Growing Resilience in Wind River Indian Reservation

Study Overview
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Brief Summary
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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
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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: 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. 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. BMA will host a Facebook support and networking group for gardeners, with ARI, BMA, and UW gardening experts providing advice as needed. 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.

Official Title
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Growing Resilience: an RCT on the Health Impact of Gardens With Wind River Indian Reservation

Conditions
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Obesity, Overweight, Diabetes

Intervention / Treatment
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* Other: Garden


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Gardening<br>Receiving two years of technical, labor and financial support in starting, growing, and harvesting from a home food garden. | Other: Garden<br>* Two years of financial and technical home gardening support for new gardeners<br>|
| No Intervention: Control<br>The control families receive a garden as a delayed intervention after two years. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adult BMI change | With four data points, every 6 months. Researcher-measured height (stadiometer) and Tanita body composition scale. | Change from baseline at 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mental Health change | measured by SF12 survey | Change from baseline at 2 years | 
| Physical Health change | measured by SF12 survey | Change from baseline at 2 years | 
| Food security change | measured by sub-set of USDA survey | Change from baseline at 2 years | 
| Self-efficacy in gardening change | by survey | Change from baseline at 2 years | 
| Pain change | by survey | Change from baseline at 2 years | 
| Blood pressure change | researcher-measured with bp monitor | Change from baseline at 2 years | 
| hand strength change | researcher-measured with dynamometer | Change from baseline at 2 years | 
| waist circumference change | researcher-measured with spring-loaded tape measure | Change from baseline at 2 years | 
| beta-carotene change | whole blood draw and assay | Change from baseline at 2 years | 
| Hb A1C change | whole blood draw and assay | Change from baseline at 2 years | 
| cholesterol change | whole blood draw and assay | Change from baseline at 2 years | 
| triglycerides change | whole blood draw and assay | Change from baseline at 2 years | 
| vitamin D change | whole blood draw and assay | Change from baseline at 2 years | 
| child BMI z-score change |  | Change from baseline at 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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garden, Native American, BMI, Emotional health, Physical health