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Coringrato E, Alaimo K, Leiferman JA, Villalobos A, Buchenau H, Decker E, Fahnestock L, Quist P, Litt JS. A process evaluation of a randomized-controlled trial of community gardening to improve health behaviors and reduce stress and anxiety. Sci Rep 2024; 14:13620. [PMID: 38871715 DOI: 10.1038/s41598-024-63889-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/03/2024] [Indexed: 06/15/2024] Open
Abstract
As part of the Community Activation for Prevention (CAPS) randomized controlled trial (RCT) of community gardening, we conducted a process evaluation to assess the implementation of a community gardening intervention over nine months, as measured by reach, fidelity (delivery, receipt, enactment), and acceptability. Evaluation instruments included repeated semi-structured interviews with study participants, direct observation of community garden sites, and an exit survey of participants. Primary outcomes were diet, physical activity, and anthropometry; secondary outcomes were stress and anxiety. The CAPS trial included 291 participants (19% non-white; 34% Hispanic/Latino; 35% without a college degree; 58% with income < $50,000 per year). Intervention delivery and receipt were high for environmental supports. Garden social events were offered by 73% of gardens, although only 48% of intervention participants reported attending these events. Of the 145 participants assigned to the gardening intervention, 97 (67%) reported gardening the entire season and reported visiting the community garden a median of 90 min per week (range: 0-840). Of the participants who completed the exit survey (48%), 89% were highly satisfied with the overall garden experience. The CAPS trial was favorably received and implemented with high fidelity, supporting the validity of the trial outcomes. These findings suggest that community gardens are a viable health promotion strategy that can be successfully implemented among new gardeners from diverse backgrounds. Strategies that engage new gardeners in the social aspects of the garden environment and connect gardeners with garden "mentors" or "buddies" to ensure new gardeners achieve success in their first years of gardening are recommended.Trial registration: NCT03089177. Registered 24 March 2017, https://clinicaltrials.gov/study/NCT03089177 .
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Affiliation(s)
- Eva Coringrato
- Department of Environmental Studies, University of Colorado Boulder, 4001 Discovery Drive, Boulder, CO, 80303, USA
| | - Katherine Alaimo
- Department of Food Science and Human Nutrition, G. Malcolm Trout Building, Room 208C, Michigan State University, 469 Wilson Road, East Lansing, MI, 48824, USA
| | - Jenn A Leiferman
- Department of Community and Behavioural Health, Colorado School of Public Health, Mail Stop B-119, Room W 3140, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Angel Villalobos
- Department of Environmental Studies, University of Colorado Boulder, 4001 Discovery Drive, Boulder, CO, 80303, USA
| | - Hannah Buchenau
- Department of Environmental Studies, University of Colorado Boulder, 4001 Discovery Drive, Boulder, CO, 80303, USA
| | - Erin Decker
- Department of Environmental Studies, University of Colorado Boulder, 4001 Discovery Drive, Boulder, CO, 80303, USA
| | - Lara Fahnestock
- Denver Urban Gardens, 1031 33rd Street, Suite 100, Denver, CO, 80205, USA
| | - Pallas Quist
- Department of Environmental Studies, University of Colorado Boulder, 4001 Discovery Drive, Boulder, CO, 80303, USA
| | - Jill S Litt
- Department of Environmental Studies, University of Colorado Boulder, 4001 Discovery Drive, Boulder, CO, 80303, USA.
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Buccini G, Saniatan KL, Poblacion A, Bauman A, Hernandez C, Larrison C, Simangan DP, Desai J, Ferguson YO, Howard A, Thompson-Robinson M. Nurturing care assets for food security: a community asset mapping approach. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:78. [PMID: 38845059 PMCID: PMC11157999 DOI: 10.1186/s41043-024-00573-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 05/28/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Zip codes classified by the Food Insecurity Index with moderate and high food insecurity (FI) risk can be a threat to the health and well-being of children during the first 1,000 days (from pregnancy to 2 years). The presence of nurturing care assets (i.e., stable environments that promote health and nutrition, learning opportunities, security and safety, and responsive relationships) can contribute to supporting families and their communities, and ultimately reduce systemic barriers to food security. We aimed to identify and characterize nurturing care assets in under-resourced communities with moderate and high FI risk. METHODS Four steps were used to conduct a Community Asset Mapping (CAM): (1) review of community documents across five zip codes in Clark County, Nevada (2), engagement of community members in identifying community assets (3), definition of the assets providing nurturing care services, and (4) classification of assets to nurturing care components, i.e., good health, adequate nutrition, safety and security, opportunities for early learning, and responsive caregiving. The Food Insecurity Index was used to determine FI risk in each zip code. Analyses explored whether disparities in nurturing care assets across zip codes with moderate and high FI exist. RESULTS We identified 353 nurturing care assets across zip codes. A more significant number of nurturing care assets were present in zip codes with high FI risk. The adequate nutrition component had the most assets overall (n = 218, 61.8%), while the responsive caregiving category had the least (n = 26, 7.4%). Most of the adequate nutrition resources consisted of convenience stores (n = 96), food pantries (n = 33), and grocery stores (n = 33). Disparities in the number and type of good health, early learning, and security and safety assets were identified within zip codes with high FI risk compared to moderate FI risk. CONCLUSIONS The quantity and type of nurturing care assets can exacerbate existing demographic disparities across zip codes, which are tied to barriers to access to food in under-resourced communities in Clark County, Nevada. Co-creating a nurturing care asset-based zip code strategy to address high FI risk will require strengthening systems across existing nurturing care assets.
