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Table 3 Studies addressing health outcomes included in this review

From: Community gardens and their effects on diet, health, psychosocial and community outcomes: a systematic review

First author, year

Country,setting

Study design

Sample characteristics (inclusion criteria, number, age and sex)

Aims

Sampling methods

Intervention/ Community garden program

Data collection Analysis (including adjustments)

Outcomes

Results

Algert et al. 2016 [28]

USA, CA, San Jose

Cross-sectional survey

Two groups:

Characteristics

Community gardeners:

n = 85

Female: 84%

Age (mean (± SD): 49 (± 13)y

Home gardeners (HG)

n = 50

Female: 50%

Age (mean (± SD): 58 (± 12)y

To compare whether the two groups of gardeners (community and home) increased their vegetable intake while gardening

1) CG: Face-to-face recruitment at 4 separate allotments

2) La Mesa Verde (LMV): Recruited through existing home gardening project for low-income families

Response rate not reported

Participants in

1) San Jose’s CG program which provides space to grow food, socialize and learn about gardening)

2) Local govt. funded (LMV; home gardening project) which provides raised beds, soil, seeds and plants; instruction on organic gardening workshops

T-tests and Chi-square test comparing home and community gardeners

No adjustments

Self-reported health status (BRFSS) and BMI

Self-reported health Community gardeners:

Excellent to very good 35%

Good 48%

Fair/poor 17%

Home gardeners:

Excellent to very good 45%

Good 35%

Fair/poor 20%

BMI

Community gardeners: 26.3 ± 5.3

Home gardeners: 28.5 ± 6.0

Barnidge et al. 2015 [29]

USA, rural Missouri, Dunklin (COM) and Pemiscot (INT) counties

Quasi-experimental study

Total n = 794

(397 COM; 397 INT)

Characteristics

INT group

Female: 62.7–63.2%

COM group:

Female: 65.0–71.3%

Age: 38.8–41.7y

Inclusion criteria

African American, ≥ 18 yrs, residing in COM or INT county

To examine effect of INT on BP, self-reported BMI, F&V consumption

(Mid-intervention results)

Cross-sectional surveys at each time point in INT and COM county

Recruited from “places frequented by African American adults (e.g. comm. org or church)”, fliers posted

MOTMGC (Men on the Move Growing Communities) – existing CG, nutrition education activities; access to healthy food through CG (participants did not do gardening themselves); 3 production gardens

Self-administered survey

Logistic regression examined changes prevalence of hypertension and BMI between INT and COM counties; models age, education, employment and income incl. in models to calculate adjusted changes over time between counties

BP directly measured

BMI from self-reported height and weight

Odds of hypertension:

Decreased in INT county (OR: 0.52; 95%CIs: 0.38–0.71) but not in COM county (OR: 1.11; 95%CIs: 0.81–1.54) in fully adjusted models

Odds of being overweight or obese:

Declined in INT county (OR: 0.73; 95%CIs: 0.52–1.02) but not in COM county (OR: 1.30; 95%CIs: 0.89–1.91) in fully adjusted models

Brown et al. 2020 [25]

USA, Montana, Native American community

RCT

(1) INT: Group-based CG program

(2) CON: No gardening

Native Americans with prediabetes or diabetes

N = 20

Age (y):

15/20 were 45–64 years, 5/25 25–44 years

Male n (%): 4/20 (25%)

CON n = 12

INT n = 8

Determine feasibility of a group gardening program and potential for collecting health outcomes

Convenience sample of participant expressing an interest in the gardening study at a diabetes clinic

Raised beds for gardening chosen for proximity to college and health centre. Plus 10 × 90-min structured sessions with hands-on gardening and food preparation activities

Outcomes measured at 7 months after baseline

Outcomes were reported as medians and ranges. Change from baseline was compared between the groups using Wilcoxon rank sum tests. No adjustments

Missing information on some outcomes

Weight, BMI, HbA1c, systolic and diastolic blood pressure (SBP and DBP)

BMI

INT (n = 8): -0.69 [-1.9, 0.3]

CON (n = 12): 0[-2.0, 3.0]

P = 0.838

SBP

INT (n = 7) -1.0 [-6.0, 16.0]

CON (n = 12) -9.0 [-28, 24]

P = 0.444

DBP

INT (n = 7) -6.0 [-18.0, 12.0]

CON (n = 12) -3.0 [-22, 10]

P = 0.983

HbA1c

INT (n = 8) -0.25 [-0.06, 0.9]

CON (n = 12) -0.2 [-2.6, 5.6]

