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Carroll C, Higgs J, McCray S, Utter J. Implementation and Impact of Health Care Gardens: A Systematic Scoping Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:431-449. [PMID: 38011751 DOI: 10.1089/jicm.2023.0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background: In community and school settings, gardens and garden interventions have been shown to confer several psychosocial, physiological, and nutritional benefits. However, little is known about the implementation and impact of health care gardens on patients, visitors, and staff health and well-being. The primary aim of this review is to identify and describe the types of gardens and common design elements implemented in health care settings and the impact these gardens have on the health and well-being of patients, visitors, and staff. A secondary aim is to assess the quality of available evidence. Methods: PubMed, CINAHL, EMBASE, and PsycINFO were systematically searched on October 28, 2022. Primary qualitative and quantitative studies (excluding case reports and studies) were eligible for inclusion if they described the types of gardens and common design elements implemented in health care settings (hospitals, aged care, rehabilitation facilities, and medical centers) and/or assessed the impact of garden interventions on the health and well-being of patients, visitors, and staff. Review, selection, and data extraction were conducted by two independent researchers, with findings synthesized and presented in narrative form. Articles were critically appraised using the mixed methods appraisal tool (MMAT). Results: Eighteen articles were included. Eight studies provided detailed descriptions of the types of gardens implemented in health care settings (healing [n = 3], therapeutic [n = 2], sensory [n = 2], children's fairy gardens [n = 1], and enriched [n = 1] gardens). Studies examining the psychosocial impacts of gardens were most frequently reported (n = 16), followed by physical (n = 4) and nutritional (n = 2). A wide range of positive outcomes, predominantly relating to patients (n = 12), were reported, including improvements in stress, quality of life (QOL), cognitive function, physical activity, and fruit and vegetable intake. The evidence was heterogeneous and low-medium quality. Conclusions: The findings suggest that implementing gardens and garden interventions in health care settings may positively impact the health and well-being of patients, visitors, and staff. Most studies related to the impact of gardens on patients' mental health and QOL, indicating the need for further research to explore physical and nutritional outcomes, as well as health outcomes of staff and visitors. Findings also suggest the need for high-quality study designs (e.g., cluster control trials) and standardized measurement tools.
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Affiliation(s)
- Chloe Carroll
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Jennifer Higgs
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Sally McCray
- Nutrition and Dietetics, Mater Health, South Brisbane, Australia
| | - Jennifer Utter
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
- Nutrition and Dietetics, Mater Health, South Brisbane, Australia
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Estradé M, Yan S, Trude AC, Fleischhacker S, Hinman S, Maudrie T, Jock BW, Redmond L, Pardilla M, Gittelsohn J. Individual- and household-level factors associated with fruit, vegetable, and dietary fiber adequacy among Native American adults in 6 reservation communities. Prev Med Rep 2021; 24:101414. [PMID: 34976600 PMCID: PMC8683900 DOI: 10.1016/j.pmedr.2021.101414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 05/15/2021] [Accepted: 05/25/2021] [Indexed: 11/12/2022] Open
Abstract
This study utilized baseline data collected in 2017 from the OPREVENT2 trial, which included 540 Native Americans in six Midwest and Southwest reservation communities. The objective was to identify correlates of fruit, vegetable, and dietary fiber adequacy among participants 18–75 years old who self-identified as the main food purchaser or preparer in their household. Mean daily servings of fruits and vegetables and grams of dietary fiber were quantified based on a 30-day semi-quantitative food frequency questionnaire. Participants consumed an average of 0.5 (±0.4) cup-equivalent servings of fruit, 2.5 (±1.8) cup-equivalent servings of vegetables, and 15.5 (±8.9) grams of fiber per day. <2% of the study population met the 2015–2020 Dietary Guidelines for Americans recommendations for fruit consumption, while 12 and 42% met recommendations for dietary fiber and vegetable consumption, respectively. Females had a prevalence ratio 1.4 times greater than males for adequate intakes of vegetables (p = 0.008) and over 6 times greater for dietary fiber (p < 0.001). Participants over the age of 30 were about twice as likely to meet dietary fiber recommendations (p = 0.031) compared to those 30 years and younger. Participants receiving food assistance from the USDA’s Food Distribution Program on Indian Reservations (FDPIR) were nearly twice as likely as non-FDPIR recipients to meet recommendations for dietary fiber (p = 0.008). These findings can help guide the development of targeted interventions to improve diet quality; however, further work is needed to understand and address underlying reasons for low fruit consumption in these rural reservation communities.