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Affiliation(s)
- Gabriela Buccini
- Department of Social and Behavioral Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV, USA.
| | - Kaelia Lynn Saniatan
- Department of Social and Behavioral Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Ana Poblacion
- Department of Pediatrics, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
| | - Ana Bauman
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MI, USA
| | - Cristina Hernandez
- Department of Social and Behavioral Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Cali Larrison
- Department of Social and Behavioral Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Dodds P Simangan
- Department of Pediatrics, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Jyoti Desai
- Department of Gynecologic Surgery and Obstetrics, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Yvonne Owens Ferguson
- Office of Strategic Coordination, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, MD, USA
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Kondo MC, Locke D, Hazer M, Mendelson T, Fix RL, Joshi A, Latshaw M, Fry D, Mmari K. A greening theory of change: How neighborhood greening impacts adolescent health disparities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 73:541-553. [PMID: 38303603 DOI: 10.1002/ajcp.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024]
Abstract
Neighborhoods are one of the key determinants of health disparities among young people in the United States. While neighborhood deprivation can exacerbate health disparities, amenities such as quality parks and greenspace can support adolescent health. Existing conceptual frameworks of greening-health largely focus on greenspace exposures, rather than greening interventions. In this paper, we develop and propose a Greening Theory of Change that explains how greening initiatives might affect adolescent health in deprived neighborhoods. The theory situates greening activities and possible mechanisms of change in the context of their ability to modify distal social determinants of health factors, stemming from macrostructural and historical processes that lead to resource inequalities, affecting both the social and built environment in which adolescents live and develop. The framework illustrates both short- and long-term health, economic, and security effects of greening. We also describe how the theory informed the development of Project VITAL (Vacant lot Improvement to Transform Adolescent Lives) in Baltimore, MD, which aims to (1) build a citywide sharable database on vacant lot restoration activities, (2) evaluate the impact of greening initiatives on adolescent health outcomes, (3) conduct cost-effectiveness analyses, and (4) develop best practices for greening programs for improved adolescent health.
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Affiliation(s)
- Michelle C Kondo
- USDA Forest Service, Northern Research Station, Philadelphia, Pennsylvania, USA
| | - Dexter Locke
- USDA Forest Service, Northern Research Station, Baltimore, Maryland, USA
| | - Meghan Hazer
- Baltimore City Department of Public Works, Office of Research and Environmental Protection, Watershed Planning + Partnerships, Baltimore, Maryland, USA
| | - Tamar Mendelson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rebecca L Fix
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ashley Joshi
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Megan Latshaw
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dustin Fry
- USDA Forest Service, Northern Research Station, Philadelphia, Pennsylvania, USA
| | - Kristin Mmari
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Skiba MB, Miller D, Stratton DB, Hall CA, McKenna S, Blair CK, Demark-Wahnefried W. Adaptation and study protocol for harvest for health together Arizona: A mentored community garden intervention for survivors of cancer. Contemp Clin Trials Commun 2024; 39:101290. [PMID: 38595771 PMCID: PMC11002544 DOI: 10.1016/j.conctc.2024.101290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/16/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
Background Current health behavior recommendations for skin cancer prevention, treatment, and survivorship are the same for survivors of other cancers; they include eating a healthy diet, being physically active, maintaining a healthy weight, and minimizing ultraviolet (U.V.) exposure. Few interventions exist to support health behaviors beyond U.V. exposure. We adapted Harvest for Health, a home-based mentored gardening intervention for cancer survivors, for implementation in Arizona as a community-based intervention. Methods Stakeholder-informed adaptations for Harvest for Health Together Arizona (H4H2-AZ) included updating intervention materials to be relevant to the arid desert environment, emphasizing the importance of sun safety in cancer survivorship, and shifting from a home-based to a community-based delivery model. Participants will be enrolled in cohorts aligned with growing seasons (e.g., spring, monsoon, fall) and matched to an individual 30 ft2 community garden plot for two growing seasons (6 months). Original intervention components retained are: 1) Master Gardeners deliver the intervention providing one-to-one mentorship and 2) gardening materials and supplies provided. This pilot six-month single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer as primary outcomes. Secondary outcomes are to explore the effects on cancer preventive health behaviors and health-related quality of life. Discussion This pilot single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer. If successful, the intervention could be widely implemented throughout existing Master Gardener programs and community garden networks for survivors of other cancers. Trial registration ClinicalTrials.gov identifier: NCT05648604. Trial registered on December 13, 2022.
