Vegetable Gardening is Associated with Greater Produce Intake in Women Attending an

OB-Gyn Clinic in Rural Appalachian Ohio

ALEXANDRIA HARRELL1,2, SUMALI HEWAGE1,2, ALEXANDER SERGEEV, MD, PHD1,3, JODY G. ZUCHOWSKI, DO4, ANGELA HAMILTON1,2, DAVID H. HOLBEN, PHD, RDN, LD1,2. OHIO
UNIVERSITY, 1COLLEGE OF HEALTH SCIENCES AND PROFESSIONS, 2SCHOOL OF APPLIED HEALTH SCIENCES AND WELLNESS, 3DEPARTMENT OF SOCIAL AND PUBLIC HEALTH,
4HERITAGE COLLEGE OF MEDICINE, ATHENS, OHIO.

ABSTRACT

INTRODUCTION

BACKGROUND: Prevalence of cervical cancer is higher in

Appalachian Ohio, compared to other regions, and adequate
produce intake may decrease risk of both HPV infection and
cervical dysplasia. Yet, studies are limited.
RESEARCH OUTCOME: This study examined household
adult food security (HAFS), gardening habits, and produce intake
of women living in rural Appalachian Ohio and attending an OBGyn clinic.
METHODS: Survey of females 21 years [USDA HFS module,
gardening behaviors]. HAFS was calculated using standardized
methods. A dichotomous variable was also calculated for HAFS
[food secure (high HAFS); any indication of food insecurity
(marginal, low, or very low HAFS)]. Pearson Chi-squared test
was used to assess for differences in gardening between HAFS
groups. Independent Samples t-test was used to assess for
differences in produce intake between gardeners/non-gardeners.
RESULTS: Participants (n=153) were 298 years. They
(n=150) primarily lived in food secure homes (n=113, 75.3%),
although 37 (24.7%) lived in homes characterized by marginal,
low, or very low HAFS. 57/151 (37.7%) gardened vegetables,
and 46/150 (30.7%) gardened fruit. Vegetable gardeners,
compared to non-vegetable gardeners, consumed more vegetable
(2.51.2 vs. 1.91.0; p=.003) and total produce (4.82.1 vs.
3.81.8; p=.003) servings daily, but fruit intake did not differ
(p=.074). Gardening fruit had no impact on produce intake
between groups (p>.05). Gardening habits did not differ by
HAFS status (p>.05).
CONCLUSIONS: Female vegetable gardeners living in rural
Appalachian Ohio and attending an OB-Gyn clinic consume
more vegetable and total produce daily, compared to nonvegetable gardeners. Teaching gardening principles may
encourage improved produce intake among women. Further
exploration of gardening interventions to improve dietary habits
is needed in rural Appalachia.

Template design only copyright 2008 Ohio University Media Production 740.597-2521 Spring Quarter

STUDY OBJECTIVES
This study examined household adult food security (HAFS),
gardening habits, and produce intake of women living in rural
Appalachian Ohio and attending an OB-Gyn clinic.

LEARNING OUTCOME
After this presentation, the learner will be able to describe the
household food security, gardening habits, and produce intake of
adult women living in rural Appalachian Ohio and attending an OBGyn clinic.

In 2011, 14.9 percent of households in the United States experienced food

insecurity at least some time during the same year (1).
In the rural Appalachian region of Ohio, food insecurity rates appear to be
remarkably high (2).
Diets low in fruits and vegetables have been identified as a probable risk
factor for high incidence and mortality rates for cervical cancer in the
Appalachian region (3).
Frequent produce intake high in antioxidants possibly can reduce the risk
of cervical dysplasia (4).
Evidence supports that there is a relationship between low fruit and
vegetable consumption and increased risk of cervical cancer among low
income women (5).
In rural Appalachian Ohio, having a garden can decrease the likelihood of
food insecurity within households with young children (6).
Eating homegrown produce improves total produce intake and the quality
of that intake among rural parents and their preschool children (7).
The CDC has identified gardening as a strategy to increase the
consumption of produce (8).

