The study is a gardening intervention among 150 older cancer survivors and individuals living with chronic disease (cardiovascular disease and diabetes) in the states of Alabama and Mississippi. This program focuses on 15 counties where a Community Health Advisor training program is in place (Bullock, Calhoun, Dallas Madison, Marengo, Monroe, Sumter, Talladega, Walker Counties in Alabama and Boliver, Granada, Humphrey, Panola, Sunflower, and Yazoo Counties in Mississippi). Participants are paired with Cooperative Extension certified Master Gardeners to plant a vegetable garden at their place of residence (the intervention). Baseline, midpoint, and 1 year follow up will occur. Previous pilot work provides an established relationship with the Cooperative Extension as well as training mechanisms for the Master Gardeners.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
Condition (as posted)
Mapped entity
Match
Confidence
Chronic Disease
—
UNRESOLVED
—
Interventions
Interventions (1)
Intervention
Type
Mapped drug
Match
Harvest for Health
Behavioral
—
UNRESOLVED
Design
Arms and outcomes
Arms (1)
type
EXPERIMENTAL
label
Harvest for Health
description
The study is a gardening intervention among 150 older cancer survivors and individuals living with chronic disease (cardiovascular disease and diabetes) in the states of Alabama and Mississippi. This program focuses on 15 counties where a Community Health Advisor training program is in place (Bullock, Calhoun, Dallas Madison, Marengo, Monroe, Sumter, Talladega, Walker Counties in Alabama and Boliver, Granada, Humphrey, Panola, Sunflower, and Yazoo Counties in Mississippi). Participants are paired with Cooperative Extension certified Master Gardeners to plant a vegetable garden at their place of residence (the intervention). Baseline, midpoint, and 1 year follow up will occur. Previous pilot work provides an established relationship with the Cooperative Extension as well as training mechanisms for the Master Gardeners.
interventionNames
Behavioral: Harvest for Health
Primary outcomes (7)
measure
Recruitment and Retention
timeFrame
1 year
description
We will be tracking the interaction with community master gardeners and study participants using REDCap questionnaires. Information gathered will include:
* Number of participants recruited
* Number of visits (total)
* Number of completed visits (within the window)
* Number of completed visits (outside of window)
Eligibility
Eligibility (as posted)
Sex
All
Minimum age
65 Years
Show eligibility criteria text
Inclusion Criteria:
* Men and women diagnosed with a cancer of favorable prognosis (localized and regional staged female breast, and prostate cancers; localized colon \& rectum, uterine cervix \& corpus, kidney/renal pelvis, non-Hodgkin lymphoma, oral cavity/pharynx, and esophagus cancers; and in situ bladder cancer); and have no medical conditions that would preclude gardening or the consumption of a diet high in fruits and vegetables (e.g., pharmacologic doses of warfarin) -In addition, men and women living who are medically stable, but managing chronic disease (cardiovascular disease and/ or diabetes) are eligible.
We will include individuals who:
* (1) are diagnosed with a loco-regionally staged cancer associated with an 80% or greater 5-year survival rate (localized and regional staged female breast, and prostate cancers; localized colon \& rectum, uterine cervix \& corpus, kidney/renal pelvis, non-Hodgkin lymphoma, oral cavity/pharynx, and esophagus cancers; and in situ bladder cancer)
* (2) diagnosed with diabetes or cardiovascular disease
* (3) reside in the 15 counties;
* (4) completed primary curative cancer treatments, i.e., surgery, chemotherapy or radiation therapy;
* (5) are at least 65 years of age;
* (6) are at higher risk of functional decline (≥ 2 physical function (PF) limitations as defined by the SF12PF subscale);
* (7) currently eat less than 5 servings of fruits and vegetables (F/V)/ day;
* (8) exercise less than 150 minutes/ week;
* (9) speak and write in English (some of our scales are not validated in other populations/languages); and
* (10) are willing to participate in the follow-up assessments;
* (11) competent to provide informed consent;
* (12) Access to a phone and/ or email and internet
We will exclude individuals who:
