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Grant Details

Grant Number: 5R01CA201362-06 Interpret this number
Primary Investigator: Demark-Wahnefried, Wendy
Organization: University Of Alabama At Birmingham
Project Title: Harvest for Health in Older Cancer Survivors
Fiscal Year: 2021


Harvest for Health in Older Cancer Survivors There are close to 15 million cancer survivors in the U.S., and the majority are 65 years of age or older. Despite improvements in treatment and 5-year cure rates, cancer survivors are at greater risk for second malignancies, cardiovascular disease, osteoporosis, and functional impairment - downstream effects that result in an annual cost of approximately $130 billion each year. Cancer survivorship has been claimed a national priority, with a call to develop effective interventions that can prevent, delay, or mitigate the adverse effects and comorbidities attendant with cancer and its treatment. Strong evidence exists that a healthful diet and regular physical activity can prevent many chronic diseases and improves physical functioning. But, more research is needed to develop interventions that can produce long-term adherence to healthful lifestyle behaviors. This study builds on strong, R21-supported preliminary data, and relies on the extant infrastructure of the Cooperative Extension Master Gardener Program. A total of 426 older (≥65 yrs.) survivors of a loco-regionally staged cancer with a good prognosis (≥ 80% 5-yr. survival) and with at least one physical function limitation will be recruited throughout Alabama and randomized to 1-of-2 study arms: 1) one that receives a 1-year mentored vegetable gardening intervention that pairs a cancer survivor with a certified Master Gardener; or 2) a wait-list control arm that receives the intervention after a 1-year delay. All participants will be followed for 2 years. This randomized controlled trial aims to: 1) determine the efficacy of the vegetable gardening intervention on fruit and vegetable intake, physical activity AND physical function (assessed by self-report and backed by objective measures: plasma α−carotene, accelerometry, and performance testing); 2) assess effects of the intervention on secondary endpoints, e.g., quality of life, biomarkers of successful aging (interleukin-6 and telomerase); 3) evaluate the durability and repeatability of the intervention; 4) explore participant factors related with program efficacy (e.g., gender, co-morbidity, age); and 5) perform an economic analysis to assess the value of health improvements relative to intervention costs. The proposed home-based, vegetable gardening intervention (using raised beds or Earthboxes® – depending on survivors' living arrangements) is a novel and feasible strategy to improve dietary intake, physical activity, and physical functioning in cancer survivors at high risk for cancer-related morbidity – one that has great clinical and public health significance given the increasing number of cancer survivors and the high economic and societal costs associated with comorbid disease. Moreover, the infrastructure for sustainability and wide-scale dissemination already exists as there are Master Gardener Programs in all 50 United States, and the proposed intervention could easily be implemented in states with 2 or more growing seasons (72% of states, plus the District of Columbia), thus reaching the vast majority of older cancer survivors (roughly 10.8 million) who reside in the temperate zones of this nation.


A comparison of two mail-based strategies to recruit older cancer survivors into a randomized controlled trial of a lifestyle intervention.
Authors: Warnock A.C. , Kaur H. , Buckman J.R. , Hoenemeyer T. , Demark-Wahnefried W. .
Source: Journal of cancer survivorship : research and practice, 2022 Oct; 16(5), p. 998-1003.
EPub date: 2021-08-03.
PMID: 34342814
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Rural and Urban Differences in Vegetable and Fruit Consumption Among Older Cancer Survivors in the Deep South: An Exploratory Cross-Sectional Study.
Authors: Kaur H. , Fernández J.R. , Locher J.L. , Demark-Wahnefried W. .
Source: Journal of the Academy of Nutrition and Dietetics, 2022 Sep; 122(9), p. 1717-1724.e4.
EPub date: 2022-01-10.
PMID: 35017097
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Dietary Supplement Use among Older Cancer Survivors: Socio-Demographic Associations, Supplement Types, Reasons for Use, and Cost.
Authors: Kaur H. , Hoenemeyer T. , Parrish K.B. , Demark-Wahnefried W. .
Source: Nutrients, 2022-08-18; 14(16), .
EPub date: 2022-08-18.
PMID: 36014907
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Impact of lymphadenectomy and lymphoedema on health-related quality of life 1 year after surgery for endometrial cancer. A prospective longitudinal multicentre study.
Authors: Wedin M. , Stålberg K. , Marcickiewicz J. , Ahlner E. , Åkesson Å. , Lindahl G. , Wodlin N.B. , Kjølhede P. , LASEC study group .
Source: BJOG : an international journal of obstetrics and gynaecology, 2022 Feb; 129(3), p. 450-460.
EPub date: 2021-09-07.
PMID: 34437763
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Southwest Harvest for Health: Adapting a mentored vegetable gardening intervention for cancer survivors in the southwest.
Authors: Blair C.K. , Harding E.M. , Adsul P. , Moran S. , Guest D. , Clough K. , Sussman A.L. , Duff D. , Cook L.S. , Rodman J. , et al. .
Source: Contemporary clinical trials communications, 2021 Mar; 21, p. 100741.
EPub date: 2021-02-11.
PMID: 33659763
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Integration of hepatitis B virus DNA in chronically infected patients assessed by Alu-PCR.
Authors: Larsson S.B. , Tripodi G. , Raimondo G. , Saitta C. , Norkrans G. , Pollicino T. , Lindh M. .
Source: Journal of medical virology, 2018 Oct; 90(10), p. 1568-1575.
EPub date: 2018-06-11.
PMID: 29797342
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A home-based mentored vegetable gardening intervention demonstrates feasibility and improvements in physical activity and performance among breast cancer survivors.
Authors: Bail J.R. , Frugé A.D. , Cases M.G. , De Los Santos J.F. , Locher J.L. , Smith K.P. , Cantor A.B. , Cohen H.J. , Demark-Wahnefried W. .
Source: Cancer, 2018 Aug; 124(16), p. 3427-3435.
EPub date: 2018-06-22.
PMID: 29932460
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High serum levels of pregenomic RNA reflect frequently failing reverse transcription in hepatitis B virus particles.
Authors: Prakash K. , Rydell G.E. , Larsson S.B. , Andersson M. , Norkrans G. , Norder H. , Lindh M. .
Source: Virology journal, 2018-05-15; 15(1), p. 86.
EPub date: 2018-05-15.
PMID: 29764511
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Pilot Randomized Controlled Trial of a Home Vegetable Gardening Intervention among Older Cancer Survivors Shows Feasibility, Satisfaction, and Promise in Improving Vegetable and Fruit Consumption, Reassurance of Worth, and the Trajectory of Central Adiposity.
Authors: Demark-Wahnefried W. , Cases M.G. , Cantor A.B. , Frugé A.D. , Smith K.P. , Locher J. , Cohen H.J. , Tsuruta Y. , Daniel M. , Kala R. , et al. .
Source: Journal of the Academy of Nutrition and Dietetics, 2018 Apr; 118(4), p. 689-704.
EPub date: 2018-01-02.
PMID: 29305129
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