PDF(Pubmed)
Abstract：
UNASSIGNED: Cancer survivors experience accelerated functional decline that threatens independence and quality of life. Previous studies have suggested that vegetable gardening may improve diet, physical activity, and physical function in this vulnerable population, which comprises more than 5% of the US population.
UNASSIGNED: To assess whether diet, physical activity and functioning, and other outcomes improved in older cancer survivors assigned to a vegetable gardening intervention compared with a waitlist.
UNASSIGNED: From May 11, 2016, to May 2, 2022, a 2-arm, assessor-blinded, crossover-designed, intent-to-treat, randomized clinical trial was conducted at cancer survivors\' homes across Alabama. Medicare-eligible survivors of cancers with 5-year survival of 60% or more were registry ascertained and screened for suboptimal vegetable and fruit consumption (<5 servings per day), physical activity (<150 moderate-to-vigorous minutes per week), and physical function (36-Item Short Form Health Survey [SF-36] subscale score ≤90). Consented participants underwent baseline assessments, were randomly assigned to intervention or waitlisted arms, and were reassessed at 1-year follow-up.
UNASSIGNED: One-year, home-based vegetable gardening intervention providing gardening supplies and mentorship by cooperative extension-certified master gardeners to plant and maintain spring, summer, and fall gardens. Waitlisted participants received the identical intervention after 12 months.
UNASSIGNED: The main outcome was a composite index of improvements in self-reported vegetable and fruit consumption, physical activity, and physical function corroborated by plasma α-carotene levels, accelerometry, and physical performance assessments, respectively.
UNASSIGNED: Of 381 enrolled participants (mean [SD] age, 69.8 [6.4] years; range, 50-95 years; 263 [69.0%] female), 194 were assigned to the gardening intervention and 187 were waitlisted (attrition rates, 7.2% and 7.0%, respectively). Intent-to-treat analyses did not detect a significant improvement in the composite index of vegetable and fruit intake, moderate-vigorous physical activity, and physical function (intervention arm vs waitlisted arm, 4.5% vs 3.1%; P = .53) or between-arm differences in vegetable and fruit intake (mean difference, 0.3 [95% CI, -0.1 to 0.7] servings per day; P = .10). The intervention arm experienced a significant improvement in vegetable and fruit intake (mean increase, 0.3 [95% CI, 0.0-0.6] servings per day; P = .04). Significant improvements also were observed in the intervention arm vs waitlisted arm in physical performance (mean difference for 2-minute step test, 6.0 [95% CI, 0.8-11.2] steps; P = .03; for 30-second chair stand, 0.8 [95% CI, 0.1-1.5] repetitions; P = .02), perceived health (8.4 [95% CI, 3.0-13.9] points on a 100-point scale [higher scores indicate better health]; P = .003), and gut microbiome alpha diversity (84.1 [95% CI, 20.5-147.6] more observed species; P = .01). The COVID-19 pandemic significantly moderated effects (eg, odds of improvement in self-reported physical functioning were greater before vs during the pandemic: odds ratio, 2.17; 95% CI, 1.12-4.22; P = .02).
UNASSIGNED: In this randomized clinical trial including older cancer survivors, a vegetable gardening intervention did not significantly improve a composite index of diet, physical activity, and physical function; however, survivors assigned to the intervention had significantly increased vegetable and fruit consumption and, compared with waitlisted survivors, experienced significant improvements in perceived health and physical performance. Further study in broader populations and during pandemic-free periods is needed to determine definitive benefits.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT02985411.
UNASSIGNED: To assess whether diet, physical activity and functioning, and other outcomes improved in older cancer survivors assigned to a vegetable gardening intervention compared with a waitlist.
UNASSIGNED: From May 11, 2016, to May 2, 2022, a 2-arm, assessor-blinded, crossover-designed, intent-to-treat, randomized clinical trial was conducted at cancer survivors\' homes across Alabama. Medicare-eligible survivors of cancers with 5-year survival of 60% or more were registry ascertained and screened for suboptimal vegetable and fruit consumption (<5 servings per day), physical activity (<150 moderate-to-vigorous minutes per week), and physical function (36-Item Short Form Health Survey [SF-36] subscale score ≤90). Consented participants underwent baseline assessments, were randomly assigned to intervention or waitlisted arms, and were reassessed at 1-year follow-up.