* (1) are not competent due to mental health or other very serious comorbid conditions (e.g., severe orthopedic conditions or scheduled for a hip or knee replacement with 6 months, paralysis, unstable angina or who have experienced a myocardial infarction, congestive heart failure or pulmonary conditions that require hospitalization or oxygen within 6 months, stroke, degenerative neurological conditions, unstable angina (UA), percutaneous coronary intervention (PCI)/coronary artery bypass grafting (CABG), severe valve disease or New York Heart Association (NYHA\_ class III-IV heart failure);
* (2) have any medical condition substantially limiting moderate physical activity;
* (3) currently taking pharmacologic doses of warfarin (does not include doses taken to maintain a port);
* (4) do not reside in a location that can accommodate 4 or more Earthboxes or 1-raised bed (4'x 8'), and that get at least 4 hours of sun a day;
* (5) do not have running water;
* (6) have recent experience with vegetable gardening, e.g. planted a vegetable garden within the past year;
* (7) have a history of lymphedema flares, axillary node dissection of 10 or more lymph nodes per side;
* (8) life expectancy of less than 1 year ;
* (9) Untreated cardiac conditions including complex congenital heart disease, or untreated complex arrhythmias; or
* (10) Current substance abuse
References
Publications (110)
BACKGROUNDPartridge EE, Fouad MN, Hinton AW, Hardy CM, Liscovicz N, White-Johnson F, Higginbotham JC. The deep South network for cancer control: eliminating cancer disparities through community-academic collaboration. Fam Community Health. 2005 Jan-Mar;28(1):6-19. doi: 10.1097/00003727-200501000-00004. PMID 15625502
BACKGROUNDLisovicz N, Johnson RE, Higginbotham J, Downey JA, Hardy CM, Fouad MN, Hinton AW, Partridge EE. The Deep South Network for cancer control. Building a community infrastructure to reduce cancer health disparities. Cancer. 2006 Oct 15;107(8 Suppl):1971-9. doi: 10.1002/cncr.22151. PMID 16921494
BACKGROUNDCenters for Disease Control and Prevention. Prevalence of Diagnosed Diabetes - 2013. https://www.cdc.gov/diabetes/data/statistics-report/diagnosed.html2018.
BACKGROUNDCastle PE, Gage JC, Partridge EE, Rausa A, Gravitt PE, Scarinci IC. Human papillomavirus genotypes detected in clinician-collected and self-collected specimens from women living in the Mississippi Delta. BMC Infect Dis. 2013 Jan 7;13:5. doi: 10.1186/1471-2334-13-5. PMID 23289357
BACKGROUNDCastle PE, Rausa A, Walls T, Gravitt PE, Partridge EE, Olivo V, Niwa S, Morrissey KG, Tucker L, Katki H, Scarinci I. Comparative community outreach to increase cervical cancer screening in the Mississippi Delta. Prev Med. 2011 Jun;52(6):452-5. doi: 10.1016/j.ypmed.2011.03.018. Epub 2011 Apr 8. PMID 21497619
BACKGROUNDLitton AG, Castle PE, Partridge EE, Scarinci IC. Cervical cancer screening preferences among African American women in the Mississippi Delta. J Health Care Poor Underserved. 2013 Feb;24(1):46-55. doi: 10.1353/hpu.2013.0017. PMID 23377716
BACKGROUNDScarinci IC, Garcia FA, Kobetz E, Partridge EE, Brandt HM, Bell MC, Dignan M, Ma GX, Daye JL, Castle PE. Cervical cancer prevention: new tools and old barriers. Cancer. 2010 Jun 1;116(11):2531-42. doi: 10.1002/cncr.25065.
measure
Treatment Delivery
timeFrame
1 year
description
The investigators will be administering the EATS survey to all participants designed to measure the intake of fruits and vegetables and has been used widely to track changes in fruit and vegetable intake in specific population groups. This screener termed the By Meal version, asks about usual intakes of fruits and other vegetables by the time of day. Participants list how many servings they eat, an algorithm converts the totals into an average per day; then this average is used to estimate the intake of each participant throughout the study.
measure
Treatment Receipt
timeFrame
1 year
description
For this data point, we will administer the Reassurance of Worth instrument (Revised Social Provision Scale \[SPS10\]): This instrument posits that social support is defined in terms of its function, namely, social provisions. This theory considers the functions of social relationships across specific social roles (e.g., romantic partner, spouse, family members, friends, colleagues, etc.), especially when individuals face critical life-changing events. Social ties provide social support and that specific social ties might meet individuals' different social support needs or might influence individuals to offer social support.