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Affiliation(s)
- Meghan B. Skiba
- Advanced Nursing Practice and Science Division, College of Nursing, University of Arizona, Tucson, AZ, USA
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Dylan Miller
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
- Department of Epidemiology, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Delaney B. Stratton
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
- Dermatology, Banner University Health, Tucson, AZ, USA
| | - Caitlyn A. Hall
- W.A. Franke Honors College, University of Arizona, Tucson, AZ, USA
- Department of Biosystems Engineering, College of Agricultural and Life Sciences, University of Arizona, Tucson, AZ, USA
| | - Sharon McKenna
- Melanoma Task Force, Arizona Department of Health Services, Phoenix, AZ, USA
| | - Cindy K. Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer 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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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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Hafleen N, D'Silva C, Mansfield E, Fierheller D, Chaze F, Parikh A, Martel S, Malhotra G, Mutta B, Hasan Z, Zenlea I. "I Am the Last Priority": Factors Influencing Diabetes Management Among South Asian Caregivers in Peel Region, Ontario. Can J Diabetes 2024:S1499-2671(24)00064-9. [PMID: 38583768 DOI: 10.1016/j.jcjd.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 03/22/2024] [Accepted: 03/30/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE In this study we aimed to identify sociocultural and systemic factors influencing diabetes management among South Asian (SA) caregivers in Peel Region, Ontario. METHODS Twenty-one semistructured interviews were conducted with SA caregivers using a qualitative descriptive design. Data were analyzed using thematic analysis and intersectionality analysis. RESULTS Themes identified included: 1) prioritizing family caregiving over diabetes self-management; 2) labour market impacts on diabetes self-management; and 3) challenges navigating Canadian health and social service systems. SA caregivers described social, economic, and systemic challenges impacting type 2 diabetes management. Systemic factors influencing diabetes management included discrimination and inequities in labour policies and lack of social and health resources funding. Recommendations by caregivers included whole-family, community-based, culturally tailored approaches to diabetes prevention and management strategies. CONCLUSIONS Providing support with system navigation, encouraging family-based approaches, and addressing the social determinants of health could be beneficial for supporting SA families with diabetes management and prevention.
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Affiliation(s)
- Nuzha Hafleen
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Chelsea D'Silva
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Elizabeth Mansfield
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Department of Occupational Health, University of Toronto, Toronto, Ontario, Canada
| | - Dianne Fierheller
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; School of Social Work, McMaster University, Hamilton, Ontario, Canada
| | - Ferzana Chaze
- Faculty of Applied Health & Community Studies, Sheridan College, Brampton, Ontario, Canada
| | - Amish Parikh
- Department of Medicine, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Sara Martel
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Institute of Communication, Culture, Information, & Technology, University of Toronto Mississauga, Ontario, Canada
| | | | - Baldev Mutta
- Punjabi Community Health Services, Mississauga, Ontario, Canada
| | | | - Ian Zenlea
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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DeJoseph ML, Ellwood-Lowe ME, Miller-Cotto D, Silverman D, Shannon KA, Reyes G, Rakesh D, Frankenhuis WE. The promise and pitfalls of a strength-based approach to child poverty and neurocognitive development: Implications for policy. Dev Cogn Neurosci 2024; 66:101375. [PMID: 38608359 PMCID: PMC11019102 DOI: 10.1016/j.dcn.2024.101375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/27/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
There has been significant progress in understanding the effects of childhood poverty on neurocognitive development. This progress has captured the attention of policymakers and promoted progressive policy reform. However, the prevailing emphasis on the harms associated with childhood poverty may have inadvertently perpetuated a deficit-based narrative, focused on the presumed shortcomings of children and families in poverty. This focus can have unintended consequences for policy (e.g., overlooking strengths) as well as public discourse (e.g., focusing on individual rather than systemic factors). Here, we join scientists across disciplines in arguing for a more well-rounded, "strength-based" approach, which incorporates the positive and/or adaptive developmental responses to experiences of social disadvantage. Specifically, we first show the value of this approach in understanding normative brain development across diverse human environments. We then highlight its application to educational and social policy, explore pitfalls and ethical considerations, and offer practical solutions to conducting strength-based research responsibly. Our paper re-ignites old and recent calls for a strength-based paradigm shift, with a focus on its application to developmental cognitive neuroscience. We also offer a unique perspective from a new generation of early-career researchers engaged in this work, several of whom themselves have grown up in conditions of poverty. Ultimately, we argue that a balanced strength-based scientific approach will be essential to building more effective policies.
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Affiliation(s)
| | | | | | - David Silverman
- Department of Psychology, Northwestern University, United States
| | | | - Gabriel Reyes
- Graduate School of Education, Stanford University, United States
| | - Divyangana Rakesh
- Neuroimaging Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Willem E Frankenhuis
- Evolutionary and Population Biology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands; Max Planck Institute for the Study of Crime, Security, and Law, Germany
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Menhas R, Yang L, Saqib ZA, Younas M, Saeed MM. Does nature-based social prescription improve mental health outcomes? A systematic review and meta-analysis. Front Public Health 2024; 12:1228271. [PMID: 38590811 PMCID: PMC10999630 DOI: 10.3389/fpubh.2024.1228271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Background A nature-based social prescription (NBSP) is an approach to improving mental health outcomes that involves prescribing nature-based interventions as complementary or alternative therapy to traditional ones. A variety of advantages are available from NBSP for people looking to enhance their mental well-being. The effect size of the nature-based social prescriptions (NBSPs) has not been thoroughly evaluated by systematic reviews and meta-analyses. Objectives The current study aimed to analyze existing studies and conduct a meta-analysis to determine the overall effect size of the nature-based social prescriptions (NBSP's) outcomes on mental health. Methods By choosing the relevant papers from among those that were available, a meta-analysis was carried out in the current study. A systematic search of electronic databases (Pub Med, Web of Science, Scopus, Cochrane Library, Embase, CINAHL, and PsychINFO) was conducted to identify relevant studies. Studies were included if they evaluated the effects of NBSP on mental health outcomes. Effect sizes were calculated using the random effects model. Results Meta-analysis of interventions statistics shows that CBT (SMD -0.0035; 95% CI: [-0.5090; 0.5020]; Tau^2: 0.1011; Tau: 0.318), digital intervention (SMD -0.3654; 95% CI: [-0.5258; 1.2566]; Tau^2: 0.2976, Tau: 0.5455), music intervention (SMD -2.1281; 95% CI: [-0.4659; 4.7221]; Tau^2: 3.4046; Tau:1.8452), and psychological interventions (SMD -0.8529; 95% CI: [0.3051; 1.4007]; Tau^2: 0.1224; Tau: 0.3499) do not significantly impact. The other interventions [social belongingness, communication training, blue intervention, nature-based education, cognitive behavior group therapy (CBGT), social prescribing coordinator, self-help intervention, participatory, organizational intervention, inpatient services, brief diet, internet-based intervention, prenatal intervention, yoga and meditation, ergonomics training program, yoga nidra intervention, and storytelling] highlighted above are significant. Conclusion The conclusion of the meta-analysis supports the idea that incorporating nature-based social prescription interventions into mental healthcare plans can effectively complement traditional therapies and improve mental health outcomes. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023412458, CRD42023412458.
