Southwest Harvest for Health: An Adapted Mentored Vegetable Gardening Intervention for Cancer Survivors.

Harvest for Health is a home-based vegetable gardening intervention that pairs cancer survivors with Master Gardeners from the Cooperative Extension System. Initially developed and tested in Alabama, the program was adapted for the different climate, growing conditions, and population in New Mexico. This paper chronicles the feasibility, acceptability, and preliminary efficacy of "Southwest Harvest for Health". During the nine-month single-arm trial, 30 cancer survivor-Master Gardener dyads worked together to establish and maintain three seasonal gardens. Primary outcomes were accrual, retention, and satisfaction. Secondary outcomes were vegetable and fruit (V and F) intake, physical activity, and quality of life. Recruitment was diverse and robust, with 30 survivors of various cancers, aged 50-83, roughly one-third minority, and two-thirds females enrolled in just 60 days. Despite challenges due to the COVID-19 pandemic, retention to the nine-month study was 100%, 93% reported "good-to-excellent" satisfaction, and 87% "would do it again." A median increase of 1.2 servings of V and F/day was documented. The adapted home-based vegetable gardening program was feasible, well-received, and resulted in increased V and F consumption among adult cancer survivors. Future studies are needed to evaluate the effectiveness of this program and to inform strategies to increase the successful implementation and further dissemination of this intervention.

Horticultural Therapy in Patients With Dementia: A Systematic Review and Meta-Analysis.

BACKGROUND: World Health Organization has communicated that dementia as a public health priority in 2012. Behavioral and psychological symptoms of dementia are the main reason results in hospitalization of dementia patients. Horticulture is one of the favorite activity for many peoples to relax their minds. OBJECTIVES: To investigate psychological health benefits of horticulture intervention in dementia patients. METHODS: The databases including Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science, and Ovid Medline were searched up to August 2017. RESULTS: Twenty-three articles for systematic review, whereas 8 articles were included in meta-analysis. Meta-analysis verified the beneficial effect of horticultural therapy (HT) on agitation level (standard mean difference: -0.59; P < .00001); increase time spent on activity engagement (mean differences [MD]: 45.10%, P < .00001); decrease time for doing nothing (MD: -29.36%, P = .02). CONCLUSIONS: Patients with dementia benefit from horticultural by alleviating their degrees of agitate behaviors, increasing time of engaging in activities and decrease time of doing nothing.

Producing food in English and Welsh prisons.

Most prison food research focuses on aspects of consumption rather than production yet farming, horticulture and gardening have been integral to the prison system in England and Wales for more than 170 years. This paper explores the interplay between penological, therapeutic and food priorities over the last fifty years through an examination of historical prison policies and contemporary case studies associated with the Greener on the Outside for Prisons (GOOP) programme. Findings are discussed in relation to how joined-up policy and practice can impact positively on whole population health and wellbeing within and beyond the prison setting.

Growing health in UK prison settings.

Globally, prisoners tend to come from marginalized and socially disadvantaged sections of the society and exhibit a high incidence of ill health, linked to social exclusion and multiple complex needs. Prisons therefore offer an important opportunity to tackle inequality and injustice, through promoting health, reducing reoffending and facilitating community reintegration.This paper reports on and critically discusses findings from an evaluative research study, which aimed to identify and explore impacts of prisoners' participation in an innovative social and therapeutic horticultural programme, 'Greener on the Outside for Prisons' (GOOP), delivered in prisons in North West England. Focus groups with 16 prisoners and semi-structured interviews with six prison staff were conducted at five sites. Presented under three overarching themes (health and well-being; skills development, employability, and work preparedness; and relationships), findings suggest that engagement with and participation in GOOP were important in improving positive mental well-being, increasing physical activity and knowledge about healthier eating; developing skills and work readiness; and building relationships and catalysing and strengthening prosocial behaviours, important for good citizenship and effective resettlement. The paper concludes that - in the context of the current UK prison reform agenda and concern about the high incidence of violence, substance misuse, self-harm and suicide - prison-based horticulture can offer multiple benefits and make a significant contribution to the creation of safe, secure, supportive and health-enhancing environments. Furthermore, it contends that by joining up health and justice agendas, programmes such as GOOP have the potential to serve as powerful catalysts for wider systemic change, thereby helping tackle inequalities and social exclusion within societies across the globe.

Quality of experience during horticultural activities: an experience sampling pilot study among older adults living in a nursing home.

