UArizona Nursing Professor Selected as Recipient of 2023 Sensor Seed Grant to Test Gardening Intervention for Cancer Survivors

Sept. 12, 2022

University of Arizona College of Nursing Assistant Professor Meghan Skiba, PhD, MS, MPH, RDN, has been selected as the recipient of a $50,000 Sensor Seed Grant. As the study’s principal investigator, Dr. Skiba will pilot test an evidenced based mentored gardening intervention for cancer survivors that will be active from August 2022 through June 2023. The pilot is adapted for Arizona through a research project titled “Feasibility of Integrating UV Sensors and Just-in-Time Feedback in a Mentored Community Vegetable Gardening Intervention for Melanoma Patients.”

“Being the recipient of the 2023 Sensor Lab Seed Grant is sensational!” Dr. Skiba says. “This grant provides the opportunity to expand wearable technologies into community engaged research for cancer survivors in a unique way and brings together an interdisciplinary team of experts.”

Dr. Skiba’s co-investigators on the grant are Delaney Stratton, PhD, DNP, FNP-BC from the UArizona Cancer Center, and Caitlyn Hall, PhD, B.S., M.S. of UArizona Biosystems Engineering. The researchers will partner with Community Gardens of Tucson, the University of Arizona Cooperative Extension Master Gardeners, Banner Dermatology, Clinica Amistad, and the Skin Cancer Institute. They will also work closely with the Sensor Lab to bring in a wearable technology to University of Arizona researchers from Shade, a company that develops UV dosimeters and a mHealth app that provides data on UV exposure.

This grant provides the opportunity to expand wearable technologies into community engaged research for cancer survivors in a unique way and brings together an interdisciplinary team of experts," ~ Meghan Skiba, PhD, MS, MPH, RDN

What was the inspiration for this new intervention?

Gardening has been shown to promote cancer preventive behaviors for cancer survivors and melanoma is a cancer control priority in Arizona.  This intervention was inspired by the uniqueness of our area, including the arid southwest environment, five distinct growing seasons, the needs and limited resources for melanoma survivors, and expansive Cooperative Extension office and community gardens across the state that show promise for scaling the intervention. Prior to submitting this grant, stakeholders were engaged to adapt an existing evidence-based intervention, Harvest for Health, in a meaningful way to build capacity and sustainability. Adapting and testing, prior to dissemination and implementation, of existing effective interventions to meet the needs of diverse populations prevents us from redundancy in research.

Meghan Skiba, PhD, MS, MPH, RDN

What will the structure of the intervention be?

Harvest for Health Together Arizona (H4H2-AZ) is an adapted multimodal mentored community garden intervention. Thirty diverse melanoma patients will be recruited to participate in a six-month intervention to grow two seasonal vegetable gardens. Participants will be matched to a ‘near peer’ Master Gardener and provided with a lease for a shared garden plot through the Community Gardens of Tucson with necessary gardening supplies including seeds and sun protection. Following a five-module handbook custom designed for H4H2-AZ, participants will work together with their Master Gardener to prepare, plant, harvest, and preserve their garden. Additionally, Master Gardeners will deliver workshops that align with module content. The innovation of this intervention comes from collecting real-time UV exposure and providing feedback to participants while in the garden. Diet, physical activity, and quality of life will be measured before and after the intervention.

What is particularly important about the research you’ll be undertaking?

This is the first study designed to improve supportive cancer care by integrating melanoma patients with existing community gardening networks in Pima County and includes wearable UV sensors and just-in-time feedback to evaluate impact on cancer preventive health behaviors -- including diet, physical activity, energy balance, and UV protection. Our findings from this study will provide important feasibility and acceptability data to inform future large-scale interventions. This work will also show the benefits of application of sensor technologies in behavioral interventions to provide objective outcome data on modifiable health behaviors.

Tell us more about the wearable technology that will be in the works with the help of Shade.

We will be integrating wearable UV sensors, or dosimeters, to monitor and provide just-in-time feedback of UV exposure to participants aiming to reduce sunburns and improve sun-protective behaviors.  The reusable UV sensors are made by Shade and come with a complementary mobile app where participants can securely share their data with us as well as see their cumulative and instantaneous UV exposure. This sensor technology has been previously used at the University of Arizona but we will be among the first to integrate it in a behavioral intervention for melanoma patients.

How did you gather your partners for this project?

The partners on this project are community leaders and experts already doing important work in our community and we hope this intervention will elevate it. The partnerships were built from conversations with members of the UACC Skin Cancer Institute, UArizona Cooperative Extension, and original H4H investigators. Dr. Delaney Stratton is a cutaneous oncology nurse practitioner brings important clinical perspective and partnerships and Dr. Hall brings in key stakeholders for environmental sustainability. In particular, Parker Filer, an extension agent with the Cooperative Extension has been a key player establishing the community connections necessary for the intervention’s success. Parker has assisted with engaging the Community Gardens of Tucson as well as the Pima County Master Gardeners.

How do you hope the results of this research improve cancer preventive health behaviors among melanoma survivors?

UV exposure is the primary modifiable risk factor for melanoma, but melanoma is also an obesity related cancer; survivors of which may benefit from adhering to current cancer prevention guidelines. H4H2-AZ promotes cancer preventive health behaviors and emphasizes sun safety, which is often absent in gardening interventions but is important for melanoma prevention and survivorship. Currently, there are limited active supportive lifestyle interventions for melanoma patients in Arizona, which makes our multiple health behavior approach fill a current need in the population. H4H has previously shown improvements in vegetable intake and physical health for cancer survivors, and we anticipate similar findings from H4H2-AZ

Can you share any details about the larger extramural grant application you’re planning for next year?

We will build on the partnerships established from this pilot and will also engage the Arizona Melanoma Task Force in scaling the intervention. H4H2-AZ is intervening on multiple levels, including the intrapersonal, interpersonal, community, and organizational, therefore we will be submitting a grant to further study optimization of the delivery of H4H2-AZ and distal outcomes, expanding the program across all AZ counties. Findings from this intervention will provide preliminary data to support an extramural grant application that has been a work in progress as part of my participation as a fellow in the 2022 cohort of the National Cancer Institute’s Multilevel Intervention Training Institute.

Big picture, where do you hope this work will lead?

We anticipate that this work will lead to sustainable connections between clinics and community to promote the health of cancer survivors and their families in Arizona. The big picture is a collage of individuals gardening in their neighborhoods and building networks of support to reduce melanoma incidence and mortality.

Learn more about Dr. Skiba’s project by visiting the Healthy Harvesters program page.