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Affiliation(s)
- Rashid Menhas
- Department of Nursing, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China
| | - Lili Yang
- Department of Nursing, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China
| | - Zulkaif Ahmed Saqib
- College of Urban Transportation and Logistics, Shenzhen Technology University, Shenzhen, China
| | - Muhammad Younas
- School of Educational Technology, Beijing Normal University, Beijing, China
| | - Muhammad Muddasar Saeed
- International Education College Chinese and Western Medicine Clinic, Dalian Medical University, Dalian, Liaoning, China
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Pasha VC, Gerchow L, Lyndon A, Clark-Cutaia M, Wright F. Understanding Food Insecurity as a Determinant of Health in Pregnancy Within the United States: An Integrative Review. Health Equity 2024; 8:206-225. [PMID: 38559844 PMCID: PMC10979674 DOI: 10.1089/heq.2023.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 04/04/2024] Open
Abstract
Background Food insecurity is a major public health concern in the United States, particularly for pregnant and postpartum individuals. In 2020, ∼13.8 million (10.5%) U.S. households experienced food insecurity. However, the association between food security and pregnancy outcomes in the United States is poorly understood. Purpose The purpose of this review was to critically appraise the state of the evidence related to food insecurity as a determinant of health within the context of pregnancy in the United States. We also explored the relationship between food insecurity and pregnancy outcomes. Methods PubMed, CINAHL, Web of Science, and Food and Nutrition Science databases were used. The inclusion criteria were peer-reviewed studies about food (in)security, position articles from professional organizations, and policy articles about pregnancy outcomes and breastfeeding practices. Studies conducted outside of the United States and those without an adequate definition of food (in)security were excluded. Neonatal health outcomes were also excluded. Included articles were critically appraised with the STROBE and Critical Appraisal Skills Program checklists. Results Nineteen studies met the inclusion criteria. Inconsistencies exist in defining and measuring household food (in)security. Pregnant and postpartum people experienced several adverse physiological and psychological outcomes that impact pregnancy compared with those who do not. Intersections between neighborhood conditions and other economic hardships were identified. Findings regarding the impact of food insecurity on breastfeeding behaviors were mixed, but generally food insecurity was not associated with poor breastfeeding outcomes in adjusted models. Conclusion Inconsistencies in definitions and measures of food security limit definitive conclusions. There is a need for standardizing definitions and measures of food insecurity, as well as a heightened awareness and policy change to alleviate experiences of food insecurity.
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Affiliation(s)
- Veronica C. Pasha
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Lauren Gerchow
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Audrey Lyndon
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Maya Clark-Cutaia
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Fay Wright
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
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Shadmand Foumani Moghadam MR, Vaezi A, Jandari S, Araste A, Rezvani R. Navigating sarcopenia in COVID-19 patients and survivors: Understanding the long-term consequences, transitioning from hospital to community with mechanisms and interventions for future preparedness. Aging Med (Milton) 2024; 7:103-114. [PMID: 38571679 PMCID: PMC10985777 DOI: 10.1002/agm2.12287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 04/05/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused widespread devastation, with millions of confirmed cases and deaths worldwide. Although there were efforts made to develop treatments and vaccines for COVID-19, the coexistence of sarcopenia, a muscle disorder, has been largely overlooked. It is while new variants of this disease (eg, BA.2.86) are challenging the current protocols. Sarcopenia is associated with increased mortality and disability, and shares common mechanisms with COVID-19, such as inflammation, hormonal changes, and malnutrition. This can worsen the effects of both conditions. Furthermore, survived patients with COVID-19 who have elevated risk, as well as aging, which increases the process of sarcopenia. Therefore, addressing sarcopenia in patients with COVID-19 and surviving individuals can be crucial for improving outcomes and preventing long-term disability. During hospital stays, assessing sarcopenia through indicators like muscle wasting and malnutrition is important. Nutritional interventions, such as malnutrition screening and enteral feeding, play a critical role in preventing sarcopenia in hospitals. Mental health and physical activity evaluations and interventions are also necessary. Even after recovering from COVID-19, there is a risk of developing sarcopenia, requiring continued monitoring. Nutrition and physical activity considerations are vital for prevention and management, necessitating tailored training programs and diet therapy. Mental health should not be overlooked, with regular screening, and community-based interventions. Infrastructure should support physical activity, and mental health services must become more accessible. Community engagement through support groups and peer networks can foster resilience and social connection. Efforts are needed to promote healthy diets and ensure access to nutritious foods.
