Growing Resilience in Wind River Indian Reservation (GR)

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

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.

Study Overview

• Status: Completed
• Conditions: Obesity; Diabetes; Overweight
• Intervention / Treatment: Other: Garden

Detailed Description

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:

1. 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.
2. 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.
3. BMA will host a Facebook support and networking group for gardeners, with ARI, BMA, and UW gardening experts providing advice as needed.
4. 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.

• Study Type: Interventional
• Enrollment (Actual): 338
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Wyoming
    • Laramie, Wyoming, United States, 82071
      • University of Wyoming

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years to 80 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

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

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: University of Wyoming
• Collaborators: National Heart, Lung, and Blood Institute (NHLBI); National Institutes of Health (NIH); National Institute of General Medical Sciences (NIGMS); Blue Mountain Associates, Incorporated; Eastern Shoshone Tribal Health; Action Resources International; Wind River Development Fund (WRDF)
• Investigators: Principal Investigator: Christine M Porter, PhD, University of Wyoming

Publications and helpful links

General Publications

• Naschold F, Porter CM. BMI Status and Trends among Native American Family Members Participating in the Growing Resilience Home Garden Study. Curr Dev Nutr. 2022 Jun 3;6(7):nzac100. doi: 10.1093/cdn/nzac100. eCollection 2022 Jul.
• Porter CM, Wechsler AM, Hime SJ, Naschold F. Adult Health Status Among Native American Families Participating in the Growing Resilience Home Garden Study. Prev Chronic Dis. 2019 Aug 22;16:E113. doi: 10.5888/pcd16.190021.
• Porter CM, Wechsler AM, Naschold F, Hime SJ, Fox L. Assessing health impacts of home food gardens with Wind River Indian Reservation families: protocol for a randomised controlled trial. BMJ Open. 2019 Apr 3;9(4):e022731. doi: 10.1136/bmjopen-2018-022731.

Helpful Links

• website for the project

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2015
• Primary Completion (Actual): August 1, 2021
• Study Completion (Actual): March 31, 2023

Study Registration Dates

• First Submitted: November 9, 2015
• First Submitted That Met QC Criteria: February 2, 2016
• First Posted (Estimated): February 3, 2016

Study Record Updates

• Last Update Posted (Actual): July 20, 2023
• Last Update Submitted That Met QC Criteria: July 18, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Keywords: BMI; Native American; Physical health; garden; Emotional health
• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Body Weight; Overweight
• Other Study ID Numbers: R01HL126666-01A1 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: IPD will be made available to each individual participant, but otherwise only the data summaries will be made available to non-partner parties unless individually arranged and approved by the IRB and project Community Advisory Board. The Northern Arapaho and the Eastern Shoshone tribes co-own the data with the research teams (and Eastern Shoshone Tribal Health and Northern Arapaho Tribal Health are entities of the tribal governments).