Vegetable garden feasibility trial to promote function in older cancer survivors

菜园可行性试验，以促进老年癌症幸存者的功能 目前美国有超过1370万癌症幸存者，而且这个数字还在稳步增长而 癌症幸存者人数的增加是值得庆祝的，癌症幸存者面临的风险要大得多， 继发性恶性肿瘤、心血管疾病、骨质疏松症和功能障碍。功能衰退， 特别是导致丧失独立性的行为，大大加重了经济负担， 也降低了癌症幸存者及其家人的生活质量。这一点尤其令人关切 老年癌症幸存者占所有癌症幸存者的大多数（>60%）， 预计到2030年将超过1400万。因此，有针对性的公共卫生潜力很大， 稳定或积极重新定向老年癌症患者功能下降的陡峭轨迹的干预措施 幸存者这项探索性研究是对衰老/癌症界面转化研究的回应 （TRACI）（PA-12-135）公告。并提出了一种新颖的整体方法，即，园艺作为一种 培养长期坚持改善饮食和增加体力活动，预计它 可以减缓这一脆弱人群的健康和功能衰退，并促进更成功的老龄化。 拟议的可行性研究依赖于亚拉巴马合作推广硕士现有的基础设施 园丁计划。共有46名老年（65岁）癌症幸存者最近被诊断为局部区域性 具有良好预后的分期癌症（即，（即80%的5年生存率）和2种或2种以上身体功能 将从亚拉巴马选定的农村和城市县招募受限制的受试者，并随机分配至2项研究中的1项 武器：1）干预组，接受为期1年的指导蔬菜园艺干预， 癌症幸存者与认证硕士园丁，或2）一个通常的护理控制组。本研究的目的是：1） 通过评估应计费用，探索指导蔬菜园艺干预的可行性和可接受性， 保留、依从性、保真度和可能的不良事件，2）获得平均值和精度估计值，以及 探索身体功能和次要终点（例如， 生活质量，水果和蔬菜摄入量，身体活动，成功衰老的生物标志物），以及3）探索 与计划功效相关的参与者因素（例如，性别、科摩罗）。建议蔬菜 园艺干预是一种新的和可行的策略，以减少功能障碍，提高质量， 老年癌症幸存者的生活美国50个州都有园艺大师项目， 这些州的比例（84%）每年有2至3个生长季节的能力。因此， 基础设施和可持续性能力以及广泛传播， 公共卫生意义。

Vegetable Garden Feasibility Trial to Promote Function in Older Cancer Survivors There are currently over 13.7 million cancer survivors in the U.S., and the number is steadily increasing. While the rising number of cancer survivors is cause for celebration, cancer survivors are at much greater risk for second malignancies, cardiovascular disease, osteoporosis, and functional impairment. Functional decline, especially that which results in a loss of independence, contributes substantially to the economic burden and also reduces quality of life among cancer survivors and their family members. This is of particular concern among older cancer survivors who comprise the majority (>60%) of all cancer survivors, and whose numbers are expected to exceed 14 million by the year 2030. Thus, there is large public health potential for targeted interventions that stabilize or positively reorient the steep trajectory of functional decline among older cancer survivors. This exploratory study is in response to the Translational Research at the Aging/Cancer Interface (TRACI) (PA-12-135) announcement. and proposes a novel and holistic approach, i.e., gardening, as a way to cultivate long-term adherence to an improved diet and increased physical activity, with the anticipation that it may slow the decline of health and function in this vulnerable population, and promote more successful aging. The proposed feasibility study relies on the extant infra-structure of the Alabama Cooperative Extension Master Gardener Program. A total of 46 older (e65 years) cancer survivors recently diagnosed with a loco-regionally staged cancer with a good prognosis (i.e., e 80% 5-year survival) and with 2 or more physical function limitations will be recruited from select rural and urban counties in Alabama and randomized to 1-of-2 study arms: 1) an intervention group that receives a 1-year mentored vegetable gardening intervention that pairs cancer survivors with certified Master Gardeners, or 2) a usual care control group. Aims of this study are to: 1) explore the feasibility and acceptability of a mentored vegetable gardening intervention by assessing accrual, retention, adherence, fidelity, and possible adverse events, 2) obtain means and precision estimates, and explore between-arm differences on pre-post changes in physical function and secondary endpoints (e.g., quality of life, fruit & vegetable intake, physical activity, biomarkers of successful aging), and 3) to explore participant factors associated with program efficacy (e.g., gender, comorbidity). The proposed vegetable gardening intervention is a novel and feasible strategy to reduce functional impairment and improve quality of life in elderly cancer survivors. The Master Gardener Program exists in all 50 United States, with a large proportion of these states (84%) having the capacity for 2-to-3 growing seasons a year. Thus, there is both an infrastructure and capacity for sustainability and wide-scale dissemination which ultimately could have great public health significance.