Horticulture was shown to represent a well-being source for older adults, encompassing the physical, mental and social domains. Aim of this pilot study was to contribute to extant literature through the investigation of the quality of experience associated with horticultural versus occupational activities. A group of 11 older residents of a nursing home were involved in a crossover study with a baseline measure. Participants attended weekly horticultural and occupational sessions for two six-week cycles. Experience Sampling Method was administered before the program and after each session, to assess participants' levels of happiness, concentration, sociability, involvement, challenges and stakes, and self-satisfaction. Altogether, 332 self-report questionnaires were collected. Findings showed that participants' levels of the cognitive and motivational variables increased during both activities, but horticulture was also perceived as providing higher challenges and stakes, and improving self-satisfaction. Results can have practical implications for well-being promotion among older adults through meaningful activity engagement.

The Power of Traditional Design Techniques: The Effects of Viewing a Japanese Garden on Individuals With Cognitive Impairment.

PURPOSE: This study is to examine how viewing a Japanese garden affects Japanese patients with dementia. BACKGROUND: In a previous study, authors explored the effect on individuals with Alzheimer's disease of viewing an indoor Japanese garden at a nursing home in the United States and reported that viewing the garden significantly reduced the heart rate, evoked short-term and long-term memories, and improved behavioral symptoms. However, it was unclear whether these effects were caused by the design of Japanese garden or unfamiliarity of the design to Caucasians. METHODS: We constructed a Japanese garden on the rooftop of a hospital in Japan and assessed with a total of 25 subjects on the following categories: (1) eye movement, (2) heart rate, and (3) behavior under four different conditions: (a) open view of the site before construction of the Japanese garden (the control space), (b) open view of the Japanese garden, (c) view of the Japanese garden through closed door, and (d) view of Japanese garden through closed door with the chrysanthemum scent. Findings/Results: Viewers' eyes scanned larger area while viewing the Japanese garden, and viewing the Japanese garden significantly reduced heart rate and improved behavioral symptoms than the control space. We also found that the effect of viewing the same Japanese garden differed across three conditions: the view through an open door, a closed door, and a closed door with added scent.

The social dimensions of therapeutic horticulture.

Harnessing nature to promote mental health is increasingly seen as a sustainable solution to healthcare across the industrialised world. The benefits of these approaches to well-being include reduced symptoms of anxiety, depression and improved social functioning. Many studies assume that contact with nature is the main therapeutic component of these interventions yet 'green care' programmes typically include activities not based on 'nature' that may contribute to positive outcomes. This study explored the views of service users participating in a Therapeutic Horticultural programme on what factors promoted their engagement in the project, to identify variables other than 'nature' that may be responsible for successful engagement in these programmes. A secondary aim was to assess the significance 'nature' plays including, for example whether a prior interest in horticultural-related activities, such as gardening, is significant. Two focus groups were held with mental health service users (n = 15) attending a gardening project in south-east England. Findings revealed that the social element of the project was the key facilitator to engagement; the flexible structure of the gardening project was also significant and allowed service users to feel empowered. 'Nature' evoked a sense of calm and provided participants with a non-threatening space that was engaging.

Design of evidence-based gardens and garden therapy for neurodisability in Scandinavia: data from 14 sites.

AIM: A total of 14 Scandinavian therapy gardens were visited and data collected on plantings, therapeutic activities and assessment of effectiveness in Spring 2014. METHODOLOGY: Data were gathered by a questionnaire and by interviewing staff in Sweden, Denmark and Norway. The data collection structured proforma used the post-occupation assessment method. RESULTS: Gardening promoted physical movement, presented cognitive challenges and provided opportunities for social participation. Half the gardens were enclosed with sensory plants and 85% were adapted for wheelchairs. A total of 57% of gardens visited had simple designs with flowers, shrubs, lawns and trees. A social center was important especially for dementia clients. Planted pots were used in 79% of gardens. The effectiveness of therapy gardens was assessed at 71% of sites.

Horticultural therapy in dementia care: a literature review.

Aim To present a narrative review of the empirical literature on the use of horticultural therapy in dementia care. Method A comprehensive literature search, conducted in December 2014, resulted in the selection of 15 primary research articles for review. Of these, three used qualitative methods, five used quantitative methods and seven used mixed methodology. The articles were critically appraised, and the narrative synthesis used a thematic approach whereby prominent themes from the articles were grouped to form representative themes. Findings Three main themes emerged from the narrative synthesis: the emotional health of people living with dementia, their perceived self-identity and their levels of engagement. Conclusion Horticultural therapy can be beneficial. At a macro-level, it is an inexpensive therapy that does not require specialist training to deliver. At a micro-level, it enhances the wellbeing of people living with dementia. Recommendations are made to promote access to appropriate horticultural therapy for people living with dementia, and for further research in this area.

Changes in experienced value of everyday occupations after nature-based vocational rehabilitation.

