Stress, Psychological
Conditions
Keywords
stress, quality of life, biopsychosocial
Brief summary
The goal of the randomized controlled trials is to learn about the effects of urban farming interventions on older adults' physical, mental, and social well-being of older adults aged 50 to 85 years. The main questions the study aims to answer are Q1. Would participants who have undergone the urban care farming intervention have lower stress levels compared to those who did not undergo the intervention? Q2. Would the quality of life and biopsychosocial factors of older adults who participate in the urban farming interventions be better before the intervention and compared to those who did not participate? Q3. Would running intervention programs as such demonstrate cost-effectiveness? Participants will be enrolled in 24 weekly lessons providing hands-on urban farming techniques, including physical activity, planting, and social interactions. Researchers will compare older participants with similar demographic profile to determine if the biological, psychological, and social factors are better for the intervention group.
Detailed description
The data collection consists of three sessions, before and after the 24-week intervention program, and 6 months post-intervention. Prior to the data collection, participants will be assessed for eligibility criteria and explained the detailed study procedures by trained research staff for informed consent. After completing the written informed consent, participants will be interviewed using detailed questionnaires relating to their health, nutrition, and dietary status, psychosocial measures, and undergo a series of physical examinations. These examinations include physical performance tests of mobility and gait, balance and strength, body measurements of weight, height, body mass index (BMI), waist-hip circumference, mid-upper-arm and calf circumference, blood pressure, and blood tests that will examine participants' clinical profile, biomarkers, and immunoassays. Participants will also be given Fitbit trackers to determine if they have improved their physical activity. Last, data collected will also include Functional near-infrared spectroscopy (fNIRS), a non-invasive procedure to determine the oxygenation levels of participants at rest and while doing some thinking activities. This data collection procedure will be conducted at baseline before the intervention and after the completion of the intervention. The intervention will include a weekly, 24-week urban farming program. Each weekly session is where participants will engage in outdoor and indoor horticultural activities ranging from fertilization, sowing, and watering, to transplanting, maintaining, and harvesting vegetables and herbs.
Interventions
BEHAVIORALUrban care farming
An intervention curriculum has been designed using horticulture therapy combined with urban farming techniques. The sessions will use plants and interaction with nature to engage and rehabilitate participants. Both the intervention and control group participants will undergo the intervention. But the intervention group will start with the urban care farming intervention first, and the control group will follow once the intervention group completes the program.
Sponsors
National University of Singapore
National Medical Research Council (NMRC), Singapore
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
Waitlist controlled trials: Participants from both the intervention and waitlist control groups will undergo the intervention 6 months apart.
Eligibility
Sex/Gender
ALL
Age
50 Years to 85 Years
Healthy volunteers
Yes
Inclusion criteria
* Willing to take part in the intervention * Agree for their data to be used for research purposes * Ambulant and able to carry out some tasks independently
Exclusion criteria
* Not willing to participate in the data collection (participants can opt not to answer some questions in the questionnaire but have to consent to the other data collection methods, e.g., Blood taking/test) * Refusal to give informed consent * Unable to give consent independently * Have a disability of the upper or lower body that limits their mobility * Have medical conditions which in the opinion of the research/investigative team that would compromise (or interfere with) their ability to participate in the study * Had a recent severe medical episode (e.g., heart attack)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| WHO Quality of Life Scale (WHOQOL-BREF) | Baseline, 6 months, 12 months | Brief version consisting of 26 QOL related questions developed by World Health Organisation. There are four domains, Physical, Psychological, Social relationships, and Environment. The minimum and maximum for each domain is 0 and 100 respectively, with higher scores being better outcome for each domain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Immuno-biomarkers: IL-1RA, IL-6, IL-8 (CXCL8), IL-10, IL-13, IL-17A (CTLA-8), MIP-3 beta (CCL19), SDF-1 alpha, MMP-3, MMP-9, MCP-1 (CCL2), and TNF alpha | Baseline, 6 months | changes in concentration of cytokines, chemokines and selected ageing and inflammatory markers in measured in pg/mL |
| Brief sense of community scale (BSCS) | Baseline, 6 months, 12 months | 8-items measuring the dimensions of needs fulfillment, group membership, influence, and emotional connection. Composite scores with the average of the 8 items is computed, min 1 and max. 8, with higher scores showing greater sense of community. |
| Fried phenotype of frailty | Baseline, 6 months, 12 months | Fried frailty phenotype (FP) assesses physical frailty through five criteria: unintentional weight loss; weakness or poor handgrip strength; self-reported exhaustion; slow walking speed; and low physical activity. Total scores are classified into 3 categories: non-frail, pre-frail, and frail. |
| Lubben social network scale (LSNS-6) | Baseline, 6 months, 12 months | This scale measure of social engagement including family and friends, min score of 6 and max. score of 30. A higher score indicating more social engagement and a cutoff of 12 points indicate risk of social isolation. |
| Functional near-infrared spectroscopy | Baseline, 6 months | Brain oxygenation levels measured in cerebral metabolic rate of oxygen (CMRO\^2). |
| EQ5D | Baseline, 6 months, 12 months | EQ5D-5L, a measure that consists five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. An utility score can be attached to the total score to determine the cost utility of the participants' quality of life. An utility score between 0 to 1 on the Singapore population will be derived. |
| MOCA | Baseline, 6 months, 12 months | Participants are scored following MOCA scoring criteria. Max. 30 points. Scores lower than 26 showed signs of cognitive impairment. |
| Brief resilience scale | Baseline, 6 months, 12 months | Resilience scale on a 5 points scale, strongly disagree to strongly agree, the higher the score, the greater resilience. |
| De jong Gierveld loneliness scale | Baseline, 6 months, 12 months | Measures emotional and/or social loneliness situation of respondents and adds up to a total loneliness score. the total loneliness score can be categorized into four levels: not lonely (score 0, 1 or 2), moderate lonely (score 3 through 8), severe lonely (score 9 or 10), and very severe lonely (score 11). |
| Fitbit | Continuous for 30 weeks | Steps count |
| Body weight and height | Baseline, 6 months, 12 months | Measured in kilograms and metres respectively. Weight and height will be combined to report BMI in kg/m\^2 |
| Fasting plasma glucose, HbA1c | Baseline, 6 months | measures average blood sugar levels over the past 3 months |
| Serum Creatinine | Baseline, 6 months | measures the level of creatinine in the blood |
| Attitude towards eating healthy food | Baseline, 6 months, 12 months | Attitude of healthy eating (11-items) adapted from Saba et al 2019 (DOI: 10.1016/j.foodqual.2018.11.017). Composite score computed from the averaged measures will have a min of 1 and max of 5. |
| Waist and hip circumference | Baseline, 6 months, 12 months | Measured in centimetres |
| Blood pressure | Baseline, 6 months, 12 months | Measured in systolic and diastolic |
| Lipid panel | Baseline, 6 months | A lipid panel measures levels of various types of lipids (fats) in the blood. Measures HDL cholesterol (High-Density Lipoprotein) and LDL cholesterol (Low-Density Lipoprotein) and Triglycerides |
| Eating fruits and vegetables behavior | Baseline, 6 months, 12 months | Behavior (8-items) towards eating fruits and vegetables developed for this study. Max. score of 10 and minimum score of 2 will be derived from this measurement. |
Countries
Singapore
Contacts
PRINCIPAL_INVESTIGATORCynthia Chen, PhD
National University of Singapore
Outcome results
None listed