|5R01CA201362-05 Interpret this number
|University Of Alabama At Birmingham
|Harvest for Health in Older Cancer Survivors
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.