successful in eliciting cancer patients' subjective experiences with nature and reveal unique patient needs.…”