Journal of Community Health Nursing

ISSN: 0737-0016 (Print) 1532-7655 (Online) Journal homepage: http://www.tandfonline.com/loi/hchn20

GROW: Green Organic Vegetable Gardens to

Promote Older Adult Wellness: a Feasibility Study

Kelley Strout, John Jemison, Liam O’Brien, David Wihry & Timothy Waterman

To cite this article: Kelley Strout, John Jemison, Liam O’Brien, David Wihry & Timothy
Waterman (2017) GROW: Green Organic Vegetable Gardens to Promote Older Adult
Wellness: a Feasibility Study, Journal of Community Health Nursing, 34:3, 115-125, DOI:
10.1080/07370016.2017.1340554

To link to this article: http://dx.doi.org/10.1080/07370016.2017.1340554

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 JOURNAL OF COMMUNITY HEALTH NURSING
2017, VOL. 34, NO. 3, 115–125
https://doi.org/10.1080/07370016.2017.1340554

GROW: Green Organic Vegetable Gardens to Promote Older Adult

Wellness: a Feasibility Study
Kelley Strout, Ph.D., RNa, John Jemison, Ph.D.b, Liam O’Brien, Ph.D.c, David Wihry, MPAd,
and Timothy Watermane
a
Assistant Professor, School of Nursing, University of Maine, Orono, Maine; bExtension Professor, Cooperative
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Extension, University of Maine, Orono, Maine; cAssociate Professor, Mathematics and Statistics, Colby College,
Waterville, Maine; dProject Manager, University of Maine Center on Aging, Bangor, Maine; eNursing Student, School
of Nursing, University of Maine, Orono, Maine

ABSTRACT
Protecting older adult’s cognitive health is a public health priority. Wellness
behaviors within 6 domains have demonstrated effectiveness in protecting
older adult’s cognitive abilities. Interventions targeted to low-income older
adults are needed because these populations experience greater social and
physical health disparities compared to adults in higher socioeconomic sta-
tuses. This study examined the feasibility of engaging independent, commu-
nity-dwelling older adults living in low-income senior housing in cultivating
raised-bed gardens and reviewed the improvements in cognition and nutri-
tion. Ten participants received ergonomic garden tools, seeds, waist-height
garden beds, and weekly garden education. Participants planted vegetables of
their choosing and tended to their garden beds for 17 weeks. Cognition and
nutrition outcomes were measured before and after the intervention. Adults
successfully engaged in the intervention throughout the duration and experi-
enced improvement in cognitive and nutrition outcomes.

Maintaining cognitive health and preventing age-related cognitive decline (CD) is a public health priority
(Center for Disease Control and Prevention [CDC], 2016; Institute of Medicine [IOM]), 2015). The risk of
CD increases with age, yet CD is not an inevitable consequence of aging. Super agers (80+ years of age)
demonstrate cognitive abilities similar to healthy persons 20–30 years younger (Harrison, Weintraub,
Mesulam, & Rogalski, 2012). It is unknown if super agers have a genetic predisposition for cognitive health
or if they develop resistance to decline through lifestyle choices; cognitive reserve theory posits that the
brain can generate additional neural pathways that may protect adults from CD, even in the face of
dementia (Stern, 2002)). Wellness behaviors may increase cognitive reserve, protecting cognition as adults
age (Strout et al., 2016; Strout & Howard, 2012, 2014).
Losing cognitive abilities is of universal concern (Phelan, Anderson, LaCroix, & Larson, 2004)
because older adults who experience CD are more likely to die prematurely, become disabled,
depend on caregivers, and require long-term care (McGuire, Ford, & Ajani, 2006). Behavioral
interventions incur less risk than drug therapies, which are currently ineffective in preventing CD
(Naqvi, Liberman, Rosenberg, Alston, & Straus, 2013).
Wellness is a multidimensional construct comprised of six integrated domains (Becker, Dolbier,
Durham, Glascoff, & Adams, 2008; Hattie, Myers, & Sweeney, 2004; National Wellness Institute, 2015;
Nenn & Vaisberg, 2010; Witmer & Sweeney, 1992). Developing healthy lifestyles is a fundamental

CONTACT Kelley Strout, Ph.D Kelley.strout@maine.edu

This manuscript has not been published elsewhere and it has not been submitted simultaneously for publication elsewhere.
Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/HCHN.
© 2017 Taylor & Francis
 116 K. STROUT ET AL.

