All ETDs from UAB

Advisory Committee Chair

Peter S Hendricks

Advisory Committee Members

Smita Bhatia

Wendy Demark-Wahnefried

Kevin R Fontaine

Scott W Snyder

Document Type

Dissertation

Date of Award

2017

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

Due to improvements in screening and treatment, the number of cancer survivors continues to increase. Cancer survivors are at increased risk for second malignancies, comorbidities, and functional decline. All three papers draw data from Harvest for Health, a 12-month home-based vegetable gardening intervention for cancer survivors. This dissertation aimed to (1) explore changes in physical functioning and physical health-related quality of life in 44 cancer survivors aged >65 years old pooled from two iterations of Harvest for Health; (2) examine predictors of continued gardening and garden expansion 12-months post-intervention; and (3) assess the capacity of sustainability of Harvest for Health from the perspective of stakeholders as well as report indicators of sustainability (i.e., continued intervention behaviors). We found that there were no significant trends of improvement in the intervention group in objective measures of physical functioning with small to medium effect sizes, but increased reporting of subjective bodily pain. In addition, of the 91 survivors contacted, 85.7% continued to garden 12-months post-intervention and 47.3% expanded their gardens using their own resources. Those who received chemotherapy were less likely to have continued gardening or to have expanded their gardens. Those further from diagnosis were less likely to have continued gardening. Harvest for Health scored favorably on the Program Sustainability Assessment Tool (5.7 of 7.0). Its highest scored domain was “Program Evaluation” (scored 6.3 of 7.0) and its lowest scored domain was “Funding Stability” (5.0 of 7.0). Moreover, given the proportion of participants that continued the intervention behavior 12-months post-intervention (85.7% continued gardening; 47.3% expanded gardens) and the five participants that became Master Gardeners, these findings support the long-term feasibility, acceptability, and implementability of this low-intensity intervention.

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