P = 0.925

Castro et al. 2013 [31]

USA, NC, Carrboro

Pre-/post (no CON)

Characteristics

60 families participated

n = 120 children

Boys: 49%

Ethnicity: 59% Latino/a

Age (Mean (± SD): 6.0 (± 3.4)y

Inclusion criteria

Families living in the community (Carrboro); had ≤ 1 child 6 + y

1. To help children achieve or maintain a healthy BMI

2. to increase children’s access to fruit and vegetables, particularly at home

3. To increase the daily number of servings of F&V children consumed

Families recruited through outreach activities at schools and other local service providers

Growing Healthy Kids (GHK)—3 yr program consisting of:

1) weekly gardening sessions; 2) cooking and nutrition workshops for parents and children; 3) social activities and events meetings; newsletter; etc.)

Height and weight collected pre-and post-program (3y)

Surveys administered at baseline and at end of each year. Survey was piloted with focus groups and previously been used with Latino families

Change in BMI

Changes in BMI

17% of obesity (n = 6) resolved

23% of overweight (n = 3) resolved

100% of healthy weight (n = 53) maintained healthy weight

De Marco et al. 2016 [32]

USA, NC, Rural, low resource county

Pre-/post design

June 2010-May 2011 (11 months)

Characteristics

Rural African

American youth (n = 17) and adults (n = 23)

Inclusion criteria

Open to adults and youth ≥ 10 y

To test the feasibility of a church

garden program to impact health outcomes in rural African American youth and adults

The assistant pastor recruited church members and community members known to him

Workshops 2 h/wk; hands-on gardening and

nutrition education

BP, height, weight, BMI

Assessed using paired t-tests

Weight, BMI, blood pressure

Youth (n = 14)

Weight: 148.5 lb to 151.9 lb

BMI percentile: 71.3 to 71.7

Systolic BP: 120.5 to 113.5

Diastolic BP: 74.6 to 73.3

Adults (n = 20)

Weight: 204.7 lb to 202.2 lb

BMI: 32.5 to 31.7

Systolic BP: 137.5 to 136.6

Diastolic BP: 84.3 to 83.8

Hawkins et al. 2011 [49]

UK; Cardiff, Wales

Cross-sectional study

(1) Indoor exercise group

(2) Walkers

(3) Allotment gardeners

(4) Home gardeners

Characteristics

(1) n = 23

Age (y): 72.9 ± 6.9

Male: 3 (13%)

(2) n = 25

Age (y): 62.4 ± 6.8

Male: 8 (32%)

(3) n = 25

Age (y): 65.7 ± 9.1

Male: 17 (68%)

(4) n = 21

Age (y): 69.5 ± 7.7

Male: 2 (10%)

Inclusion criteria

 ≥ 50 y attending various local activity groups

Measure health status and perceived stress of allotment gardeners compared to other activity groups (indoor exercisers, walkers, home gardeners)

Recruited via leaflets, posters and visits to groups from researcher

Response rate 87.8%

Compared leisure activity groups to members of allotment gardening group

No intervention

Self-reported health using the SF-36v2; PA (MET (min/wk) and sitting time measured using the International Physical Activity Questionnaire); BMI, BP, forced vital capacity (FVC; a measure of lung function)

Physical activity, sitting, self-reported health, BMI, pulse pressure calculated from Psystolic – Pdiastolic), lung function

No group differences in health outcomes

Self-reported physical health (median; IQR)

(1) 48.3 (41.2–55.9)

(2) 51.6 (43.9–54.1)

(3) 53.5 (43.2–57.9)

(4) 50.0 (45.3–56.2)

PA (MET min/week; median (IQR))

(1) 3576 (2076–5760)

(2) 3450 (2232–6985)

(3) 5915 (2428–11,196)

(4) 3282 (1724–5630)

Sitting time (min/wk; mean ± SD)

(1) 346 ± 210

(2) 356 ± 183

(3) 305 ± 139

(4) 371 ± 190

BMI (mean ± SD)

(1) 26.2 ± 5.2

(2) 26.9 ± 4.3

(3) 25.5 ± 3.3

(4) 27.3 ± 2.2

Pulse pressure; mean ± SD)

(1) 64.3 ± 15.4

(2) 54.6 ± 14.2

(3) 62.4 ± 16.3

(4) 63.7 ± 15.1

FVC (mean ± SD)

(1) 94.8 ± 25.4

(2) 99.4 ± 34.2

(3) 104.9 ± 33.3

(4) 93.6 ± 21.9

Heilmayr and Friedman 2020 [34]

