Harvest for health gardening intervention feasibility study in cancer survivors

Figures & data

Table I. Demographic and lifestyle characteristics of the participants at baseline.

	Adult survivors (N = 8)	Child survivors (N = 4)	Parents of children (N = 4)
Age (mean, sd)	56.3 ± 4.4	9.8 ± 1.0	37.5 ± 4.7
Female	4 (50%)	4 (100%)	3 (75%)
Non-hispanic white	6 (75%)	2 (50%)	2 (50%)
College education	4 (50%)	NA	3 (75%)
Cancer type	Prostate (50%)	Leukemia (75%)	NA
	Breast (50%)	Brain (25%)
Cancer treatment
Surgery (N, %)	8 (100%)	1 (25%)
Radiation (N, %)	2 (25%)	1 (25%)	NA
Chemotherapy (N, %)	2 (25%)	4 (100%)
Years since diagnosis (Med., IQR)	1.2 (1.0, 1.9)	1.7 (1.4, 3.8)	NA
Years since treatment completion^δ	1.0 (0.8, 1.7)	0.0 (− 0.9, 1.8)	NA
Ever smoker	2 (25%)	0 (0%)	2 (50%)
BMI (kg/m^2 or percentile)*
Median, IQR	32.3 (27.1, 32.8)	83.3 (74.2, 87.3)	25.6 (24.4, 42.2)
Overweight/obese (N, %)	7 (88%)	2 (50%)	2 (50%)
Servings/day fruit & vegetables^†
Median, IQR	3.5 (1.8, 4.2)	3.2 (1.7, 3.5)	1.9 (1.2, 2.9)
≥ 5 servings/day	1 (13%)	0 (0%)	0 (0%)
Days/week physical activity^‡
Median, IQR	3.0 (2.0, 4.5)	5.0 (4.5, 5.0)	2.5 (1.5, 4.0)
≥ 5 days/week	2 (25%)	3 (75%)	1 (25%)
≥ 1 comorbid conditions	1 (13%)	1 (25%)	2 (50%)

IQR, interquartile range; NA, not applicable.

^δTwo childhood cancer survivors were still receiving treatment (chemotherapy) during most of the intervention.

*Overweight/obese: BMI ≥ 25 kg/m² for adults; ≥ 85th age- and sex-specific BMI percentile for children.

^†Fruit and vegetable servings/day calculated from the NIH Fruit & vegetable screener from the Eating at America's Table Study.

^‡Number of days participant was physically active for at least 30 minutes per day.

Figure 1. Achievement of health goals after a one-year vegetable gardening intervention: increase in ≥ 1 fruit and vegetable servings per day, increase in ≥ 30 minutes per week of moderate or vigorous physical activity, and improvement in three of four physical function measures.

Table II. Change in fruit and vegetable intake, physical activity and function, and Quality of Life following a one-year gardening intervention in cancer survivors (N = 10).

