title: Understanding the impacts of care farms on health and well-being of disadvantaged populations: a protocol of the Evaluating Community Orders (ECO) pilot study.
abstract: BACKGROUND
  Care farms, where all or part of the farm is used for therapeutic purposes, show much potential for improving the health and well-being of a range of disadvantaged groups. Studies to date have been qualitative or observational, with limited empirical evidence of the effectiveness of care farms in improving health and well-being. Understanding the underlying mechanisms that lead to improvements for different disadvantaged groups is a further gap in the evidence. Participants in this study are offenders serving community orders. Their low socioeconomic status and poor health outcomes relative to the general population exemplifies disadvantage.
  
  
  METHODS
  This paper describes the protocol of a study to understand the impacts of care farms and to pilot the design and tools for a study to assess cost-effectiveness of care farms in improving the quality of life of offenders. As a pilot study, no power calculation has been conducted. However, 150 offenders serving community sentences on care farms and 150 on other probation locations (eg, litter picking, painting) will be recruited over a 1-year period. Changes in quality of life, measured by Clinical Outcome in Routine Evaluation-Outcome Measure, health and reconvictions of offenders at care farms compared to other probation locations will be analysed to inform the sample size calculation for the follow on study. The feasibility of recruitment, retention, collecting cost data and modelling cost-effectiveness will also be assessed. The study will use qualitative methods to explore the experiences of offenders attending care farms and perceptions of probation and care farm staff on the processes and impacts of the intervention.
  
  
  BACKGROUND
  Findings will be published and inform development of a natural experiment and will be disseminated to probation services, care farms and academics. University of Leeds Ethical Review Board approved: SoMREC/13/014. National Offender Management Service (NOMS) approved: 2013-257.
authors.affiliation: Academic Unit of Public Health, University of Leeds, Leeds, UK.
authors.forename: H
authors.initials: H
authors.lastname: Elsey
authors.affiliation: Essex Sustainability Institute, University of Essex, Colchester, UK.
authors.forename: R
authors.initials: R
authors.lastname: Bragg
authors.affiliation: Plant Research International, Wageningen University, Wageningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Elings
authors.affiliation: Nutritional Epidemiology Group, University of Leeds, Leeds, UK.
authors.forename: J E
authors.initials: JE
authors.lastname: Cade
authors.affiliation: Academic Unit of Public Health, University of Leeds, Leeds, UK.
authors.forename: C
authors.initials: C
authors.lastname: Brennan
authors.affiliation: Academic Unit of Public Health, University of Leeds, Leeds, UK.
authors.forename: T
authors.initials: T
authors.lastname: Farragher
authors.affiliation: Academic Unit of Health Economics, University of Leeds, Leeds, UK.
authors.forename: S
authors.initials: S
authors.lastname: Tubeuf
authors.affiliation: West Yorkshire Community Rehabilitation Company Limited, Wakefield, UK.
authors.forename: R
authors.initials: R
authors.lastname: Gold
authors.affiliation: Academic Unit of Public Health, University of Leeds, Leeds, UK.
authors.forename: D
authors.initials: D
authors.lastname: Shickle
authors.affiliation: Academic Unit of Health Economics, University of Leeds, Leeds, UK.
authors.forename: N
authors.initials: N
authors.lastname: Wickramasekera
authors.affiliation: Academic Unit of Public Health, University of Leeds, Leeds, UK.
authors.forename: Z
authors.initials: Z
authors.lastname: Richardson
authors.affiliation: Academic Unit of Public Health, University of Leeds, Leeds, UK.
authors.forename: J
authors.initials: J
authors.lastname: Murray
mesh_terms: D000383:Agriculture / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D057237:Criminals / Q000523:psychology* / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008603:Mental Health; D010549:Personal Satisfaction; D010865:Pilot Projects; D011788:Quality of Life; D012946:Social Welfare / Q000331:legislation & jurisprudence / Q000523:psychology* / Q000706:statistics & numerical data; D035862:Vulnerable Populations / Q000523:psychology* / Q000706:statistics & numerical data
keywords: LAW (see Medical Law); MENTAL HEALTH; PUBLIC HEALTH