USA, CA

RCT with 5 INT groups:

(1) Community gardening

(2) moderate indoor exercise

(3) Exposure to nature

(4) Social club (watching films)

(5) Indoor container gardening

University students

Characteristics

Baseline data reported in combination (not by group allocation)

Age (y): 20.6 ± 3.3

Male: 31.2%

(1) n = 21

(2) n = 21

(3) n = 23

(4) n = 22

(5) n = 23

To compare community gardening with four theoretically driven comparison groups to understand possible causal mechanisms around how community gardens have improved outcomes

Convenience sample recruited via flyers, emails and the Psychology Subject Pool

4 week INT; assigned an activity for 2–3 h/wk

Data were analysed by ANOVA with pre-/post-test values to assess how groups changed from baseline and a group by time interaction

Self-reported health; Sleepiness; PA Fatigue Short Form a (4-items, responses NR), Body mass index

Self-reported health (post-test only; mean ± SD)

(1) 63.2 ± 18.8

(2) 63.9 ± 17.6

(3) 61.9 ± 17.9

(4) 61.0 ± 17.1

(5) 64.0 ± 16.2

Sleepiness (post-test only; mean ± SD)

(1) 9.2 ± 4.1

(2) 7.7 ± 4.9

(3) 8.8 ± 5.5

(4) 9.3 ± 3.1

(5) 9.3 ± 4.0

PA (post-test only; mean ± SD)

(1) 2.8 ± 1.2

(2) 3.1 ± 1.2

(3) 3.1 ± 1.2

(4) 3.1 ± 1.2

(5) 3.4 ± 1.6

Hopkins and Holben 2018 [35]

USA, OH, rural Appalachia (Athens)

Cross-sectional study

Characteristics

n = 50

Ethnicity: 81.6% white

Female: 67.4%

Education: 46.9% college educated

Inclusion criteria

CG plot in Athens

To examine relationships among food security, produce intake and behaviors, health and social capital among community gardeners

All community gardeners (n = 120) in Athens invited

No intervention

Individuals with CG plots

Survey distributed via email (response rate = 42%)

Descriptive stats reported, no adjustment

Health and PA questions

100% ‘good’ to ‘excellent’ health at end of gardening season 66% do more PA due to CG

No association of food security with PA

Litt et al. 2015 [38]

USA, CO, Denver

Cross-sectional survey

n = 469

Characteristics

Age (mean ± SD): 46.1 ± 15.9y

Female: 67.4%

Education: 57.4% college educated

59.3% identified as gardeners

n = 92 neighborhoods

49.6% residents college educated

25% residents minority

40.8% lived in area for ≥ 5 yrs

Inclusion criteria

English or Spanish speaking

 ≥ 18 yrs

To examine the direct and indirect pathways by which gardening influences self-rated health

Area-based sample of general population, n = 1154 randomly drawn from 40 block groups

13 gardens identified; List-based census of community gardeners n = 300

No intervention

Individuals participating in CGs compared with non-gardeners

Surveys interviewer administered

Path analysis controlling for age, education, years in neighborhood, % college education in neighborhood, observed incivilities

Self-rated health

Gardening did not predict self-rated health (β = 0.04, ns)

Collective efficacy predicted higher self-rated health (β = 0.14, p < 0.05)

Gardening impacted self-rated health indirectly, through social involvement, aesthetics and collective efficacy

Machida 2019 [39]

Japan

Cross-sectional survey

Web-based survey limited to age 60–69 y, professional farmers excluded

(1) Community gardeners n = 129

Male n(%): 87(67%)

Age (y): 64.1 ± 2.6

(2) Home gardeners (HG) n = 371

Male n(%):280(76%

Age (y): 63.9 ± 2.7

(3) Non-gardeners n = 500

Male n(%): 327 (65%)

Age (y): 63.3 ± 2.5

To study the relationship between community or home gardening and health status or a healthy lifestyle

The survey was conducted by a marketing company with 4.2 million people registered across all 47 prefectures in Japan

No INT

Odds Ratios adjusted for sex, age, family structure and employment status (not described)

BMI, exercise (> 30 min/d, at least 2 d/wk for over a year) and physically active (> 1 h/day), sitting time (categorized as < 3 h, 3–6 h and ≥ 6 h); walking speed faster than same generation and gender (yes/no)

Sleep (enough + moderate versus not enough + shortage)

BMI (ref 20–24.9)

(1) CG:

Underweight (< 20): 0.97 (0.65, 1.46)