METHODS
SUBJECTS
The Institutional Review Board (IRB) at Ohio University, Athens,
Ohio approved this study prior to the collection of any data.
Subjects were females who were English speaking and writing, 21
years and older, and attending River Rose OB/Gyn health clinic for
cervical screening/testing (includes Pap test, HPV test, and/or
colposcopy) enrolled in this pilot study during February and March,
2013.
The participants (n=153) completed a survey and gave permission to
view their results of the cervical screening/testing (Pap, HPV, and/or
colposcopy).
SURVEY
The survey included the following validated measures:
U.S. Household 10-item Food Security Survey Module to
measure the level of household food security status (9);
13-item Tool to Assess Psychosocial Indicators of Fruit and
Vegetable Intake in Low Income Communities (10);
7-item Food Behavior Checklist for a Limited Resource
Audience (11); and
The Community Awareness Resources and Education (CARE)
Risky Sexual Behavior Index (12).
STATISTICAL ANALYSIS
Data were tabulated and analyses were computed using the SPSS
version 18 (SPSS: An IBM Company, Chicago, IL) software.
t-tests were used to determine differences between groups for FS and
produce intake/behaviors.
A p < 0.05 was used for statistical significance.

DISCUSSION/CONCLUSIONS

RESULTS

Age: 298 years

Participant characteristics (Race) :
White/Non-Hispanic, 94.1% (n=144)
Participant characteristics (Highest Level of Education):
Some College or Higher, 86.8% (n=132)
Tables 1-4 summarize food security status, food security and gardening
habits, vegetable gardening and produce intake, and fruit gardening and
vegetable intake, respectively.

Table 1. Household and Adult Food Security Status of Adult Women

Attending an OB-Gyn Clinic in Rural Appalachian Ohio.
Food Secure
Food Insecure
(Fully Food
(Any Indication of Food Insecurity)
Secure)
High Food Marginal Food Low Food Very Low Food
Security
Security
Security
Security
75.3%
10.7%
10.0%
4.0%
(n = 113)
(n = 16)
(n = 15)
(n=6)

Food
Security
Category
Percent
(n)

Table 2. Food Security and Gardening Habits.

Vegetable Gardening

Fruit Gardening

Gc

NGd

p-value

NG

p-value

FSa

44
(78.6%)

68
(73.1%)

0.456

33
(73.3%)

79
(76.7%)

0.661

FIb

12
(21.4%)

25
(26.9%)

12
(26.6%)

24
(23.3%)

a Fully Food Secure

c Gardener

b Not Fully Food Secure

d Non-Gardener

VGa

NVGb

p-value

Vegetable Intake

2.5 1.2

1.9 1.0

.003

Fruit Intake

2.2 1.2

1.9 1.0

.074

Total Produce Intake

4.8 2.1

3.8 1.8

.003

b Non-Vegetable Gardeners

Table 4. Fruit Gardening and Produce Intake.

FGa

NFGb

p-value

Vegetable Intake

2.3 1.1

2.1 1.2

.272

Fruit Intake

2.1 1.0

2.0 1.1

.805

Total Produce Intake

4.4 1.7

4.1 2.0

.342

a Fruit Gardeners

b Non-Fruit Gardeners

Gardening did not vary by food security status.

Produce intake among women in rural Appalachian Ohio was greater
among those who gardened their own vegetables.
There was no significant difference in total produce intake between
women who gardened fruit and those who did not garden fruit.
Teaching gardening principles may encourage improved produce intake
among women. Further exploration of gardening interventions to
improve dietary habits is needed in rural Appalachia.

REFERENCES
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ACKNOWLEDGEMENTS
Funding for this study was provided by the Appalachian Rural Health Institute, Ohio University, Athens, Ohio.
Poster funding was provided by the College of Health Sciences and Professions and School of Applied Health
Sciences and Wellness, Ohio University, Athens, Ohio.

Table 3. Vegetable Gardening and Produce Intake.

a Vegetable Gardeners