title: Feasibility, Preliminary Efficacy, and Lessons Learned From a Garden-Based Lifestyle Intervention for Cancer Survivors.
abstract: BACKGROUND
  Cancer survivors remain at increased risk for secondary malignancies, comorbidities, and all-cause mortality. Lifestyle behaviors, such as diet and physical activity, are strongly linked to a decreased risk of chronic disease and improved health outcomes, yet a paucity of research has been conducted in this vulnerable population.
  
  
  METHODS
  Adult cancer survivors were recruited to participate in Growing Hope, an experimental single-group study designed to assess the feasibility and efficacy of a theory-driven and evidence-based intervention. For 4 months, 22 participants received group and individual education and had access to harvesting fresh produce at an urban garden. Data on program satisfaction, compliance, diet, and physical activity were collected via surveys; anthropometrics, blood values, and skin carotenoids were objectively measured.
  
  
  RESULTS
  The intervention resulted in significant improvements in consumption of fruits and vegetables (P = .003), decreased consumption of red and processed meats (P = .030) and sugar-sweetened beverages (P = .020). Levels of skin carotenoids, fasting blood glucose, and non-high density lipoprotein cholesterol were also significantly improved (P = .011, P = .043, and P = .05, respectively).
  
  
  CONCLUSIONS
  The results of this study support the feasibility and efficacy of a multifaceted, garden-based intervention for cancer survivors. In addition, these preliminary results demonstrate a positive impact aligning with the current lifestyle recommendations for cancer survivorship. Larger randomized controlled trials are warranted to define impact on sustained health outcomes.
authors.affiliation: Medical Dietetics and Health Sciences, OSU College of Medicine, Columbus, OH 43210, USA. Spees.11@osu.edu.
authors.forename: Colleen K
authors.initials: CK
authors.lastname: Spees
authors.forename: Emily B
authors.initials: EB
authors.lastname: Hill
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Grainger
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Buell
authors.forename: Susan E
authors.initials: SE
authors.lastname: White
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Kleinhenz
authors.forename: Steven K
authors.initials: SK
authors.lastname: Clinton
mesh_terms: D005240:Feasibility Studies; D005260:Female; D000072506:Gardens / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D017741:Survivors