Overweight or obese (≥ 25): 1.10 (0.78, 1.55)

(2) HG:

Underweight (< 20): 0.83 (0.46, 1.48)

Overweight or obese (≥ 25): 0.69 (0.40, 1.19)

Exercise

(1) CG: 1.57 (1.19, 2.07)

(2) HG: 1.79 (1.20, 2.67)

PA

(1) CG: 1.94 (1.45, 2.59)

(2) HG: 2.32 (1.50, 3.59)

Sitting time (ref ≥ 6 h/d)

(1) CG

3–6 h/d: 1.59 (1.14, 2.22)

 < 3 h/d: 1.80 (1.21, 2.69)

(2) HG:

3–6 h/d: 1.47 (0.91, 2.39)

 < 3 h/d: 1.74 (0.99, 3.05

Walking speed (faster than same generation and gender)

(1) CG: 1.22 (0.92, 1.63)

(2) HG: 1.48 (0.96, 2.26)

Sleep

(1) CG:0.99 (0.67, 1.46)

(2) HG: 1.11 (0.63, 1.96)

Mangadu et al. 2017 [40]

USA, NM, US-Mexico border areas

Cross-sectional study

Two CGs accessible by public. (CG1, CG2)

CG1 (n = 16)

CG2 (n = 9)

Characteristics

% Male NR

Age NR

CG@ is a local government project comprising a neighborhood CG and a garden on a juvenile probation campus. Where possible, data from the probation campus are not extracted

To identify the best practices in implementing and increasing the potential or sustainability of community gardens

NR

NR

Descriptive statistics only. Not adjusted for anything

PA (1-item), ‘Do you think you are more physically active

Are you more physically active as a result of being engaged in CGs:

CG1: Yes, n = NR (75%)

CG2: yes, n = NR (100%)

Soga et al. 2017 [50]

Japan, Tokyo, Nerima district in central Tokyo

Cross-sectional survey

Gardeners (n = 165) vs non-gardeners (n = 167)

Characteristics

Gardeners:

Male: 68.1%

Age (mean ± SD): 62 ± 17y

Non-gardeners:

Male: 42%

Age (mean ± SD):

61 ± 16y

To quantify effects of allotment gardening on physical, psychological and social health

Gardeners located by face-to-face recruitment at allotment gardens (90% response rate)

Non-gardeners recruited via a letter sent to 1000 Nerima households (20% response rate)

NR

Adjusted for sex, age, household income, employment, smoking, drinking, vegetable intake and physical activity (days per week of > 30 min/day of moderate activity)

BMI (self-reported height, weight), Physical activity (days per week)

Compared with non-gardeners:

Gardeners mean BMI (± SE) was 0.56 ± 0.39 higher

Days of physical activity did not differ between gardeners (3.9 ± 2.3) and non-gardeners (3.9 ± 3.3)

Tharrey et al. 2020 [46]

France, Montpellier

Longitudinal cohort study

Data collected at baseline and 1 year later

Characteristics

(1) Community gardeners (n = 66)

Male n(%): 16(24.2)

Age (y): 44.0 ± 14.0

(2) Non-gardeners (n = 66)

Male n(%): 16(24.2)

Age (y): 44.9 ± 13.7

Inclusion criteria

Starting gardening in a community garden; residents of Montpelier; ability to read

French

To assess the impact or urban community garden participation the adoption of sustainable lifestyles

Gardeners recruited when new to the gardening community

Non-gardeners recruited via volunteers for a population-based survey on food supply behaviors

Community gardens plots used collectively or individually

Analyzed with mixed-effects models with group by time interaction

Adjustments for education, BMI, meals consumed outside the home, social desirability where appropriate

PA energy expenditure (PAEE), time spend inactive (< 1.5 METs) and moderate-to-vigorous activity (> 3 METs) using accelerometry worn for 9 consecutive days

BMI from self-reported height and weight

PAEE at 1 year (mean ± SD)

(1) 40.3 ± 12.3

(2) 39.9 ± 13.5

Inactivity at 1 year (h/day; mean ± SD)

(1) 9.9 ± 1.5

(2) 9.8 ± 1.4

Moderate-to-vigorous activity at 1 year (h/d; mean ± SD)

(1) 1.6 ± 0.7

(2) 1.7 ± 0.8

BMI at 1 year (mean ± SD)

(1) 22.8 ± 3.1

(2) 23.9 ± 4.1

van den Berg et al. 2010 [51]

The Netherlands, “large cities”

Cross-sectional survey

Gardeners (n = 121) from 12 allotment gardens

Non-gardener (n = 63)