approach to cognitive health research, as behaviors within the six wellness domains are associated with
cognitive health protection as adults age (Strout et al., 2016; Strout & Howard, 2012, 2014).
Social wellness, demonstrated through positive personal relationships and productive social
engagement, may protect cognitive health and function during aging (Seeman, Lusignolo, Albert,
& Berkman, 2001; Zunzunegi, Alvarado, Del Ser, & Otero, 2003), even among older adults with
cognitive pathologies (Bennett, Schneider, Tang, Arnold, & Wilson, 2006). Emotional wellness is the
ability to acknowledge, with emotional stability and positivity, personal responsibility for life
decisions (Hettler, 1976). Emotional wellness is associated with cognitive health among older adults
(Strout & Howard, 2012, 2014). Older adults who engage in routine physical activity, such as
walking, and consume diets rich in fruits and vegetables and unsaturated fats demonstrate less
risk for cognitive impairment as they age (Strout et al., 2016; Strout & Howard, 2012, 2014). Spiritual
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wellness, evidenced by a purpose in life and a personal value system (Hettler, 1976) is also associated
with cognitive health among older adults (Bennett, Schneider, Tang, Arnold, & Wilson; Boyle,
Buchman, Barnes, & Bennett, 2010). Engagement in paid or unpaid meaningful employment
describes occupational wellness (Hettler, 1976); adults who work with data or frequent human
interaction demonstrate less risk for cognitive decline as they age, and volunteering is correlated
with less risk (Coin et al., Karp et al., 2006). Intellectual wellness is participation in mentally
stimulating activities and lifelong learning (Hettler, 1976). Behavioral interventions targeting intel-
lectual wellness are widely studied, with outcomes that demonstrate cognitive health protection
among older adults (Strout et al., 2016).
Scientists postulate that promoting cognitive health and preventing CD may require a variety of
wellness interventions, with those that target multiple domains providing greater resilience against
aging-related CD (Andel et al., 2005; Coin et al., 2010; Strout et al., 2016; Strout & Howard, 2012,
2014; Wang & Glicksman, 2013). Gardening is an intervention that engages multiple wellness
domains and may provide cognitive and other health benefits.
Gardening is an intervention that may promote wellness and support aging in place. Gardening is
associated with greater vegetable consumption, greater levels of physical activity, and higher levels of
happiness and emotional well-being among older adults; additionally, gardening interventions have
demonstrated improvement in cognition, sleep, and waist circumference (Calkins, Szmerekovsky, &
Biddle, 2007; Dwyer, Pajot, Lawlor, McGivern, & Pagotto, 2016; Nicklett, Anderson, & Yen, 2014;
Austin, Johnson, Morgan, 2006; Park, Lee, Son, Lee, & Kim, 2016; Wang and Macmillan’s, 2013).
Gardening has demonstrated a positive impact on participants’ behaviors, well-being, and quality of
life, including decreased falls and reductions in the use of psychotropic medications, improved
memory, enhanced social interaction, achievement of meaningful goals, and enhanced interpersonal
intimacy (Calkins et al., 2007; Nicklett et al., 2014; Yao & Chen, 2016).
The study of gardening as a health intervention for older adults is in the preliminary phase of
research. A number of previous studies that examine gardening as a health intervention focus on
institutionalized older adults and use self-reported surveys or cross-sectional designs (Gonzalez &
Kirkevold, 2013; Yao, Ya-F, Chen, K-M, 2016; Leng, Wang, 2016); some investigated the effects of
nonedible gardening activities such as using flowers to decorate and creating flower arrangements
(Kim, Cho, Han, & Kim, 2004; Lee & Kim, 2008; Leng, Wang, 2016; Wang & Macmillan, 2013).
Interventions that examine health benefits associated and the ability of older adults to grow
nutritious, edible food independently at their residence is absent. To promote wellness and aging-
in-place, accessible gardening interventions that provide nutrient dense food and purposeful activity
to well older adult populations must be explored.
Given the positive association between cognition and interventions that promote wellness in
multiple domains (Strout et al., 2016; Strout & Howard, 2012, 2014), gardening may be useful in
protecting cognition among older adults by promoting health and well-being; however, older adults
from low socioeconomic status face disparities in their engagement in behavioral wellness-focused
interventions. Low socioeconomic status negatively affects physical and mental health; these indivi-
duals demonstrate a lower health-related quality of life, smaller social networks, and lower quality of
 JOURNAL OF COMMUNITY HEALTH NURSING 117