OBJECTIVE: The aim of this study was to describe and assess changes in participants' experiences of everyday occupations after nature-based vocational rehabilitation (NBVR), to assess changes regarding symptoms of severe stress and the rate of return to work and possible association with experiencing the occupational value of everyday occupations. METHODS: The NBVR was carried out by a transdisciplinary rehabilitation team and took place in a specially designed rehabilitation garden. The study had a longitudinal and mixed-method approach. Data concerning experiences of everyday occupations (Oval-pd), self-assessed occupational competence (OSA-F), health status (EQ-VAS, SCI-93), and sense of coherence (SOC-13) were collected before and after the intervention, and a one-year follow-up was carried out regarding returning to work. Semi-structured interviews were performed 12 weeks after the intervention. RESULTS: Significant changes were measured regarding perceived occupational values in daily life, symptoms of severe stress, and returning to work. Both the return to work rate and symptoms of severe stress were significantly associated with changed experience of everyday occupation. CONCLUSIONS: In the interviews, participants explained that they now had a slower pace of everyday life and that everyday occupations were more often related to nature and creativity. This could be interpreted as nature-based rehabilitation inducing changes through meaningful occupations in restorative environments, leading to a positive change in perceived values of everyday occupations.

Primary-care based participatory rehabilitation: users' views of a horticultural and arts project.

BACKGROUND: Participation in horticulture and arts may improve wellbeing in those with mental and physical illness. AIM: To conduct an in-depth exploration of the views and experience of participants of a primary-care-based horticultural and participatory arts rehabilitation project (Sydenham Garden). DESIGN AND SETTING: Qualitative interview study of a primary-care-based horticultural and participatory arts rehabilitation project in South London. METHOD: Semi-structured interviews were conducted with 16 participants (referred to as 'coworkers') of Sydenham Garden. Seven were female. Participants were aged between 38 and 91 years and had a range of severe mental and physical health problems; most had depression. The interviews were analysed using constant comparison and thematic analysis. RESULTS: Data were overwhelmingly positive concerning participation. Coworkers considered participation in the project to promote wellbeing by providing purposeful and enjoyable activity and interest, improving mood and self-perceptions, and providing an escape from life's pressures. Being outdoors was considered therapeutic. The most-valued aspect of participation was the social contact derived as a result of it. Many of the coworkers who were interviewed developed transferable skills, including nationally recognised qualifications, which they valued highly. CONCLUSION: Delivery of horticultural therapy and participatory arts is a feasible model for improving wellbeing in patients in primary care who have serious illness. Longer-term studies are needed to address what happens to people after leaving such projects.

Rooftop hospital gardens for physical therapy: a post-occupancy evaluation.

OBJECTIVE: The goal of this study was to understand successes and weaknesses of a rooftop hospital garden used primarily for physical therapy. BACKGROUND: Literature on the healing benefits of nature and designed outdoor spaces in healthcare contexts continues to become more focused on specific patient populations. This study contributes to the knowledge of rooftop hospital gardens and gardens for physical rehabilitation. METHODS: A post-occupancy evaluation was conducted using interviews with a lead therapist and landscape architect, behavior mapping, a staff survey, and a patient questionnaire. RESULTS: The designer and administrative staff perceived high accessibility while patients and staff reported low accessibility. Patients reported high satisfaction with the garden while staff reported little time for garden use. Poor maintenance decisions resulted in decreased functional and aesthetic value. CONCLUSIONS: Garden elements take on added layers of meaning and value to users seeking to escape the indoor environment, placing increased importance on evidence-based site design. Multiple perspectives must be considered in facility and garden master planning. Finally, designers and horticultural therapists must be retained in garden management to preserve and enhance garden functionality.

A prospective study of existential issues in therapeutic horticulture for clinical depression.

Two studies with single-group design (Study 1 N = 18, Study 2 N = 28) addressed whether horticultural activities ameliorate depression severity and existential issues. Measures were obtained before and after a 12-week therapeutic horticulture program and at 3-month follow-up. In both studies, depression severity declined significantly during the intervention and remained low at the follow-up. In both studies the existential outcomes did not change significantly; however, the change that did occur during the intervention correlated (rho > .43) with change in depression severity. Participants' open-ended accounts described the therapeutic horticulture experience as meaningful and influential for their view of life.

Nursing home quality of life: study of an enabling garden.

The purpose of this study was to conduct an in-depth evaluation of the impact of the construction and use of an enabling garden on resident quality of life in a rural nursing home. This qualitative study used interviews with residents, family members, staff members, and community volunteers who built the garden. Findings suggest the garden had positive effects on resident quality of life, particularly in terms of meaningful daily activities, enjoyment of daily life, resident relationships, and functional competency. Implications for research and practice are discussed.