UNASSIGNED: One-year, home-based vegetable gardening intervention providing gardening supplies and mentorship by cooperative extension-certified master gardeners to plant and maintain spring, summer, and fall gardens. Waitlisted participants received the identical intervention after 12 months.
UNASSIGNED: The main outcome was a composite index of improvements in self-reported vegetable and fruit consumption, physical activity, and physical function corroborated by plasma α-carotene levels, accelerometry, and physical performance assessments, respectively.
UNASSIGNED: Of 381 enrolled participants (mean [SD] age, 69.8 [6.4] years; range, 50-95 years; 263 [69.0%] female), 194 were assigned to the gardening intervention and 187 were waitlisted (attrition rates, 7.2% and 7.0%, respectively). Intent-to-treat analyses did not detect a significant improvement in the composite index of vegetable and fruit intake, moderate-vigorous physical activity, and physical function (intervention arm vs waitlisted arm, 4.5% vs 3.1%; P = .53) or between-arm differences in vegetable and fruit intake (mean difference, 0.3 [95% CI, -0.1 to 0.7] servings per day; P = .10). The intervention arm experienced a significant improvement in vegetable and fruit intake (mean increase, 0.3 [95% CI, 0.0-0.6] servings per day; P = .04). Significant improvements also were observed in the intervention arm vs waitlisted arm in physical performance (mean difference for 2-minute step test, 6.0 [95% CI, 0.8-11.2] steps; P = .03; for 30-second chair stand, 0.8 [95% CI, 0.1-1.5] repetitions; P = .02), perceived health (8.4 [95% CI, 3.0-13.9] points on a 100-point scale [higher scores indicate better health]; P = .003), and gut microbiome alpha diversity (84.1 [95% CI, 20.5-147.6] more observed species; P = .01). The COVID-19 pandemic significantly moderated effects (eg, odds of improvement in self-reported physical functioning were greater before vs during the pandemic: odds ratio, 2.17; 95% CI, 1.12-4.22; P = .02).
UNASSIGNED: In this randomized clinical trial including older cancer survivors, a vegetable gardening intervention did not significantly improve a composite index of diet, physical activity, and physical function; however, survivors assigned to the intervention had significantly increased vegetable and fruit consumption and, compared with waitlisted survivors, experienced significant improvements in perceived health and physical performance. Further study in broader populations and during pandemic-free periods is needed to determine definitive benefits.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT02985411.