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Chauvenet C, Sheppard B, Siddique N, Gallagher B, Kearney W, De Marco M. A Qualitative Study of Rural Low-Wealth Participants’ Experiences with Community Gardens. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2021.1907641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Christina Chauvenet
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - Brett Sheppard
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, USA
| | - Nasir Siddique
- Dr. Kiran C Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, United States
| | - Bridget Gallagher
- Brody School of Medicine, East Carolina University, Greenville, United States
| | - William Kearney
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, USA
| | - Molly De Marco
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, USA
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, USA
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Blair CK, Harding EM, Adsul P, Moran S, Guest D, Clough K, Sussman AL, Duff D, Cook LS, Rodman J, Dayao Z, Brown-Glaberman U, King TV, Pankratz VS, Servin E, Davis S, Demark-Wahnefried W. Southwest Harvest for Health: Adapting a mentored vegetable gardening intervention for cancer survivors in the southwest. Contemp Clin Trials Commun 2021; 21:100741. [PMID: 33659763 PMCID: PMC7896154 DOI: 10.1016/j.conctc.2021.100741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/26/2020] [Accepted: 02/04/2021] [Indexed: 01/22/2023] Open
Abstract
Few diet and physical activity evidence-based interventions have been routinely used in community settings to achieve population health outcomes. Adapting interventions to fit the implementation context is important to achieve the desired results. Harvest for Health is a home-based vegetable gardening intervention that pairs cancer survivors with certified Master Gardeners from the Cooperative Extension Service with the ultimate goal of increasing vegetable consumption and physical activity, and improving physical functioning and health-related quality-of-life. Harvest for Health has potential for widespread dissemination since Master Gardener Programs exist throughout the United States. However, state- and population-specific adaptations may be needed to improve intervention adoption by other Master Gardener Programs. Our primary objective was to adapt this evidence-informed intervention that was initially incepted in Alabama, for the drastically different climate and growing conditions of New Mexico using a recommended adaptation framework. Our secondary objective was to develop a study protocol to support a pilot test of the adapted intervention, Southwest Harvest for Health. The adaptation phase is a critical first step towards widespread dissemination, implementation, and scale-out of an evidence-based intervention. This paper describes the adaptation process and outcomes, and the resulting protocol for the ongoing pilot study that is currently following 30 cancer survivors and their paired Extension Master Gardener mentors.
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Affiliation(s)
- Cindy K. Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | | | - Prajakta Adsul
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Sara Moran
- Extension Plant Sciences, New Mexico State University, Las Cruces, NM, USA
| | - Dolores Guest
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Kathy Clough
- Albuquerque Area Extension Master Gardener Program, NMSU Cooperative Extension Service, Albuquerque, NM, USA
| | - Andrew L. Sussman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Dorothy Duff
- Albuquerque Area Extension Master Gardener Program, NMSU Cooperative Extension Service, Albuquerque, NM, USA
| | - Linda S. Cook
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Joseph Rodman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Zoneddy Dayao
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Ursa Brown-Glaberman
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Towela V. King
- School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - V. Shane Pankratz
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Eduardo Servin
- Extension Plant Sciences, New Mexico State University, Las Cruces, NM, USA
| | - Sally Davis
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Prevention Research Center, Albuquerque, NM, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
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Tharrey M, Sachs A, Perignon M, Simon C, Mejean C, Litt J, Darmon N. Improving lifestyles sustainability through community gardening: results and lessons learnt from the JArDinS quasi-experimental study. BMC Public Health 2020; 20:1798. [PMID: 33243204 PMCID: PMC7690132 DOI: 10.1186/s12889-020-09836-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/04/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Despite an increasing number of studies highlighting the health benefits of community gardening, the literature is limited by cross-sectional designs. The "JArDinS" quasi-experimental study aimed to assess the impact of community garden participation on the adoption of more sustainable lifestyles among French adults. METHODS Individuals entering a community garden in Montpellier (France) in 2018 (n = 66) were compared with pairwise matched individuals with no experience in community gardening (n = 66). Nutritional quality, environmental impact and cost of monthly household food supplies, level of physical activity measured by accelerometers, as well as mental and social well-being, sensitivity to food waste, and connection with nature were evaluated at baseline (t0) and 12 months later (t1) to explore sustainability of lifestyles in social/health, environmental and economic dimensions. Linear mixed models were used to determine the independent effect of community gardening on investigated lifestyles components. In-depth interviews were conducted at t1 with 15 gardeners to better understand changes that may have occurred in gardeners' lives during the first year of gardening. RESULTS At t0, gardeners had lower education level, lower BMI and their household reported lower percentage of meals consumed outside of the home compared to non-gardeners (p < 0.05). Participating in the community garden had no significant impact, in spite of sufficient statistical power, on fruit and vegetables supplies (main outcome), nor on physical activity parameters, nor on others of the social/health, environmental and economic lifestyles components investigated. Qualitative interviews suggested the existence of pre-established health and environmental consciousness in some gardeners and revealed several barriers to the participation such as lack of time, lack of gardening knowledge, physical difficulty of gardening, health problems and conflicts with other gardeners. CONCLUSIONS The health benefits of community gardening previously reported by cross-sectional studies might be confounded by selection bias. The JArDinS study highlights the need to identify solutions to overcome barriers related to community garden participation when designing relevant public health interventions for the promotion of sustainable lifestyles. TRIAL REGISTRATION The study was registered at clinicaltrials.gov as NCT03694782 . Date of registration: 3rd October 2018, retrospectively registered.
