title: Process Evaluation of a Community Garden at an Urban Outpatient Clinic.
abstract: In addition to expediting patient recovery, community gardens that are associated with medical facilities can provide fresh produce to patients and their families, serve as a platform for clinic-based nutrition education, and help patients develop new skills and insights that can lead to positive health behavior change. While community gardening is undergoing resurgence, there is a strong need for evaluation studies that employ valid and reliable measures. The objective of this study was to conduct a process evaluation of a community garden program at an urban medical clinic to estimate the prevalence of patient awareness and participation, food security, barriers to participation, and personal characteristics; garden volunteer satisfaction; and clinic staff perspectives in using the garden for patient education/treatment. Clinic patients (n = 411) completed a community garden participation screener and a random sample completed a longer evaluation survey (n = 152); garden volunteers and medical staff completed additional surveys. Among patients, 39% had heard of and 18% had received vegetables from the garden; the greatest barrier for participation was lack of awareness. Volunteers reported learning about gardening, feeling more involved in the neighborhood, and environmental concern; and medical staff endorsed the garden for patient education/treatment. Comprehensive process evaluations can be utilized to quantify benefits of community gardens in medical centers as well as to point out areas for further development, such as increasing patient awareness. As garden programming at medical centers is formalized, future research should include systematic evaluations to determine whether this unique component of the healthcare environment helps improve patient outcomes.
authors.affiliation: Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, 1601 Cherry Street, Mail Stop 31030, Philadelphia, PA, 19102, USA. bm645@drexel.edu.
authors.forename: Brandy-Joe
authors.identifier: http://orcid.org/0000-0003-1113-9043
authors.initials: BJ
authors.lastname: Milliron
authors.affiliation: Department of Epidemiology and Prevention, Medical Center Boulevard, Wake Forest School of Medicine and Comprehensive Cancer Center at Wake Forest Baptist Health, Winston-Salem, NC, 27157, USA.
authors.forename: Mara Z
authors.initials: MZ
authors.lastname: Vitolins
authors.affiliation: Medical Center Boulevard, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gamble
authors.affiliation: Downtown Health Plaza, Wake Forest Baptist Health, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Jones
authors.affiliation: Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, 1601 Cherry Street, Mail Stop 31030, Philadelphia, PA, 19102, USA.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Chenault
authors.affiliation: Department of Biostatistics, Medical Center Boulevard, Wake Forest School of Medicine and Comprehensive Cancer Center at Wake Forest Baptist Health, Winston-Salem, NC, 27157, USA.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Tooze
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001364:Awareness; D003256:Community Participation / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D005523:Food Supply; D051639:Gardening; D000072506:Gardens / Q000706:statistics & numerical data*; D006266:Health Education / Q000379:methods*; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology; D015397:Program Evaluation; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014505:Urban Population; D014675:Vegetables; D014838:Volunteers / Q000523:psychology; D044465:White People
keywords: Agriculture; Community gardens; Gardening; Process evaluation; Urban health