摘要：
■癌症幸存者经历加速的功能衰退，威胁独立性和生活质量。以前的研究表明，蔬菜园艺可以改善饮食，身体活动,以及这些弱势群体的身体功能，占美国人口的5%以上。
■为了评估饮食，身体活动和功能，与等待名单相比，分配给蔬菜园艺干预的老年癌症幸存者的其他结局有所改善。
■从2016年5月11日到2022年5月2日，双臂，评估者盲化，交叉设计，意向治疗，在阿拉巴马州的癌症幸存者家中进行了随机临床试验。5年生存率为60％或更高的符合Medicare资格的癌症幸存者进行了注册，并筛选了次优的蔬菜和水果摄入量（每天<5份）。身体活动（每周<150分钟的中度至剧烈运动），和身体功能（36项简短形式健康调查[SF-36]子量表得分≤90）。同意的参与者接受了基线评估，被随机分配到干预或等待名单上的武器，并在1年随访时重新评估。
■一年，以家庭为基础的蔬菜园艺干预措施，提供园艺用品和指导，由合作的扩展认证的大师园丁种植和维护春天，夏天,秋天的花园Waitlist参与者在12个月后接受相同的干预。
■主要结果是自我报告的蔬菜和水果消费改善的综合指数，身体活动,和血浆α-胡萝卜素水平证实的身体功能，加速计,和身体性能评估，分别。
■381名注册参与者(平均[SD]年龄，69.8[6.4]年；范围，50-95岁；263[69.0％]女性），194人被分配到园艺干预中，187人被列入候补名单(流失率，7.2%和7.0%，分别)。意向治疗分析未发现蔬菜和水果摄入量的综合指数有显著改善，中等强度的体力活动，和身体功能(干预臂vs等待臂，4.5%vs3.1%；P=.53)或蔬菜和水果摄入量的臂间差异(平均差，每天0.3份[95%CI，-0.1至0.7]；P=.10)。干预组的蔬菜和水果摄入量有了显著改善(平均增加，每天0.3份[95%CI，0.0-0.6]；P=0.04)。还观察到干预臂与waitlisted臂在物理性能方面的显着改善（2分钟步进测试的平均差，6.0[95%CI，0.8-11.2]步；P=.03；对于30秒的椅子支架，0.8[95%CI，0.1-1.5]重复；P=.02)，感知健康（100分量表上8.4[95%CI，3.0-13.9]分[分数越高表示健康状况越好]；P=.003），和肠道微生物组α多样性(84.1[95%CI，20.5-147.6]更多观察到的物种；P=0.01)。COVID-19大流行显著缓解了影响(例如，与大流行期间相比，自我报告的身体功能改善的几率更大：优势比，2.17；95%CI，1.12-4.22；P=.02）。
■在这项包括老年癌症幸存者的随机临床试验中，蔬菜园艺干预并没有显着改善饮食的综合指数，身体活动,和身体功能；然而，分配到干预措施的幸存者的蔬菜和水果消费量显着增加，与候补幸存者相比，在感知健康和身体表现方面有显著改善。需要在更广泛的人群和无大流行期间进行进一步研究，以确定最终的益处。
■ClinicalTrials.gov标识符：NCT02985411。
■为了评估饮食，身体活动和功能，与等待名单相比，分配给蔬菜园艺干预的老年癌症幸存者的其他结局有所改善。
■从2016年5月11日到2022年5月2日，双臂，评估者盲化，交叉设计，意向治疗，在阿拉巴马州的癌症幸存者家中进行了随机临床试验。5年生存率为60％或更高的符合Medicare资格的癌症幸存者进行了注册，并筛选了次优的蔬菜和水果摄入量（每天<5份）。身体活动（每周<150分钟的中度至剧烈运动），和身体功能（36项简短形式健康调查[SF-36]子量表得分≤90）。同意的参与者接受了基线评估，被随机分配到干预或等待名单上的武器，并在1年随访时重新评估。
■一年，以家庭为基础的蔬菜园艺干预措施，提供园艺用品和指导，由合作的扩展认证的大师园丁种植和维护春天，夏天,秋天的花园Waitlist参与者在12个月后接受相同的干预。
■主要结果是自我报告的蔬菜和水果消费改善的综合指数，身体活动,和血浆α-胡萝卜素水平证实的身体功能，加速计,和身体性能评估，分别。
■381名注册参与者(平均[SD]年龄，69.8[6.4]年；范围，50-95岁；263[69.0％]女性），194人被分配到园艺干预中，187人被列入候补名单(流失率，7.2%和7.0%，分别)。意向治疗分析未发现蔬菜和水果摄入量的综合指数有显著改善，中等强度的体力活动，和身体功能(干预臂vs等待臂，4.5%vs3.1%；P=.53)或蔬菜和水果摄入量的臂间差异(平均差，每天0.3份[95%CI，-0.1至0.7]；P=.10)。干预组的蔬菜和水果摄入量有了显著改善(平均增加，每天0.3份[95%CI，0.0-0.6]；P=0.04)。还观察到干预臂与waitlisted臂在物理性能方面的显着改善（2分钟步进测试的平均差，6.0[95%CI，0.8-11.2]步；P=.03；对于30秒的椅子支架，0.8[95%CI，0.1-1.5]重复；P=.02)，感知健康（100分量表上8.4[95%CI，3.0-13.9]分[分数越高表示健康状况越好]；P=.003），和肠道微生物组α多样性(84.1[95%CI，20.5-147.6]更多观察到的物种；P=0.01)。COVID-19大流行显著缓解了影响(例如，与大流行期间相比，自我报告的身体功能改善的几率更大：优势比，2.17；95%CI，1.12-4.22；P=.02）。
■在这项包括老年癌症幸存者的随机临床试验中，蔬菜园艺干预并没有显着改善饮食的综合指数，身体活动,和身体功能；然而，分配到干预措施的幸存者的蔬菜和水果消费量显着增加，与候补幸存者相比，在感知健康和身体表现方面有显著改善。需要在更广泛的人群和无大流行期间进行进一步研究，以确定最终的益处。
■ClinicalTrials.gov标识符：NCT02985411。
