Sustainability via Active Garden Education: The Sustainability Action Plan Model and Process

Int J Environ Res Public Health. 2022 May 1;19(9):5511. doi: 10.3390/ijerph19095511.


Sustainability of intervention programming is challenging to achieve under real world conditions, since few models exist and many studies do not plan far beyond the funding period. Programming content in early care and education centers (ECECs) is often driven by guidelines. However, implementation is very sensitive to contextual factors, such as the setting and implementer (teacher) characteristics. This paper presents the model, definitions, and methodology used for the sustainability action plan capitalizing on a community-based participatory research (CBPR) approach, developed for a multi-site, multi-level garden-based childhood obesity prevention study, Sustainability via Active Garden Education (SAGE). The Ecologic Model of Obesity is applied to develop a sustainability action plan (SAP) and accompanying measures to link early care and education (ECE) environment, the community, policies, and classroom practices to an early childhood obesity prevention program. The SAGE SAP provides an example of how to iteratively evaluate and refine sustainability processes for an obesity prevention intervention utilizing CBPR approaches and will be applied to assess the sustainability of SAGE in a cluster randomized controlled trial. This SAP model can also help inform intervention delivery and scalability within ECECs.

Keywords: children; community; diet; early care and education; intervention study; organization; physical activity.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child, Preschool
  • Community-Based Participatory Research
  • Gardening / education
  • Gardens*
  • Health Promotion / methods
  • Humans
  • Pediatric Obesity* / prevention & control
  • Problem-Based Learning

Grants and funding

This research was supported by the National Institutes of Health through the National Institute on Minority Health and Health Disparities cooperative agreement 5U01MD010667-03 awarded to Rebecca E. Lee, the National Institute of Nursing Research grant F31 NR017560 awarded to Elizabeth Lorenzo, the National Cancer Institute/NIH Grant—National Cancer Institute/NIH Grant T32/CA057712 awarded to the University of Texas Health Science Center at Houston School of Public Health Cancer Education and Career Development Program. Partial funding by the Michael & Susan Dell Center for Healthy Living for Jacob Szeszulski, the Jonas Scholar Nurse Leader 2016–2018 Cohort awarded to Elizabeth Lorenzo, and a dissertation completion fellowship awarded by Arizona State University’s Graduate College to Jacob Szeszulski. Teresia M. O’Connor receives support by the United States Department of Agriculture/Agricultural Research Service (USDA/ARS) [cooperative agreement 58-3092-0-001]. The contents of this work are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or USDA. None of the funding agencies played any role in the design, data collection, analysis, interpretation or reporting of data from this study.