The scale is as follows:
Strongly Disagree Disagree Agree Strongly Agree
1 2 3 4
SPS-10 can be a useful clinical and research tool to assess perceived social support not only in perinatal and pae-diatric settings, but also in general medical and mental health settings
measure
Enactment of Treatment Skills
timeFrame
1 year
description
We will administer the self-efficacy for gardening: This investigator-created screener is designed to gather information on the degree to which participants feel confident working in their own garden. Questions are centered on: 1.) time spent in the garden, 2.) did participants partake in gardening with anyone else, 3.) and whether or not gardening influenced participants to eat more vegetables.
measure
Fruit and vegetable intake
timeFrame
1 year
description
We will administer the EATS screener: This assessment tool was designed to measure intake of fruits and vegetables and has been used widely to track changes in fruit and vegetable intake in specific population groups. There are two versions of this screener. This version, termed the By Meal version, asks about usual intakes of fruits and other vegetables by time of day. The other version, termed the All-Day version, asks about usual intakes of all items. Both are machine scan-able.
Goal achievement is based on an increase of ≥1 serving/ day of Fruits and vegetables assessed via the EATS score pre-and post-program intervention.
measure
SF36 Physical Function Subscale
timeFrame
1 year
description
Goal achievement based on an increase of ≥5 points on the SF36 Physical Function subscale (PFSS) The SF36 PFSS is a 10-item subscale assessing general physical function and is valid and reliable for use in healthy and chronically-ill adults. Internal consistency is excellent: α=0.89 to 0.92. It has published norms, is sensitive to change, and has performed well in our past studies; we have found it free of ceiling effects.
measure
Senior Fitness Test Battery
timeFrame
1 year
description
Goal achievement is based on an improvement in \> 4 of 6 performance tests Senior Fitness Test Battery tests several physical function domains: lower and upper body strength (30-second chair stand, arm curl), endurance (2-minute step test), flexibility (chair sit and-reach, back scratch), agility/dynamic balance (8-ft Get Up \& Go), and gait speed (8-foot walk); the test battery provides an objective measure of physical function, is sensitive to change, not associated with ceiling effects, and has normative scores. Additional test include grip strength, objectively measured via dynamometer (disability and functional limitation predictor).
Secondary outcomes (13)
measure
SF12 Health Related Quality of Life Index
timeFrame
1-year
description
SF12 Health Related Quality of Life Index The SF12 Health-Related Quality of Life Index (HRQoL) will provide a global measure of HRQoL, and each of the eight subscales will be explored separate (i.e. Physical functioning, Role-physical, Bodily pain, General health, Vitality, Social functioning, Role-emotional, Mental heat). Internal consistency and reliability for all eight subscales is high, ICC ranging from 0.78 to 0.93. HRQoL weights to create Quality Adjusted Life Years (QALYs) from the SF12 will be done using methods of Brazier \& colleagues.
measure
Reassurance of Worth:
timeFrame
1-year
description
One of six subscales of the Revised Social Provision Scale, this measure will be used to assess the psychosocial benefits of gardening. Several gardening studies have reported enhanced self-esteem, increased independence, and increased zest for life associated with gardening. Reliability estimates range from 0.60 to 0.70.
Social Support and Eating Habits (10 items) and Exercise Surveys (13 items): This has been widely used in diverse samples and has strong psychometric properties (α=.70), surveys will be adapted for gardening using identical anchors
measure
Self-Efficacy for Gardening
timeFrame
1-year
description
This is the organizing concept in Social Cognitive Theory and is defined as people's beliefs in their capability to organize and execute courses of action to deal with prospective situations. Self-efficacy beliefs are domain-specific; thus, within the context of this study, self-efficacy is survivors' beliefs in their ability to meet the challenges of maintaining a successful vegetable garden.
measure
Physical Activity: Godin Lesiure Time Activity Questionnaire
timeFrame
1-year
description
Goal achievement based on an increase of ≥30 minutes/week of moderate to vigorous activity assessed via Godin Leisure Time Activity Questionnaire. Self-reported physical activity will be provided using the Godin Leisure Time Activity Questionnaire, a validated and sensitive tool that captures physical activities.
