Vegetable Garden Feasibility Trial to Promote Function in Older Cancer Survivors There are currently over 13.7 million cancer survivors in the U.S., and the number is steadily increasing. While the rising number of cancer survivors is cause for celebration, cancer survivors are at much greater risk for second malignancies, cardiovascular disease, osteoporosis, and functional impairment. Functional decline, especially that which results in a loss of independence, contributes substantially to the economic burden and also reduces quality of life among cancer survivors and their family members. This is of particular concern among older cancer survivors who comprise the majority (>60%) of all cancer survivors, and whose numbers are expected to exceed 14 million by the year 2030. Thus, there is large public health potential for targeted interventions that stabilize or positively reorient the steep trajectory of functional decline among older cancer survivors. This exploratory study is in response to the Translational Research at the Aging/Cancer Interface (TRACI) (PA-12-135) announcement. and proposes a novel and holistic approach, i.e., gardening, as a way to cultivate long-term adherence to an improved diet and increased physical activity, with the anticipation that it may slow the decline of health and function in this vulnerable population, and promote more successful aging. The proposed feasibility study relies on the extant infra-structure of the Alabama Cooperative Extension Master Gardener Program. A total of 46 older (e65 years) cancer survivors recently diagnosed with a loco-regionally staged cancer with a good prognosis (i.e., e 80% 5-year survival) and with 2 or more physical function limitations will be recruited from select rural and urban counties in Alabama and randomized to 1-of-2 study arms: 1) an intervention group that receives a 1-year mentored vegetable gardening intervention that pairs cancer survivors with certified Master Gardeners, or 2) a usual care control group.
Aims of this study are to: 1) explore the feasibility and acceptability of a mentored vegetable gardening intervention by assessing accrual, retention, adherence, fidelity, and possible adverse events, 2) obtain means and precision estimates, and explore between-arm differences on pre-post changes in physical function and secondary endpoints (e.g., quality of life, fruit &vegetable intake, physical activity, biomarkers of successful aging), and 3) to explore participant factors associated with program efficacy (e.g., gender, comorbidity). The proposed vegetable gardening intervention is a novel and feasible strategy to reduce functional impairment and improve quality of life in elderly cancer survivors. The Master Gardener Program exists in all 50 United States, with a large proportion of these states (84%) having the capacity for 2-to-3 growing seasons a year. Thus, there is both an infrastructure and capacity for sustainability and wide-scale dissemination which ultimately could have great public health significance.

Public Health Relevance

Cancer survivors are at increased risk for age- and treatment-related comorbidities, including second cancers, cardiovascular disease, and impaired physical functioning. This project will explore the feasibility of a vegetable gardening intervention that pairs older cancer survivors with community-based Master Gardeners. We also will explore the impact of this holistic intervention that targets the aging-cancer interface and obtain parameter estimates on physical functioning, biomarkers of successful aging, and behaviors affecting cancer control.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Exploratory/Developmental Grants (R21)
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Community-Level Health Promotion Study Section (CLHP)
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Alfano, Catherine M
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University of Alabama Birmingham
Schools of Allied Health Profes
United States
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