Outcome measure	Baseline median (IQR) (min, max)	6-Months median (IQR) (min, max)	1-Year median (IQR) (min, max)	Baseline to 1 Year median change (IQR) (min, max)
Physical function tests
Chair stand (stands/30 seconds)	15.0 (13.0, 18.0) (12.0, 18.0)	17.0 (14.0, 18.0) (13.0, 22.0)	17.5 (15.0, 20.0) (12.0, 24.0)	3.0 (− 1.0, 5.0) (−3.0, 9.0)
Get Up & Go Test (seconds)^†	6.2 (4.8, 6.9) (4.1, 7.4)	4.7 (4.0, 5.3) (3.3, 6.0)	5.0 (4.4, 5.4) (3.8, 6.0)	−1.02(−1.75, −0.20) (−2.73, 0.33)
6-minute walk (meters)	573.0 (533.4, 603.5) (426.7, 714.8)	637.0 (524.3, 734.6) (486.2, 880.9)	579.1 (542.5, 609.6) (492.3, 762.0)	11.4 (6.1, 48.8) (−79.2, 82.3)
Grip test (kg)
Left hand	22.9 (12.1, 45.3) (11.2, 51.8)	24.6 (16.6, 47.0) (12.4, 54.5)	24.0 (15.4, 47.7) (13.3, 56.1)	2.00 (0.05, 3.60) (−1.35 9.55)
Right hand	24.8 (13.7, 44.7) (11.9, 55.4)	26.4 (18.0, 50.3) (11.1, 57.3)	27.3 (20.7, 48.4) (12.7, 61.2)	4.83 (3.00, 6.65) (−1.25 10.85)
Physical activity^‡
Times/week (≥ 15 minutes/time.)	2.0 (2.0, 4.0) (1.0, 12.0)	3.5 (2.0, 7.0) (0.0, 15.0)	4.0 (0.0, 9.0) (0.0, 26.0)	0.5 (−2.0, 4.0) (−2.0, 22.0)
Days/week (≥ 30 minutes/day)	4.0 (2.0, 5.0) (1.0, 7.0)	5.0 (2.0, 7.0) (0.0, 7.0)	4.5 (3.0, 6.0) (0.0, 7.0)	0.0 ( 0.0, 2.0) (−3.0, 3.0)
Fruit & vegetables (servings/day)	3.4 (2.4, 3.7) (0.5, 9.2)	3.4 (2.9, 4.2) (0.4, 7.5)	3.5 (2.7, 7.2) (1.0, 8.3)	0.73 (−0.22,3.39) (−2.3, 4.1)
Biomarkers^§
Total vitamin D (ng/mL)	33.30 (25.40, 45.50) (20.30, 48.80)	NA	32.20 (24.60, 39.40) (18.60, 55.50)	−2.50 (−6.10, −0.80) (−11.00, 8.00)
Total carotenoids (μmol/L)	1.243 (0.967, 1.467) (0.473, 2.397)	NA	1.479 (1.268, 1.777) (0.790, 2.264)	0.317 (0.033, 0.573) (−1.116, 0.890)
Quality of life^¶
Adult survivors	87.6 (83.3, 93.9) (54.3, 95.1)	89.2 (83.3, 90.7) (26.6, 98.2)	88.4 (63.0, 95.9) (51.4, 96.2)	0.73 (−2.86, 2.00) (−24.0, 4.9)
Child survivors	79.9 (68.8, 89.3) (67.0, 89.3)	71.0 (61.2, 78.1) (54.5, 82.1)	72.8 (64.7, 81.3) (57.1, 89.3)	1.3 (−16.1, 4.0) (−32.1, 5.4)
Body mass index
Adult survivors (kg/m^2)	32.3 (27.2, 32.7) (25.0, 34.3)	31.5 (27.4, 33.3) (24.2, 33.3)	31.5 (27.5, 32.8) (24.8, 34.2)	−0.06 (−0.13, 0.30) (−2.0, 0.5)
Child survivors (percentile)^**	82.8 (76.4, 86.0) (70.8, 88.5)	89.1 (86.2, 90.9) (84.9, 91.2)	91.0 (87.5, 92.9) (84.4, 94.2)	5.83 (1.98, 16.0) (0.86, 23.4)

^†Decrease in scores on the Get Up & Go Test represents a faster speed and therefore an improvement

^‡Times/week: average number of times per week of moderate or vigorous physical activity, ≥ 15 minutes/time; Days/week: average number of days per week (≥ 30 minutes/day) of physical activity that increases heart and breathing rate

^§Follow-up blood sample missing for 1 individual

^¶RAND 36-Item Health Survey (version 1.0) for adults and Peds QL Pediatric Quality of Life Inventory (Child Report ages 8–12)

^**age- and sex-specific BMI percentiles

Table III. Debriefing summary of the vegetable gardening intervention.

Debriefing Question	Response	Comments
Effect of the intervention on motivating behavior change to (10 point scale from 1 (not at all) to 10 (very much))
eat a healthier diet?	Mean (SD): 8.9 (1.4)
eat more vegetables?	Mean (SD): 8.1 (2.2)
be more physically active?	Mean (SD): 6.8 (2.3)	5 participants responded that they were already very active at baseline; Others were motivated to do more yard work, walking, or bicycling.
Intention of future gardening (anchors: No, not at all; Probably no; Maybe; Probably yes; Yes, most definitely)
Do you plan to continue the garden?	92% yes, most definitely 8% probably yes
Do you plan to expand your garden?	89% yes, most definitely 11% maybe
Suggestions and recommendations for future gardening studies*
Would you have liked more information on gardening?	63% Yes 37% No	Provide more information on the square foot/raised bed gardening method, helpful websites (e.g., organic gardening), written instructions for using fertilizer and protecting the garden from heat/pests/animals, and additional possible plants each season.
Would you have liked more information on healthy eating?	37% Yes 63% No	Distribute recipes, particularly for different ways to prepare vegetables, ideas for cooking quick and healthy meals.
Additional suggestions		Create a website/Facebook to share gardening photos and discuss gardening problems/solutions.
Select comments provided during the intervention or at study completion
“The study also helped my husband and my family to eat better.”
“Gardening helped loosen up my joints and to feel better, so I decided to do more work in my yard.”
“Please know the garden has been a real solace to me. It has helped me to get my mind to a better place several times in the last several months.” (in reference to dealing with his/her cancer recurrence and metastasis)
“I may not always feel up to it, but if I know there's a tomato or something else to be picked, you better believe that I am not going to sit here and let them rot.” (from a cancer survivor with multiple comorbidities)
“This was a wonderful thing to do. I'm glad I did it.”
“The program not only taught me how to grow my own fruits and vegetables and the importance of eating more fruits and vegetables, but also to focus on the circle of life. This provided me with a more optimistic outlook on life in general, which was greatly needed at that point in my recovery.”

*The suggestions and recommendations for future gardening studies include responses from the parents of the child cancer survivors since the children deferred to their parent.