social relations (Huguet, Kaplan, & Feeny, 2008). Older adults living in low-income neighborhoods
are more likely to have underdeveloped and poorly integrated social networks or engage in adequate
amounts of physical activity (Huguet et al., 2008; Black & Rubinstein; Rao, Afshin, Singh, &
Mozaffarian, 2013). Semistructured community garden programs are known to enhance social
interaction and, as health interventions for older adults, have yielded positive physical, social, and
cognitive health outcomes (Gigliotti & Jarrott, 2005; Wang & Macmillian, 2013; Nicklett, Anderson,
& Yen, 2014). Gardening (with appropriate support) may slow the rate of cognitive decline, but
additional research is indicated to evaluate the feasibility and effectiveness of community-dwelling
older adults independently cultivating raised-bed gardens as a wellness intervention (Gigliotti &
Jarrott, 2005; Wang & Macmillian, 2013; Nicklett, Anderson, & Yen, 2014). Implementing structured
raised-bed gardening programs in low-income older adult housing communities facilitates access to
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a behavioral wellness intervention that addresses multiple wellness domains. This intervention also
has the potential to support the development of stronger, more united communities among older
adults living in low-income housing and provide opportunities to engage in physical activity. Also, it
provides low-cost access to fresh, nutritious vegetables that may be otherwise unattainable.
To evaluate the feasibility of engaging independent, community-dwelling older adults who live in
low-income senior housing to cultivate, harvest, and consume vegetables grown in raised beds as a
method of improving health and cognition, this study sought to address the following research
questions: (a) Is it feasible for residents living in an affordable senior housing community to
cultivate, harvest, and consume green leafy vegetables grown in accessible raised garden beds and
(b) what are the effects of gardening on nutrition and cognitive outcomes among community-
dwelling older adults?

Materials and methods

Participants and setting
The study site was a private, affordable housing development in the northeast. All residents of the
selected senior housing community meet annual income guidelines outlined by United States
Housing and Urban Development for the fiscal year 2016 (United States Department of Housing
and Urban Development, 2016). Independently living male and female residents age 65 and older at
the selected congregate housing site were eligible to participate in this study. Adults who were
younger than 65 years old or physically unable to participate based on self-report were excluded.

Recruitment
With support from the site’s housing manager and activities director, the research team recruited 10
participants. Thirty-nine residents met the age eligibility criteria and received an invitation by mail.
The research team posted flyers featuring contact information for the principal investigator through-
out the housing development. Three trained research assistants visited the site 1 week after the
mailing to discuss the study in face-to-face meetings. Residents who demonstrated interest were
screened to validate age eligibility and asked to sign an informed consent. Figure 1 displays the
participant flow.

Intervention
Ten six foot by four foot, waist-height garden beds were constructed by local community college
students enrolled in a wood construction course as an experiential learning assignment (see
Figure 2 for garden bed design). Finished beds were delivered to the study site in early May.
Each participant was assigned a garden bed and provided ergonomic gardening tools. A hose
with an ergonomic sprayer and a storage shed were also installed on site. A gardening expert
 118 K. STROUT ET AL.
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Figure 1. Flow diagram of enrollment for grow.

Figure 2. Waist-height garden bed design.

from the partnering university’s cooperative extension led the participants in 1-hr gardening
education and demonstrations weekly throughout the 17-week intervention. Residents chose
seeds from a selection of 12 leafy green vegetables selected based on nutrient density and ability
to grow close together in limited space. Participants planted their first seeds during the third
week of May. The gardening expert demonstrated proper gardening techniques (i.e., planting
seeds, thinning, harvesting, and watering), and observed the participants performing displayed
tasks in their raised beds weekly. Guidance was also provided as needed outside of the regular 1-
hr sessions to enable the free participation of study subjects. Participants received 20 recipes that
included vegetables represented in the original seed selection.

Measurement
Qualitative methods were used to evaluate the feasibility of older adults who reside in affordable
senior housing cultivating, harvesting, and consuming organic leafy green vegetables with minimal
support. The principal investigator monitored challenges and successes through photographs, by
listening and recording weekly feedback from participants, and through analysis of data gathered in
a post-intervention focus group.
Participants’ cognition was measured pre- and postintervention using the Mini-Mental State
Examination (MMSE), a widely used cognitive assessment. The MMSE consists of 11 questions
designed to evaluate global cognition. The MMSE has been validated for assessing the cognitive
 JOURNAL OF COMMUNITY HEALTH NURSING 119

health of older populations and is recognized as a reliable assessment tool when administered by
trained personnel (Folstein, Folstein, McHugh, & Fanjiang, 2001).
Nutritional health was evaluated using the Mini Nutritional Assessment (MNA), a validated
screening tool that measures the nutritional health of adults age 65 or older (Kaiser et al., 2009).
Pre- and postintervention MNA measures were collected and analyzed.

