Vegetable garden feasibility trial to promote function in older cancer survivors

植物园促进老年癌症幸存者功能的可行性试验 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加。而当 癌症幸存者人数的增加值得庆祝，癌症幸存者患癌症的风险要大得多。 其次是恶性肿瘤、心血管疾病、骨质疏松症和功能障碍。功能性衰退， 特别是那些导致丧失独立性的问题，大大增加了经济负担和 也会降低癌症幸存者及其家人的生活质量。这一点特别令人担忧。 在占所有癌症幸存者的大多数(60%)的老年癌症幸存者中，他们的人数 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 稳定或积极重新定位老年癌症患者功能下降急剧轨迹的干预措施 幸存者。这项探索性研究是对衰老/癌症界面的翻译研究的回应 (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的习惯，并期望 可能会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阿拉巴马州合作推广中心现有的基础设施 园丁计划。共有46名年龄较大(65岁)的癌症幸存者最近被诊断出患有地区性 预后良好的分期癌症(即80%的5年存活率)，并有2个或2个以上的身体功能 限制因素将从阿拉巴马州选定的农村和城市县招募，并随机进行1/2研究 ARMS：1)干预组，接受为期1年的有指导的蔬菜园艺干预 癌症幸存者与认证的园艺大师，或2)常规护理对照组。本研究的目的是：1) 通过评估应计利润，探索有指导的蔬菜种植干预的可行性和可接受性。 保留率、依从性、保真度和可能的不良事件，2)获得方法和精确的估计，以及 探索手臂之间在术后前身体功能和次要终点变化方面的差异(例如， 生活质量、水果和蔬菜摄入量、体力活动、成功衰老的生物标志物)，以及3)探索 与计划效果相关的参与者因素(例如，性别、共病)。建议的蔬菜 园艺干预是一种新的可行的策略，可以减少功能损害，提高质量 老年癌症幸存者的生活。园艺大师计划在美国所有50个州都有，有大量的 这些州中有84%的州一年有2到3个生长季的能力。因此，既有一个 可持续和广泛传播的基础设施和能力，最终可能会产生巨大的影响 对公共卫生的意义。

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.