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Affiliation(s)
| | | | - Sajedeh Jandari
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Asie Araste
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Reza Rezvani
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
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11
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Panțiru I, Ronaldson A, Sima N, Dregan A, Sima R. The impact of gardening on well-being, mental health, and quality of life: an umbrella review and meta-analysis. Syst Rev 2024; 13:45. [PMID: 38287430 PMCID: PMC10823662 DOI: 10.1186/s13643-024-02457-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Gardening and horticultural therapy (HT) has been widely recognised as a multicomponent approach that has affected a broad range of health and well-being outcomes. The aim of this umbrella review and meta-analysis was to compare the findings of previous reviews on the impact of multiple gardening interventions and gardening attributes on different well-being constructs. METHODS Electronic databases including PubMed, Web of Science, Science Direct, the Cochrane Library, and Google Scholar were searched from inception to December 2022. Interventional and observational reviews were eligible for inclusion in this umbrella review. Outcome measures included mental well-being, health status and quality of life. The key exposure variables were gardening and horticultural therapy. Narrative synthesis was used to evaluate the overall impact of gardening and HT on study outcomes. For a subsample of studies with available quantitative data, a random effect meta-analysis was conducted. RESULTS This umbrella review included 40 studies (10 interventional studies, 2 observational studies, and 28 mixed interventional and observational studies). The reviewed studies reported an overall positive impact of gardening activities on several measures of mental well-being, quality of life, and health status. Meta-analysis showed a significant and positive effect of gardening and HT activities on well-being (effect size (ES) 0.55, 95% confidence interval (CI) 0.23, 0.87, p < 0.001). CONCLUSIONS Evidence from observational and interventional studies supports a positive role for gardening and HT activities on well-being and general health. Interventional studies with horticultural-based therapies were effective in improving well-being and quality of life both in the general population and vulnerable subgroups. The high degree of heterogeneity in the included studies cautions against any direct clinical implications of the study findings.
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Affiliation(s)
- I Panțiru
- Department of Horticulture and Landscape, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Cluj-Napoca-Napoca, Romania
| | - A Ronaldson
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - N Sima
- Department of Technological Sciences, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Cluj-Napoca-Napoca, Romania
| | - A Dregan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - R Sima
- Department of Horticulture and Landscape, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Cluj-Napoca-Napoca, Romania.
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12
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Saaka M, Awini S, Kizito F, Nang E. Relationship between home garden ownership and the consumption of fruits and vegetables. Public Health Nutr 2024; 27:e46. [PMID: 38253554 PMCID: PMC10882533 DOI: 10.1017/s1368980024000272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
OBJECTIVE This study assessed the extent to which access to home gardens associate with the frequency of fruit and vegetable (FV) consumption. SETTING The study was carried out in fifty rural communities in Northern Ghana where food insecurity and malnutrition including micronutrient deficiencies are prevalent. DESIGN A community-based comparative analytical cross-sectional study. PARTICIPANTS A sample of 847 randomly selected rural households. RESULTS The proportion of households that consumed FV at least 3 d in a week was 45 %. Members in households who owned a home garden were 1·5 times more likely to consume FV at least 3 d in a week (adjusted OR (AOR) = 1·46 (95 % CI 1·06-2·0)), compared with their counterparts who had no home gardens. Furthermore, households in which mothers had a positive attitude towards FV consumption were 1·6 times more likely to consume FV (AOR = 1·63 (95 % CI 1·17-2·27)) compared with mothers who were less positive. CONCLUSIONS Our results suggest that food and nutrition policy measures that promote home gardens can improve consumption of diversified diets including FV among vulnerable rural households in Northern Ghana. Additionally, households with lower income may benefit from nutrition behaviour change communication campaigns directed towards increasing a positive attitude to FV intake.
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Affiliation(s)
- Mahama Saaka
- University for Development Studies, School of Allied Health Sciences, P O Box 1883, Tamale, Ghana
| | - Simon Awini
- Ghana Health Service, Wa West District Health Administration, Wechau, Ghana
| | - Fred Kizito
- International Institute of Tropical Agriculture (IITA), Tamale, Ghana
| | - Eric Nang
- Ghana Health Service, Nadowli-Kaleo District Health Administration, Nadowli, Ghana
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13
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Carroll C, McCray S, Utter J. Acceptability and Feasibility of a Hospital-Based Herb and Vegetable Garden for Health Care Workers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:877-883. [PMID: 37921799 DOI: 10.1016/j.jneb.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Evaluate the acceptability and feasibility and explore the potential health impacts of a hospital-based herb and vegetable garden. METHODS Mixed-method program evaluation assessed dietetic and food service staff health, well-being, and garden engagement. Surveys were administered at baseline and follow-up (6 months). Key informant interviews (n = 6) were conducted at 6 months to evaluate program feasibility. RESULTS There was good acceptance and engagement with the garden, with 18 participants volunteering to maintain the garden. Key informant interviews identified workforce, leadership, and garden design engagement factors. Participants also noted several psychosocial benefits. CONCLUSION AND IMPLICATIONS A hospital-based garden for staff is feasible if programmatic improvements are addressed. More robust evaluations considering challenges with measuring key outcomes with survey methodology and extended periods are warranted.
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Affiliation(s)
- Chloe Carroll
- Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia
| | - Sally McCray
- Mater Dietetic and Foodservice, Mater Health, South Brisbane, Queensland, Australia
| | - Jennifer Utter
- Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia; Mater Dietetic and Foodservice, Mater Health, South Brisbane, Queensland, Australia.
