The GHK program used community gardens as a vehicle for providing low-income families that are raising young children access to information about proper nutrition and healthy eating. The project also provided these families an opportunity to work with their children to grow fresh vegetables for their families. Some of the vegetables and fruits grown include lettuce, spinach, Swiss chard, potatoes, peppers, squash, cucumbers, onion, strawberries, melons, roselle, lemongrass, hot peppers (various), beets, carrots, cilantro, mint, basil, sweet potatoes, pumpkins, gourds, and peas. Between Spring 2008 and Spring 2009, three community gardens were established. All three gardens were located in Carrboro NC (at an elementary school, a community park, and land owned by a utility company), and served families from surrounding communities within Orange County. The GHK program included five components, as follows.
Weekly gardening work sessions
From April through November of each of the three program years (2008, 2009, and 2010), each community garden held established hours every week when the gardens were open and staff were present to assist families with preparing, planting, tending, and harvesting their gardens. During these weekly work sessions, the families learned specific gardening skills, such as soil preparation, proper planting and watering methods, and weeding. Work sessions also gave families the opportunity to practice gardening skills. All tools and materials were provided to families. Of the 60 participating families, 27 (45%) participated every week in the work sessions; 27 (45%) participated two to three times per month; and 4 (7%) participated once a month or less. For two families (3%), no attendance data were reported.
Cooking and nutrition workshops
North Carolina Cooperative Extension staff conducted a 7-week cooking and nutrition workshop series for all families, including both parents and children, participating in the GHK project. During the 2010 growing season, the cooking and nutrition workshops were offered in Spanish and specifically targeted toward the Hispanic families in the GHK program. The workshops also provided families and their children with useful information and resources related to making healthy food choices. All participants completed postworkshop session evaluations.
Nine of the 25 Hispanic mothers/families (36%) participated in the Expanded Food and Nutrition Education Program (EFNEP) conducted by the North Carolina Cooperative Extension. Six cooking classes were conducted between May 1, 2010, and June 12, 2010, on Saturdays. NC Cooperative Extension staff taught all classes in Spanish. Seven of the nine mothers (77.8%) participated in all six classes; one mother participated in five classes; and one mother participated in four classes.
Social activities and events
Additional activities were planned to further emphasize the community nature of the project. Many community gardens utilize these types of activities to build and maintain interest in the garden and foster interaction between garden members. Several of these activities coincided with data collection dates and brought the families together in an easy-to-access location as they met with the project data collection staff. During the course of each program year, three to four additional activities and events were planned for participating families.
Activities focused on the inclusion of the whole family participating in seasonal potluck dinners (with food made from garden ingredients using healthy recipes that were in many cases developed by the gardeners); garden community meetings to discuss the progress being made in the garden and troubleshoot any issues arising in the gardens; scarecrow making; birdhouse building; and pumpkin carving at the local farmers' market. A garden newsletter published in Spanish and English further emphasized the work of the gardeners and highlighted healthy recipes, common garden/growing issues, and included a children's section. Initially project staff planned the events but with the growth of the gardener advisory group, the families began to take much more responsibility for organizing the events, especially the potluck community meetings where more and more information was exchanged as the project progressed.
Study Design and Data Collection
The program centered on three primary goals related to preventing obesity and promoting healthy eating in young children. First, the program sought to help children achieve or maintain a healthy body weight for their age and height. To measure the achievement of this program goal, the height, weight, date of birth, and gender of each child was recorded at the time that their family began participating in the GHK program. Also, post-program height and weight information was collected and recorded for each child to determine change in child's BMI classification over the program period.
Based on these measures, each child's BMI was calculated and classified using the CDC growth charts for children and the CDC's BMI classification categories. Children aged 2–5 years with a BMI-for-age ≥95th percentile were classified as obese; children between the 85th and 94th percentile were classified as overweight. A final change in BMI classification was determined based on each child's beginning BMI classification and his or her last recorded BMI classification.
A second goal of the GHK program was to increase the number of fresh, frozen, and canned fruits and vegetables that children had access to, particularly in their homes. Providing access can increase the likelihood of children's consumption of fruits and vegetables. To measure the change in children's access to fruits and vegetables at home over the period of time their families participated in the GHK program, data were collected from parents using surveys administered at baseline and again at the end of each year the family participated in the program.
The survey was designed after an agency-wide planning process that included focus groups with families. Feedback was received from the agency's community garden advisory committee. Also, the instrument was used with Latino families prior to this project. For each participating family, a primary parent was identified and asked to complete all surveys on behalf of the family. At each survey administration, the primary parents were asked to name all the fresh, frozen, and canned fruits that were currently available in their homes. The number of unique fruits identified by the primary parents at each survey administration was counted and recorded. Similarly, but separately, the primary parents were also asked to name all the fresh, frozen, and canned vegetables currently available in their homes. The numbers of unique vegetables identified at each administration of the surveys were also counted and recorded.
The change in the availability of fruits in the children's homes was calculated as the difference between the total number of fruits named at baseline and at the last survey administration. In addition, both the absolute change and the relative change in the number of fruits available to children in their homes over the period of time their families participated in the GHK program were calculated.
A third goal of the GHK program was to increase the number of servings of fresh, frozen, and canned fruits and vegetables the children ate each day. To measure the change in children's average daily consumption of fresh, frozen, and canned fruits and vegetables over the period of time their families participated in the GHK program, data were again collected from parents using surveys administered at baseline and at the end of each year the family participated. Each family identified a primary parent to complete all surveys.
At each survey administration, the primary parents were asked: On a typical weekday, how many servings of fruit does your child eat? (Include fresh, frozen, dried, and canned fruit and 100% fruit juice. Don't include flavored drinks or snacks. Count servings your child may get both at daycare or preschool and at home.) The number of servings of fruits identified by the primary parents at each survey administration was counted and recorded. Similarly, but separately, the primary parents were also asked: On a typical weekday, how many servings of vegetables does your child eat? (Include fresh, frozen, and canned vegetables. Don't include french fries. Count servings your child may get both at daycare or preschool and at home.) The number of servings of vegetables identified at each administration of the surveys was also counted and recorded.
The change in children's consumption of fresh, frozen, and canned fruits in their homes was calculated by subtracting the total number of servings of fruits identified by the primary parent at baseline from the total number of servings identified at the last (for that family) survey administration. In addition to the absolute change in number of servings of fruits eaten by the children during a typical weekday during the time their families participated, the relative change was calculated by dividing the post-program number of servings of fruits by the pre-program number of servings of fruits and multiplying by 100. For example, if the parent named four fruits in the home when the family joined the program and seven fruits in the home at their final survey, the absolute change in fruit availability would be recorded as +3, and the relative change as +175%. This process was repeated to determine the change in availability of fresh, frozen, and canned vegetables in the home from pre- to post-program.
Data were collected across three growing seasons—2008, 2009, and 2010—and were analyzed throughout the duration of the study for progress monitoring purposes. The final analyses were conducted in early 2011 after the last data collection period in Fall 2010.