Results
The research team recruited 10 older adults and signed participation and flow is summarized in
Figure 1. Eight women and two men participated in the study. The mean age was 77.42 years; the
youngest participant was 67, and the oldest was 89.5 years of age. Forty percent of participants had
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earned a Bachelor’s degree, 20% held an Associate’s degree, 10% had completed some college
courses, and 30% had earned a high school diploma.

Research question 1
Is it feasible for residents living in an affordable senior housing site to cultivate, harvest, and
consume green leafy vegetables grown in elevated raised beds? During the 17-week intervention,
100% of participants remained engaged and expressed a desire to participate in the intervention in
the future. An average of eight participants attended the regular weekly sessions with the gardening
expert and the principal investigator. All participants worked independently in their gardens
throughout the 17-week intervention. At the conclusion of the study, an independent researcher
who was not involved in the data collection or weekly sessions conducted a focus group with
participants. This session was recorded and subsequently transcribed for use in project evaluation.
Two researchers reviewed the transcripts independently and met later to discuss themes. Data was
independently coded according to identified themes using the scissor-and-sort technique (Weber,
1990). Key themes are described in the following, with selected quotes listed in Table 1.

Table 1. Selected focus group comments relevant to data themes.

Pleasure &
Bed Design Commitment Learning Enjoyment
The great thing about the design of It was just enough for us to get into We learned as much from each I love doing
these beds is probably 9/10 people it and not work at it; it was not other as we did from the something extra, it
that live in these units are not able overwhelming. experts. gets you out.
to get down on their knees. You The gardens now are in the second I didn’t know what kale was.
know, arthritis, whatever. If I tried planting. . .Just on our own time. Now I know.
to get down, I wouldn’t get back We know what to do pretty All winter you look
up. So the raised beds are exactly much now, don’t we? forward to that. It’ll
at the level where we can all be one more thing to
access them. You can go from one look forward to.
side to another and walk around
easily.
It wasn’t overwhelming. I’ve learned from everybody. We’re already
planning for spring!
Sharing Social Engagement Consumption Vegetable Variety
We didn’t waste anything; we were When you’re in your own home, you I made a cranberry, nut, and We ate greens and
brought up not to waste. have your own yard. Here, you do kale salad and it tasted really greens and more
not. The gardens promoted talking to good. It is nice to see things greens, we want
people, walking by the gardens, you grow and then eat it. more vegetable
know? It was a way to meet new variety.
people.
We live in one unit, she lives in
SHARE! I am just one person. I can’t another unit. The only way we really
eat it all! got together was the fact that we
come together doing this.
 120 K. STROUT ET AL.

Pleasure and enjoyment

The participants found the intervention pleasurable and enjoyable. Many shared that the experience
reminded them of their past when they were able to garden.

Manageable commitment
At the beginning of the study, many participants expressed concerns about the time commitment
required to participate in this intervention; time was identified as a reason for opting out of this
study. In the end, the intervention, including the weekly sessions with the gardening expert, were
perceived as manageable for the participants.

Vegetable variety
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Participants grew an abundance of leafy green vegetables, in fact, individual yields were far greater
than any one person could consume. Many participants became overwhelmed with their yield. Seed
selections were limited to leafy green vegetables in this feasibility study, but participants recom-
mended expanding the variety of vegetables available for future research.

Sharing
Because of the excess vegetable yield, participants shared their vegetables with neighbors within the
housing complex, local homeless shelters, and crisis centers for pregnant women, as well as with
their families and other senior housing sites.

Learning from each other

Participants attended weekly sessions with the gardening expert to learn gardening techniques and
skills, but they also learned from each other. They shared their experience with watering and
harvesting, and they shared recipes and food preservation ideas with one another.

