Gardening for Health for Cancer Survivors (G4H-CS)

Experimental: Gardening and Nutrition Intervention for Cancer Survivors

Participants will receive a six-week, in-person gardening and nutrition-based intervention delivered at the University of Vermont Medical Center rooftop garden. The program consists of six weekly sessions, each approximately two hours in duration, led by a multidisciplinary team. Participants will also receive educational materials to support gardening and healthy eating. Outcomes will be assessed using self-report questionnaires administered at baseline prior to the intervention and immediately following completion of the program.

Comportamental: Gardening and Nutrition Intervention

The intervention is a structured, six-week, in-person gardening and nutrition-based program delivered at the University of Vermont Medical Center rooftop garden. Participants will attend one session per week, each approximately two hours in duration, for a total of six sessions. The program is led by a multidisciplinary team.

Each session integrates hands-on gardening activities (e.g., planting, garden maintenance, harvesting), nutrition education (e.g., dietary fiber, hydration, anti-inflammatory foods), and culinary instruction focused on preparing healthy meals. The program also incorporates experiential components such as mindfulness practices, light physical activity, and engagement with natural outdoor environments.

Participants will receive educational materials, including a gardening and nutrition curriculum packet, to support continued application of skills outside of the sessions.

Acceptability of the Gardening and Nutrition Intervention

Acceptability will be assessed using a post-intervention participant satisfaction survey. Measures will include participant-reported satisfaction with the program, perceived usefulness of the intervention components, and willingness to recommend the program to others. Responses will be summarized descriptively to evaluate overall participant satisfaction and perceived value of the intervention.

Responses will be scored on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree).

Recruitment Rate

Recruitment rate will be defined as the number of participants enrolled divided by the number of eligible participants who expressed interest in the study during the recruitment period.

Unit of Measure: Percentage (%) Time Frame: During study enrollment period (up to 6 weeks)

Retention Rate

Retention rate will be defined as the proportion of enrolled participants who complete the full intervention and post-intervention assessments (T2).

Unit of Measure: Percentage (%)

Session Attendance

Session attendance will be defined as the number of intervention sessions attended by each participant out of 6 total sessions. Attendance will be summarized as both the mean number of sessions attended and the proportion of sessions attended.

Unit of Measure: Number of sessions (0-6) and Percentage (%)

Assessment Completion Rate

Assessment completion will be defined as the proportion of participants who complete all required baseline (T1) and post-intervention (T2) questionnaires.

Unit of Measure: Percentage (%)

Change in Health-Related Quality of Life (SF-36)

Health-related quality of life will be assessed using the 36-Item Short Form Health Survey (SF-36). The SF-36 evaluates eight domains, including physical functioning, role limitations, emotional well-being, social functioning, pain, energy, and general health. Scores will be calculated according to standard scoring procedures, and changes from baseline to post-intervention will be analyzed.

Each domain score is transformed to a 0 to 100 scale, with higher scores indicating better health-related quality of life.

The outcome will be defined as the change in SF-36 domain scores from baseline (T1) to post-intervention (T2).

Change in Perceived Stress (Perceived Stress Scale)

Perceived stress will be assessed using the 10-item Perceived Stress Scale (PSS). The PSS measures the degree to which situations in one's life are perceived as stressful over the past month. The PSS includes 10 items rated on a Likert scale from 0 (never) to 4 (very often), with total scores ranging from 0 to 40. Total scores will be calculated, and changes from baseline to post-intervention will be evaluated. Higher scores indicate greater perceived stress (worse outcome).

The outcome will be defined as the change in total PSS score from baseline (T1) to post-intervention (T2).

Change in Sense of Belonging (General Belongingness Scale)

Sense of belonging will be assessed using the General Belongingness Scale (GBS), which measures feelings of social inclusion and rejection. The GBS consists of 12 items rated on a Likert scale from 1 (strongly disagree) to 7 (strongly agree), with total scores ranging from 12 to 84. Total and subscale scores will be calculated, and changes from baseline to post-intervention will be analyzed.

Higher scores indicate greater sense of belonging (better outcome).