Diabetes, Obesity, Overweight
Conditions
Keywords
garden, Native American, BMI, Emotional health, Physical health
Brief summary
The Growing Resilience research leverages reservation-based assets of land, family, culture, and front-line tribal health organizations to develop and evaluate home food gardens as a family-based health promotion intervention to reduce disparities suffered by Native Americans in nearly every measure of health. Home gardening interventions show great promise for enabling families to improve their health, and this study aims to fulfill that promise with university and Wind River Indian Reservation partners. The investigators will develop an empowering, scalable, and sustainable family-based health promotion intervention with, by, and for Native American families and conduct the first RCT to assess the health impacts of home gardens.
Detailed description
The intervention is comprised of designing and providing two years of support for home gardens. Families randomized to intervention will receive the following supports and services: 1. Blue Mountain Associates will host a gardening workshop to include crop planning, receipt of customized guides to the crops the family selects (these are currently in development and will be ready by 2015), and hands-on basic skills training (mid-April). CHRs and interested local healthcare providers will also participate in workshops to help them prepare for supporting gardeners. 2. BMA's garden manager and assistant(s) will visit each family to help the family install a garden and will provide the family with all needed supplies (late April to early May). Based on garden harvest measures collected in the Food Dignity project and the large gardens preferred by families in the pilot, the minimum garden size will be 80 sq. ft. with at least 30 sq. ft. devoted to crops other than corn and potatoes. The manager will design at least part of each garden in a way that allows the least physically able family members to participate in gardening. 3. BMA will host a Facebook support and networking group for gardeners, with ARI, BMA, and UW gardening experts providing advice as needed. 4. BMA's staff will visit each gardening family at least twice more during the growing season and will be available throughout the season for phone consultations and Facebook advice. For all years, the BMA garden manager will track actual intervention support provided to each family (e.g., timing and number of visits, training and supplies provided). The University of Wyoming research team will collect health measures before and at the end of each gardening season with gardening and control families for two years, after which the control families also receive the gardening intervention. The investigators anticipate enrolling about 100 families into the study with 400 (half adults, half children) people participating in the health measures.
Interventions
Two years of financial and technical home gardening support for new gardeners
Sponsors
Study design
Masking description
The primary data analyst will not know which set of results are from people in the gardening vs. the control condition.
Eligibility
Inclusion criteria
* self-identify as having one or more household members who are enrolled in a tribe * express interest in having a food garden * express willingness to wait to create a food garden for two years if randomized to control * live within the boundaries of Wind River Indian Reservation, including the City of Riverton. * if the household has two or more adults, that at least two adults in the household express willingness to participate in the semi-annual data gathering for two years.
Exclusion criteria
* had a home food garden plot in the previous year that is over 30 square feet in area.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adult BMI change | Change from baseline at 2 years | With four data points, every 6 months. Researcher-measured height (stadiometer) and Tanita body composition scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Physical Health change | Change from baseline at 2 years | measured by SF12 survey |
| Food security change | Change from baseline at 2 years | measured by sub-set of USDA survey |
| Self-efficacy in gardening change | Change from baseline at 2 years | by survey |
| Pain change | Change from baseline at 2 years | by survey |
| Blood pressure change | Change from baseline at 2 years | researcher-measured with bp monitor |
| hand strength change | Change from baseline at 2 years | researcher-measured with dynamometer |
| Mental Health change | Change from baseline at 2 years | measured by SF12 survey |
| beta-carotene change | Change from baseline at 2 years | whole blood draw and assay |
| Hb A1C change | Change from baseline at 2 years | whole blood draw and assay |
| cholesterol change | Change from baseline at 2 years | whole blood draw and assay |
| triglycerides change | Change from baseline at 2 years | whole blood draw and assay |
| vitamin D change | Change from baseline at 2 years | whole blood draw and assay |
| child BMI z-score change | Change from baseline at 2 years | — |
| waist circumference change | Change from baseline at 2 years | researcher-measured with spring-loaded tape measure |
Countries
United States