Social engagement
The garden beds were installed side-by-side in a designated garden area. The arrangement of the
beds promoted shared activity and social engagement. Few participants knew one another before
the study; at the conclusion, they had become friends. They frequently helped one another
throughout the study such as when fellow participants had planned trips to visit family or
when unexpectedly hospitalized. During these times, other study participants volunteered to
water and harvest vegetables and delivered them to their peers. Participants also supported one
another with other tasks. For example, one participant shared that after seeing a fellow gardener
carrying laundry across the parking lot in the rain, she gladly ran to provide an umbrella and a
helping hand.

The design of beds

The height of the garden beds provided easy access for older adults with physical mobility challenges.
Participants who relied on canes, walkers, or oxygen, or were legally blind, were not excluded from
this project because the garden beds were designed to ensure accessibility. Study subjects were not
required to kneel or to bend to access the gardens. Many hung their canes on the side of the beds
while they worked, or would sit on their rolling walkers when they became tired. As a bonus, the
height of the beds limited the growth of weeds.

Vegetable consumption
Participants enjoyed consuming the vegetables they grew. Over the course of the project, they
demonstrated pride in the growth and progress of their gardens. They experimented by planting
and consuming vegetables they had never eaten before. In addition to sharing their excess vegetables,
participants preserved and froze vegetables to consume at a later date.
 JOURNAL OF COMMUNITY HEALTH NURSING 121

Expansion of project
Participants enthusiastically supported continuing this project in their community. They suggested
expanding the variety of vegetables available and requested additional education on food preserva-
tion, including recipes and techniques. Volunteer gardeners also expressed a desire to install benches
and chairs near the gardens so that their neighbors who did not participate could enjoy the beauty of
the garden and find meaningful and peaceful locations for reflection. Most believed that older adults
in low-income senior housing should be involved in similar projects, based on the benefits they
enjoyed. Moreover, participants expressed a desire to expand the study to include indoor gardening
during the winter months.
Installing elevated raised garden beds in low-income senior housing and providing older adults
with appropriate support and resources to plant, grow, harvest, and consume organic vegetables is
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feasible and was greatly enjoyed by this population.

Research question two

What are the effects of gardening on nutrition and cognitive outcomes among community-dwelling
older adults? The research team limited the number of participants in this feasibility study to 10,
understanding that initial results would not be statistically significant. Pre- and postintervention
outcome measures were compared to identify percentages of positive and negative improvements on
each outcome measure. Table 2 summarizes cognitive and nutrition outcomes of this study. Older
adults who participated in the study increased their protein intake, consumption of vegetables, and
water after participating in the study. They also demonstrated higher self-rated health and nutri-
tional status after the intervention. The participants’ scores on the MMSE improved after the
intervention.

Discussion
The first objective of this study was to determine if it was feasible for residents living in an affordable
senior housing site to cultivate, harvest, and consume green leafy vegetables if given adequate
resources and gardening support. Throughout the 17-week intervention, 100% of participants
remained engaged in the study, and at the conclusion, all expressed their intention to continue
gardening in the future. Participants equipped with gardening supplies that support older adults with
physical limitations are able to cultivate, grow, and consume their own vegetables. Participants
received waist-height garden beds and ergonomic hoses and hand tools to minimize musculoskeletal
strain. Weekly visits from a gardening expert provided seniors with guidance and expertise.
Participants found the experience enjoyable and meaningful; they increased their social interactions,
consumed increased amounts of fresh vegetables, and shared the excess vegetables with others.
The second objective of this study was to examine the effects of gardening on nutrition and
cognitive outcomes among community-dwelling older adults who live in affordable housing com-
plexes. Because the primary aim of the study was to examine the feasibility of the intervention, the

Table 2. Percent change in nutrition and cognitive outcome measures from baseline to post-GROW intervention.
Percentage of Positive Difference Percentage of Negative Difference
Presence of acute distress in past 3 months 10% 20%
Adequate Protein Intake 50% 10%
Consumes 2 or more servings of fruit of vegetables 10% 0%
per day
Consumes 5 or more cups of water per day 30% 0%
Self view of nutritional status 30% 20%
Self view of own health 40% 10%
Cognition 40% 0%
 122 K. STROUT ET AL.