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Affiliation(s)
- Marion Tharrey
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France.
| | - Ashby Sachs
- University of Colorado Boulder, Boulder, CO, USA
| | - Marlène Perignon
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
| | - Chantal Simon
- CarMen Laboratory, INSERM 1060, INRA 1397, University of Lyon, F-69600, Oullins, France
| | - Caroline Mejean
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
| | - Jill Litt
- University of Colorado Boulder, Boulder, CO, USA.,ISGlobal, Barcelona, Spain
| | - Nicole Darmon
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
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Palar K, Lemus Hufstedler E, Hernandez K, Chang A, Ferguson L, Lozano R, Weiser SD. Nutrition and Health Improvements After Participation in an Urban Home Garden Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:1037-1046. [PMID: 31601420 PMCID: PMC6949143 DOI: 10.1016/j.jneb.2019.06.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 05/18/2023]
Abstract
OBJECTIVE To elucidate the perceived health benefits of an urban home gardening and nutritional education program in a population at high cardiometabolic risk. DESIGN Qualitative data collected via in-depth, semistructured interviews in Spanish or English. SETTING Community-based program offering supported urban home gardening together with nutrition education in Santa Clara County, CA. PARTICIPANTS A total of 32 purposively sampled low-income participants in an urban home gardening program. Participants were primarily female (n = 24) and Latino/a (n = 22). PHENOMENON OF INTEREST Perceptions of the nutrition and health benefits of education-enhanced urban home gardening. ANALYSIS Bilingual researchers coded transcripts using a hybrid inductive and deductive approach. Two coders double coded at intervals, independently reviewed coding reports, organized content into key themes, and selected exemplary quotations. RESULTS The most salient perceived impacts were greater food access, increased consumption of fresh produce, a shift toward home cooking, and decreased fast food consumption. Participants attributed these changes to greater affordability, freshness, flavor, and convenience of their garden produce; increased health motivation owing to pride in their gardens; and improved nutritional knowledge. Participants also reported improved physical activity, mental health, and stress management; some reported improved weight and adherence to diabetes-healthy diets. CONCLUSIONS AND IMPLICATIONS Education-enhanced urban home gardening may facilitate multidimensional nutrition and health improvements in marginalized populations at high cardiometabolic risk.
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Affiliation(s)
- Kartika Palar
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA.
| | - Emiliano Lemus Hufstedler
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA; University of California, Berkeley-UCSF Joint Medical Program, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Karen Hernandez
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Annie Chang
- University of California, Berkeley-UCSF Joint Medical Program, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Laura Ferguson
- Global Health Sciences, University of California, San Francisco, San Francisco, CA
| | | | - Sheri D Weiser
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA; Institute for Global Health, Keck School of Medicine of the University of Southern California, Los Angeles, CA
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Brown B, Dybdal L, Noonan C, Pedersen MG, Parker M, Corcoran M. Group Gardening in a Native American Community: A Collaborative Approach. Health Promot Pract 2019; 21:611-623. [PMID: 30786795 DOI: 10.1177/1524839919830930] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background. There is increasing awareness of the potential health benefits derived from gardening activities. Gardening practices are gaining momentum in Native American (NA) communities, yet no efforts have applied a community-based participatory research approach within a social-ecological model to understand opportunities and barriers for group gardening on an American Indian reservation. Objectives. The primary objective of this study was to identify influences across social-ecological levels that promote or hinder the implementation of community gardens and use of locally grown foods on the reservation; a secondary objective was to assess the feasibility of implementing a group gardening program for NA adults and potential of collecting health outcome measures. Method. Community members and academicians collaborated to develop and implement this study. The study (1) conducted interviews with key stakeholders to identify influences across social-ecological levels that promote or hinder the implementation of community gardens and using locally produced food and (2) assessed the physical and psychological well-being of NA adults participating in a group gardening feasibility study. Results. Major factors influencing using locally grown food and community gardens that emerged from nine interviews included knowledge/experience, self-efficacy, Elders, traditional ways, community values, generational gaps, and local tribal policies. Twenty NA adults with prediabetes or diabetes participated in the feasibility study. The Profile of Mood States Inventory showed consistently positive change in score for participants in the group gardening program versus the comparison group. Conclusions. This study identified key influences for growing locally grown food, and approaches for implementing group gardening programs for NA adults.
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Affiliation(s)
| | | | | | | | - Martin Parker
- Chippewa Cree Tribal Health Center, Box Elder, MT, USA
| | - Mary Corcoran
- Chippewa Cree Tribal Health Center, Box Elder, MT, USA
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