measure
Weight
timeFrame
1year
description
Participants will be weighed (to the nearest 0.1 kg) at each assessment (baseline and 1-year) while wearing light clothing without shoes using a professional digital scale regularly calibrated to current standards.
measure
Height
timeFrame
1year
description
Participants' height (to the nearest 0.1 cm) will be measured without shoes using a tape measure. Height will be measured only at the baseline.
measure
Body Mass Index (BMI)
timeFrame
1year
description
Using weight and height data described above, BMI will be calculated using the equation BMI = weight (kg)/height (m2).
measure
Waist Circumference
timeFrame
1year
description
Waist circumference will be measured (to the nearest 0.5cm) at the end of normal expiration on base skin at the belly button using a constant-tension spring-loaded tape device. Measures will be taken in a private room rather than in a larger group setting. A privacy screen or curtain will be used when a larger room must be subdivided for the assessments.
measure
Blood Pressure
timeFrame
1year
description
Participant blood pressure (BP) will be measured by trained staff using a calibrated automatic sphygmomanometer. Arm circumference will be measured to determine the proper size arm cuff, to avoid over- or under-estimation of the true BP. Participants will be asked to sit with both feet flat on the floor and to rest without talking for five minutes before measurement. BP will be measured twice according standard NHLBI protocols. The two measurements will be averaged.
measure
Total Cholesterol
timeFrame
1year
description
A blood sample will be collected by trained phlebotomists to process lipid profile \[including total cholesterol (TC), High Density Lipoprotein cholesterol (HDL-C), triglycerides and Low Density Lipoprotein cholesterol (LDLC)\], glucose and Hemaglobin A1c (HbA1C). Samples will be stored in a cooler for transport back to lab (UAB or community location) for processing. At the lab, plasma and/or serum will be aliquoted into 0.5 ml cryovials and stored on in -80 degree freezer until analyses. Lipids, glucose, and HbA1C will be analyzed in the UAB Diabetes Research Core laboratory. (Overnight fasting is required).
measure
High Density Lipoprotein Cholesterol (HDL-C)
timeFrame
1year
description
A blood sample will be collected by trained phlebotomists to process lipid profile \[including total cholesterol (TC), High Density Lipoprotein cholesterol (HDL-C), triglycerides and Low Density Lipoprotein cholesterol (LDLC)\], glucose and Hemaglobin A1c (HbA1C). Samples will be stored in a cooler for transport back to lab (UAB or community location) for processing. At the lab, plasma and/or serum will be aliquoted into 0.5 ml cryovials and stored on in -80 degree freezer until analyses. Lipids, glucose, and HbA1C will be analyzed in the UAB Diabetes Research Core laboratory. (Overnight fasting is required).
measure
Low Density Lipoprotein Cholesterol (LDL-C)
timeFrame
1year
description
A blood sample will be collected by trained phlebotomists to process lipid profile \[including total cholesterol (TC), High Density Lipoprotein cholesterol (HDL-C), triglycerides and Low Density Lipoprotein cholesterol (LDLC)\], glucose and Hemaglobin A1c (HbA1C). Samples will be stored in a cooler for transport back to lab (UAB or community location) for processing. At the lab, plasma and/or serum will be aliquoted into 0.5 ml cryovials and stored on in -80 degree freezer until analyses. Lipids, glucose, and HbA1C will be analyzed in the UAB Diabetes Research Core laboratory. (Overnight fasting is required).
measure
Glucose and Hemaglobin A1c (HbA1C)
timeFrame
1year
description
A blood sample will be collected by trained phlebotomists to process lipid profile \[including total cholesterol (TC), High Density Lipoprotein cholesterol (HDL-C), triglycerides and Low Density Lipoprotein cholesterol (LDLC)\], glucose and Hemaglobin A1c (HbA1C). Samples will be stored in a cooler for transport back to lab (UAB or community location) for processing. At the lab, plasma and/or serum will be aliquoted into 0.5 ml cryovials and stored on in -80 degree freezer until analyses. Lipids, glucose, and HbA1C will be analyzed in the UAB Diabetes Research Core laboratory. (Overnight fasting is required).
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