sample was limited to 10 participants and results were not intended to be analyzed for statistical
significance. However, pre- and postintervention measures were collected and analyzed and demon-
strated a positive improvement on participants’ cognition, protein intake, fruit and vegetable
consumption, hydration, and self-rated nutrition and health status.
GROW outcomes align with the findings from other research studies that evaluated gardening
among older adult populations. Gardening as an intervention has demonstrated preliminary health
benefits among older adults who live in Alzheimer’s and dementia long-term care facilities, or who
attend AZ daycare and senior care centers (Gonzalz & Kirkevold, 2013; Kim et al., 2004; Lee & Kim,
2008; Nicklett et al., 2014; Wang & Macmillan, 2013). A gardening intervention that offered
reduced-cost landscaping services to older adults who reside in their homes demonstrated health
benefits (Same, Lee, McNarmara, & Rosenwax, 2016). GROW outcomes highlight positive nutri-
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tional outcomes among participants; older adults who consumed healthy, plant-based diets rich in
fruits and vegetables demonstrate less risk for CD, compared to those who consumed less healthy
foods (Nurk et al., 2010; Polidori et al., 2009). The cost of healthy eating is $1.50 per person, per day
more than the cost of unhealthy food, which creates significant financial limitations for those living
on fixed incomes that GROW can address (Rao et al., 2013).
Promoting social engagement is an emerging focus of cognitive health prevention (IOM, 2015).
Increased social interaction was a primary theme revealed in the postintervention analysis of the
GROW focus group feedback. Gardening provides a purposeful activity that appears to promotes
social engagement. This purposeful activity may address a social disparity among older adults living
in low-income populations where social engagement and quality of social relations is a challenge
(Black & Rubinstein, 2000; Huguet et al., 2008).
When older adults relocate to senior housing, they typically lose their ability to garden, based
on limited gardening space and access to resources. For example, housing sites may restrict water
access, or implement policies regarding the use of outdoor space. The property management team
at the host site in this study embraced the concept of the intervention and supported the
implementation of the study. They actively encouraged participation and shared in the partici-
pants’ joy as the gardens sprouted and became ready to harvest. According to Grant and
Windeman (2007), factors such as the values and attitudes of organizational staff members can
promote or deter gardening among older adults in congregate housing. Because congregate
housing offers an environment to reinforce social benefits of gardening, these senior communities
present a unique opportunity to promote cognitive health among a vulnerable population; older
adults’ living conditions can impact cognitive health (IOM, 2015 & Grant & Winemann, 2007). It
is critical that staff members in these communities understand the significance of the environ-
ment on cognitive health outcomes.

Limitations
The sample size in this study is the most obvious limitation, yet participation was purposely limited
to 10 subjects to maintain the scope of a feasibility study. Narrow outcome measures are another
limitation. The MMSE, which is a global measure of cognition, is unlikely to detect minimal change
among otherwise healthy populations. Comprehensive measures such as the NIH Toolbox Cognition
Battery are more sensitive to cognitive change and more efficiently evaluate intervention goals
(Slotkin et al., 2015). Consistent and comprehensive cognitive measurements are necessary for
data pooling and harmonization (Griffith et al., 2015). In this study, funding limitations precluded
the use of the NIH Toolbox Cognition Battery. The MNA identifies malnourishment for older adults
(Kaiser et al., 2009), although GROW analyses did not include malnourishment scores. In this study,
individual nutrient variables representative of optimal nutrition were assessed to understand the
intervention’s impact. Validated nutrition assessment measures designed for well older adults are not
available; future studies should include the development and psychometric evaluation of a nutrition
assessment designed for well older adults.
 JOURNAL OF COMMUNITY HEALTH NURSING 123

Future research
Future research should examine the effects of GROW using a site-matched, randomized control
design adequately powered to detect cognitive changes in participants. Incorporating a nutrition and
food preservation curriculum, and greater choice of vegetable varieties should also be considered to
enhance the intervention. Additional measures should be collected and analyzed to determine
comprehensive health benefits associated with grow such as physical activity, social engagement,
purpose in life, and emotional well being.

Conclusion
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This feasibility study demonstrated that older adults who live in affordable senior housing sites are
able to independently plant, tend, harvest, and consume vegetables when provided adequate support
and resources. GROW improved participants’ nutrition and cognition. Older adults residing in these
environments often have financial and physical limitations that negatively impact their ability to
access fresh organic produce. This intervention eliminates accessibility and economic concerns while
promoting wellness behaviors such as nutrition, physical activity, social engagement, and cognitive
health. Future research is needed to more thoroughly understand how gardening improves health
among older adults living in congregate affordable housing.

Compliance with ethical standards

Funding: This study was funded by Dr. Thomas U. Cole Fund and the University of Maine Office of the Vice President
for Research and Bangor Green Drinks
Conflict of Interest: The authors declare that they have no conflict of interest.

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