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14
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Bridi L, Kaki DA, Behnam R, Khan X, Albahsahli B, Bencheikh N, Aljenabi R, Ahmadi N, Dajani R, Al-Rousan T. Attitudes toward dementia and cognitive aging among Syrian refugees resettled in Jordan: a qualitative study. BMC Public Health 2023; 23:2307. [PMID: 37990313 PMCID: PMC10664261 DOI: 10.1186/s12889-023-17183-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/08/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Mounting evidence is revealing disparities in cognitive function and heightened dementia risk among refugees, yet research in this area remains scant. Despite bearing most of the world's refugee burden, limited-resource countries like Jordan are facing challenges when dealing with refugee health. There is a lack of research on the attitudes toward dementia and the cognitive healthcare gaps among refugees in Jordan. METHODS 32 older (≥ 55 years) Syrian refugees resettled in Jordan were recruited through a local community-based organization and interviewed in four focus groups (2 female and 2 male groups). Interviews were transcribed and translated, then coded using inductive thematic analysis. RESULTS Mean age of the sample was 60.1 years and 53.1% were female. Only 34.4% rated their memory as good or excellent. Themes were organized using the socioecological model: 1) At the individual level, participants believed high levels of stress, including low socioeconomic status, poor health, and traumatic history from their refugee experience increased their dementia risk. 2) Interpersonally, there is a fear of dementia due to the possible impact and burden on loved ones, particularly with the stigma surrounding dementia. 3) At the community level, participants noted that resettlement in Jordan - with a shared language, religion, and culture - offered protective effects due to facilitated access to social connection, information, and mental health self-care. 4) At the institution and policy level, participants believed older refugees faced restrictive policies for economic aid, healthcare, and employment, presenting a significant barrier to healthy aging. CONCLUSIONS Findings from this study are the first to examine the attitudes of Syrian refugees in Jordan toward dementia and cognitive aging. These results could provide essential data inclusive of refugees as Jordan develops its National Dementia Plan. Investing in dementia awareness interventions and age-friendly neighborhoods may benefit aging refugees in limited-resources settings.
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Affiliation(s)
- Lana Bridi
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Dahlia A Kaki
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Rawnaq Behnam
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
| | - Xara Khan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- School of Social Sciences, University of California, San Diego, San Diego, CA, USA
| | - Behnan Albahsahli
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
| | - Nissma Bencheikh
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Raghad Aljenabi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- School of Social Sciences, University of California, San Diego, San Diego, CA, USA
| | - Nargis Ahmadi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
| | - Rana Dajani
- Department of Biology and Biotechnology, The Hashemite University, Zarqa, Jordan
| | - Tala Al-Rousan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA.
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15
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Lin PJ, Lee TLI, Hershey MS, Shih CW, Tausi S, Sosene V, Maani PP, Tupulaga M, Wu SM, López-Gil JF, Lo YH, Shiau SC, Hsu YT, Chang CR, Wei CF. Exploring the link between home garden use and severe obesity: Insights from a nationwide survey in Tuvalu. J Glob Health 2023; 13:04097. [PMID: 37655368 PMCID: PMC10472202 DOI: 10.7189/jogh.13.04097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background Obesity is prevalent and increasing but understudied across Pacific Islanders. Tuvalu is a South Pacific country with a high obesity rate and faces multiple threats of food insecurity. Home garden serves as a sustainable food source and can be a possible intervention for the obesity pandemic in Tuvalu. This study investigated Tuvaluans' home garden use and obesity, and explored factors associated with increased use of home gardens. Methods We conducted a nationwide, cross-sectional study in Tuvalu during 2022. Structured questionnaires were administered during the in-person interviews, and trained interviewers measured the height and weight of each participant. The association between home garden use, obesity and severe obesity were tested with univariate and multivariable logistic regression. We also applied overlapping weights to balance the distribution of baseline demographic factors. Results The average body mass index was 34.87 kilogrammes (kg) / square metre (m2) among the study population of 1024 adults (630 from Funafuti and 394 from other islands in Tuvalu). Overall, people having home gardens was associated lower odds for severe obesity compared to those without a home garden in overlap weighting models (odds ratio (OR) = 0.946, 95% CI = 0.897-0.997, P = 0.039) and the association was stronger in Funafuti (OR = 0.927, 95% CI = 0.866-0.991, P = 0.027) than in the outlying islands (OR = 0.967, 95% CI = 0.889-1.052, P = 0.435). Furthermore, increased age was positively associated with having a home garden in Funafuti, and smoking showed an inverse association. Conclusions Having a home garden is associated with lower odds of severe obesity in Tuvalu, and the association is stronger in Funafuti. Smokers are less likely to have home gardens, and increased age is positively associated with having home gardens. These findings promote more home garden utilisation and provide evidence for targeted interventions in Tuvalu.