Characteristics

Gardeners:

Male: 53%

Age (mean ± SD): 62 ± 12 y

Non-gardeners:

Male: 41%

Age (mean ± SD):

56 ± 14 y

To directly compare the health, wellbeing and physical activity of allotment gardeners to that of controls without an allotment garden

Gardeners sent invitations to their home addresses

Non-gardeners were responders living next to the home address of allotment gardeners

Ranged from residential parks, day-recreational parks and food production parks

Adjusted for age, sex, education, income, access to a garden at home, physical activity in winter and stressful life events, and included an age by gardening interaction term. Results separated by age

Physical activity as days/ week engaging in at least half an hour of intensive activities

Count of chronic illnesses (e.g. cardiovas-cular, musculo-skeletal conditions)

Count of GP consultations in past 2 months

Physical activity (days per week in summer):

Mean ± SD (unadjusted)

 < 62 yrs

Gardeners 5.6 ± 0.2

Non-gardeners 5.1 ± 0.2

 ≥ 62 yrs

Gardeners 5.8 ± 0.2

Non-gardeners 5.0 ± 0.2

meanadjusted ± SE

Chronic illness

 < 62 yrs

Gardeners 0.6 ± 0.1

Non-gardeners 0.5 ± 0.1

 ≥ 62 yrs

Gardeners 0.5 ± 0.1

Non-gardeners 0.8 ± 0.2

GP consultations

 < 62 yrs

Gardeners 0.7 ± 0.2

Non-gardeners 0.9 ± 0.2

 ≥ 62 yrs

Gardeners 0.5 ± 0.1

Non-gardeners 1.1 ± 0.2

Weltin 2013 [52] and Weltin and Lavin 2012 [48]

USA, IA, Dubuque

Pre-/post-

Immigrants from the Marshall Is living in Dubuque Iowa, who attended a local clinic for patients with diabetes (n = 17). Follow up data on n = 13 (n = 5 Gardeners n = 8 non-gardeners)

Characteristics

Male: 53%

Age 33-81y

(mean 51y)

To monitor HbA1c levels in Marshallese population who participated in a CG

From clinic

Clinic staff and their families donated supplies and taught how to prepare soil, plant, weed and harvest produce at a local church garden. Unclear if the garden was freely available for all to use

Comparison of pre-gardeners and non-gardeners using independent t tests. No adjustments

BMI, blood pressure and HbA1c levels 6 months after the interventions

All mean ± SD

BMI

Gardeners 30.2 ± 3.1 kg/m2

Non-gardeners 34.1 ± 1.4 kg/m2

Blood pressure

NR separately for gardeners vs Non-gardeners

HbA1c

Gardeners 8.2 ± 1.6

Non-gardeners 9.3 ± 1.5

Zick et al. 2013 [53]

USA, UT, Salt Lake City

Cross-sectional study of linked administrative data

n = 198 community gardeners

To examine the association of participation in community gardening with healthy body weight

Wasatch CGs (WCG, non profit organization); Utah Population Database (UPDB)

WCG staff provided details of 423 adults who gardened in 1 of WCG’s CG plots for ≥ 1 year; and not growing produce for sale

375 data linkage to UPDB, linkage rate of 88.7%

INT: community gardeners

vs. 3 CON groups: (1) unrelated individuals who lived in gardeners’ neighborhoods, (2) siblings of community gardeners, and (3) spouses of the community gardeners

Multivariable analyses, controlling for year of BMI, age, gender, education, race

Self-reported height and weight (BMI)

All mean ± SD

BMI

Women CG vs women neighbors

CG 23.9 ± 5.3 Neighbors 25.5 ± 5.7

BMI Women CG vs women siblings

BMI: 23.9 ± 5.2

Siblings: 25.2 ± 5.6

Women CG vs women spouses

CG: 24.3 ± 5.0

Spouses: 26.6 ± 12.8

Men CG vs neighbors

CG: 24.7 ± 4.3

Neighbors 27.2 ± 4.8

Men CG vs Men siblings

CG: 25.10 ± 4.63

Siblings: 25.63 ± 4.63

Men CG vs Men spouses

CG: 25.34 ± 3.07

Spouses: 27.89 ± 5.83

  1. Abbreviations: BMI Body mass index, CG Community garden, COM Comparison group, CON Control group, F&V Fruit and vegetable, INT Intervention group, NR Not reported, OR Odds ratio, PA Physical activity, RCT Randomized controlled trial, SD Standard deviation, SE Standard error, SEP Socioeconomic position