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Affiliation(s)
- Po-Jen Lin
- Taiwan International Cooperation and Development Fund (ICDF), Taipei, Taiwan
- Department of Medicine, Nuvance Health Danbury Hospital, Danbury, Connecticut, USA
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tai-Lin I Lee
- Division of Medical Imaging, Department of Radiology, Far Eastern Memorial Hospital, New Taipei city, Taiwan
| | - Maria Soledad Hershey
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chih-Wei Shih
- Taiwan International Cooperation and Development Fund (ICDF), Taipei, Taiwan
- Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
| | - Selotia Tausi
- Department of Agriculture, Tuvalu Ministry of Local Government and Agriculture, Funafuti, Tuvalu
| | - Vine Sosene
- Department of Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu
| | - Pauke P Maani
- Department of Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu
| | - Malo Tupulaga
- Department of Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu
| | - Stephanie M Wu
- Department of Biostatistics, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - José Francisco López-Gil
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra, IdiSNA, Pamplona, Navarra, Spain
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Yuan-Hung Lo
- Taiwan International Cooperation and Development Fund (ICDF), Taipei, Taiwan
- Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
| | - Shi-Chian Shiau
- Taiwan International Cooperation and Development Fund (ICDF), Taipei, Taiwan
- Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
| | - Yu-Tien Hsu
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chia-Rui Chang
- Department of Biostatistics, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chih-Fu Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
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16
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Alaimo K, Beavers AW, Coringrato E, Lacy K, Ma W, Hurley TG, Hébert JR. Community Gardening Increases Vegetable Intake and Seasonal Eating From Baseline to Harvest: Results from a Mixed Methods Randomized Controlled Trial. Curr Dev Nutr 2023; 7:100077. [PMID: 37215644 PMCID: PMC10196338 DOI: 10.1016/j.cdnut.2023.100077] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/29/2023] [Accepted: 04/12/2023] [Indexed: 05/24/2023] Open
Abstract
Background Gardening has been associated with greater fruit and vegetable intake, but few randomized trials have been conducted. Objectives We sought: 1) to determine changes in fruits and vegetable intake combined and separately from baseline (spring) to harvest time (fall), as well as from baseline to winter follow-up, and 2) to identify the mediators (both quantitatively and qualitatively) between gardening and vegetable intake. Methods A randomized controlled trial of community gardening was conducted in Denver, Colorado, USA. Post hoc quantitative difference score analysis and mediation analysis were conducted by comparing intervention group participants who were randomized to receive a community garden plot, plants and seeds, and a gardening class with control group participants who were randomized to remain on a waitlist for a community garden plot (n = 243). Qualitative interviews were completed with a subset of participants (n = 34) and analyzed to explore the influences of gardening on diets. Results The average age of participants was 41 y, 82% of them were female, and 34% of them were Hispanic. Compared with control participants, from baseline to harvest, community gardeners significantly increased their intake of total vegetables by 0.63 servings (P = 0.047) and garden vegetables by 0.67 servings (P = 0.02) but not combined fruit/vegetable or fruit intake. There were no differences between the groups from baseline to winter follow-up. Community gardening was positively associated with eating seasonally (P = 0.02), which had a significant indirect effect on the association between community gardening and garden vegetable intake (bootstrap 95% CI: 0.002, 0.284). Reasons qualitative participants gave for eating garden vegetables and making dietary changes included the availability of garden produce; emotional attachment with the plants; feelings of pride, accomplishment, and self-reliance; taste and quality of garden produce; trying new foods; cooking and sharing food; and increased seasonal eating. Conclusions Community gardening increased vegetable intake through increased seasonal eating. Community gardening should be recognized as an important setting for improving diets.This trial was registered in ClinicalTrials.gov as NCT03089177 (https://clinicaltrials.gov/ct2/show/NCT03089177).
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Affiliation(s)
- Katherine Alaimo
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Alyssa W. Beavers
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI, United States
| | - Eva Coringrato
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI, United States
| | - Kristin Lacy
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI, United States
| | - Wenjuan Ma
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI, United States
| | - Thomas G. Hurley
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - James R. Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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17
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Emmanuel R, Read UM, Grande AJ, Harding S. Acceptability and Feasibility of Community Gardening Interventions for the Prevention of Non-Communicable Diseases among Indigenous Populations: A Scoping Review. Nutrients 2023; 15:791. [PMID: 36771495 PMCID: PMC9921708 DOI: 10.3390/nu15030791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
Compared with non-Indigenous populations, Indigenous populations experience worse health across many outcomes, including non-communicable diseases, and they are three times more likely to live in extreme poverty. The objectives were to identify (1) the content, implementation, and duration of the intervention; (2) the evaluation designs used; (3) the outcomes reported; and (4) the enablers and the challenges. Using the PRISMA-ScR guidelines, a search of research databases and grey literature was conducted. Seven studies met the inclusion criteria. Papers reported on acceptability, nutrition knowledge, fruit and vegetable intake, self-efficacy, motivation, and preference concerning fruit and vegetable, diet, and gardening. No study measured all outcomes. All papers reported on acceptability, whether implicitly or explicitly. The evaluation used mostly pre- and post-intervention assessments. The effect of gardening on nutrition and gardening knowledge and fruit and vegetable intake was inconclusive, and was related to a general lack of robust evaluations. Applying the He Pikinga Waiora Framework, however, revealed strong evidence for community engagement, cultural centeredness, integrated knowledge translation and systems thinking in increasing the acceptability and feasibility of gardening in Indigenous communities. Despite environmental challenges, the evidence signaled that gardening was an acceptable intervention for the Indigenous communities.
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Affiliation(s)
- Rosana Emmanuel
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
| | - Ursula M Read
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Antonio Jose Grande
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
- Department of Medicine, Universidade Estadual de Mato Grosso do Sul-(UEMS), P.O. Box 351, Dourados 79804-970, Brazil
| | - Seeromanie Harding
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
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18
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Litt JS, Alaimo K, Harrall KK, Hamman RF, Hébert JR, Hurley TG, Leiferman JA, Li K, Villalobos A, Coringrato E, Courtney JB, Payton M, Glueck DH. Effects of a community gardening intervention on diet, physical activity, and anthropometry outcomes in the USA (CAPS): an observer-blind, randomised controlled trial. Lancet Planet Health 2023; 7:e23-e32. [PMID: 36608945 PMCID: PMC9936951 DOI: 10.1016/s2542-5196(22)00303-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 05/30/2023]
Abstract
BACKGROUND Unhealthy diet, physical inactivity, and social disconnection are important modifiable risk factors for non-communicable and other chronic diseases, which might be alleviated through nature-based community interventions. We tested whether a community gardening intervention could reduce these common health risks in an adult population that is diverse in terms of age, ethnicity, and socioeconomic status. METHODS In this observer-blind, randomised, controlled trial, we recruited individuals who were on Denver Urban Garden waiting lists for community gardens in Denver and Aurora (CO, USA), aged 18 years or older, and had not gardened in the past 2 years. Participants were randomly assigned (1:1), using a randomised block design in block sizes of two, four, or six, to receive a community garden plot (intervention group) or remain on a waiting list and not garden (control group). Researchers were masked to group allocation. Primary outcomes were diet, physical activity, and anthropometry; secondary outcomes were perceived stress and anxiety. During spring (April to early June, before randomisation; timepoint 1 [T1]), autumn (late August to October; timepoint 2 [T2]), and winter (January to March, after the intervention; timepoint 3 [T3]), participants completed three diet recalls, 7-day accelerometry, surveys, and anthropometry. Analyses were done using the intention-to-treat principle (ie, including all participants randomly assigned to groups, and assessed as randomised). We used mixed models to test time-by-intervention hypotheses at an α level of 0·04, with T2 and T3 intervention effects at an α level of 0·005 (99·5% CI). Due to potential effects of the COVID-19 pandemic on outcomes, we excluded all participant data collected after Feb 1, 2020. This study is registered with ClinicalTrials.gov, NCT03089177, and data collection is now complete. FINDINGS Between Jan 1, 2017, and June 15, 2019, 493 adults were screened and 291 completed baseline measures and were randomly assigned to the intervention (n=145) or control (n=146) groups. Mean age was 41·5 years (SD 13·5), 238 (82%) of 291 participants were female, 52 (18%) were male, 99 (34%) identified as Hispanic, and 191 (66%) identified as non-Hispanic. 237 (81%) completed measurements before the beginning of the COVID-19 pandemic. One (<1%) participant in the intervention group had an adverse allergic event in the garden. Significant time-by-intervention effects were observed for fibre intake (p=0·034), with mean between-group difference (intervention minus control) at T2 of 1·41 g per day (99·5% CI -2·09 to 4·92), and for moderate-to-vigorous physical activity (p=0·012), with mean between-group difference of 5·80 min per day (99·5% CI -4·44 to 16·05). We found no significant time-by-intervention interactions for combined fruit and vegetable intake, Healthy Eating Index (measured using Healthy Eating Index-2010), sedentary time, BMI, and waist circumference (all p>0·04). Difference score models showed greater reductions between T1 and T2 in perceived stress and anxiety among participants in the intervention group than among those in the control group. INTERPRETATION Community gardening can provide a nature-based solution, accessible to a diverse population including new gardeners, to improve wellbeing and important behavioural risk factors for non-communicable and chronic diseases. FUNDING American Cancer Society, University of Colorado Cancer Centre, University of Colorado Boulder, National Institutes of Health, US Department of Agriculture National Institute of Food and Agriculture, Michigan AgBioResearch Hatch projects.
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Affiliation(s)
- Jill S Litt
- Department of Environmental Studies, University of Colorado Boulder, Boulder, CO, USA.
| | - Katherine Alaimo
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Kylie K Harrall
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Richard F Hamman
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Thomas G Hurley
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jenn A Leiferman
- Department of Community and Behavioural Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kaigang Li
- Department of Health and Exercise Science, College of Health and Human Sciences, Colorado State University, Fort Collins, CO, USA
| | - Angel Villalobos
- Department of Environmental Studies, University of Colorado Boulder, Boulder, CO, USA
| | - Eva Coringrato
- Department of Environmental Studies, University of Colorado Boulder, Boulder, CO, USA
| | - Jimikaye Beck Courtney
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Deborah H Glueck
- Colorado School of Public Health and Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Lin PJ, Lee TLI, Wei CF, Shih CW, Hershey MS, Hsu YT, Tausi S, Sosene V, Maani PP, Tupulaga M, Lo YH. Does one size fit all? Differences between islands in Tuvalu and ecological perspectives. J Glob Health 2022; 12:03082. [PMID: 36472935 DOI: 10.7189/jogh.12.03082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Po-Jen Lin
- Taiwan International Cooperation and Development Fund, Taipei, Taiwan.,Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tai-Lin I Lee
- Division of Medical Imaging, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chih-Fu Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chih-Wei Shih
- Taiwan International Cooperation and Development Fund, Taipei, Taiwan.,Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
| | - Maria Soledad Hershey
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Yu-Tien Hsu
- Department of Social & Behavioural Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Vine Sosene
- Department of Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu
| | - Pauke P Maani
- Department of Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu
| | - Malo Tupulaga
- Department of Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu
| | - Yuan-Hung Lo
- Taiwan International Cooperation and Development Fund, Taipei, Taiwan.,Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
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