Marjolein Elings

THE DEVELOPMENT OF GREEN CARE IN WESTERN EUROPEAN COUNTRIES

This article represents a review of green care across Western European countries. The following questions are addressed: What is green care, and what are its basic goals? What are the most commonly known types of green care interventions, and how are they connected to each other? There are different sectors of green care intervention that vary from each other regarding their structure, specific goals, and purpose. These traits will be investigated in this review. And lastly, how these interventions are designed and their approach to promote and provide health will be examined.

Care farms in the Netherlands: attractive empowerment-oriented and strengths-based practices in the community.

Empowerment-oriented and strengths-based practices focusing on community integration have gained recognition for various client groups in recent decades. This paper discusses whether care farms in the Netherlands are relevant examples of such practices. We identify characteristics associated with care farms that are relevant for three different client groups: clients with severe mental health problems, clients from youth care backgrounds, and frail elderly clients. We interviewed 41 clients, 33 care farmers, and 27 health professionals. The study shows that care farms are experienced as unique services because of a combination of different types of characteristic qualities: the personal and involved attitude of the farmer, a safe community, useful and diverse activities, and a green environment. This leads to an informal context that is close to normal life. We found no essential differences in the assessment of characteristics between different client groups and between clients, farmers, and health professionals. Care farms can be considered as an innovative example of community-based services that can improve the quality of life of clients.

People-plant interaction: the physiological, psychological and sociological effects of plants on people

This paper reports the results of a literature study into the effects of plants on human wellbeing. Different studies from various countries show that there are many different settings in which humans interact with plants. Some of these settings have a therapeutic aim, others do not. This paper demonstrates that various target groups can benefit from working with plants. Little is known, however, about the mechanisms behind horticultural therapy while the evidence is weak due to the methodological limitations of the studies

FARMING FOR HEALTH IN THE NETHERLANDS

The development of green care farms is described in this chapter, followed by other examples of farming for health in the urban areas. Some interesting projects and the main challenges are discussed

Understanding the impacts of care farms on health and well-being of disadvantaged populations: a protocol of the Evaluating Community Orders (ECO) pilot study

Introduction Care farms, where all or part of the farm is used for therapeutic purposes, show much potential for improving the health and well-being of a range of disadvantaged groups. Studies to date have been qualitative or observational, with limited empirical evidence of the effectiveness of care farms in improving health and well-being. Understanding the underlying mechanisms that lead to improvements for different disadvantaged groups is a further gap in the evidence. Participants in this study are offenders serving community orders. Their low socioeconomic status and poor health outcomes relative to the general population exemplifies disadvantage. Methods and analysis This paper describes the protocol of a study to understand the impacts of care farms and to pilot the design and tools for a study to assess cost-effectiveness of care farms in improving the quality of life of offenders. As a pilot study, no power calculation has been conducted. However, 150 offenders serving community sentences on care farms and 150 on other probation locations (eg, litter picking, painting) will be recruited over a 1-year period. Changes in quality of life, measured by Clinical Outcome in Routine Evaluation–Outcome Measure, health and reconvictions of offenders at care farms compared to other probation locations will be analysed to inform the sample size calculation for the follow on study. The feasibility of recruitment, retention, collecting cost data and modelling cost-effectiveness will also be assessed. The study will use qualitative methods to explore the experiences of offenders attending care farms and perceptions of probation and care farm staff on the processes and impacts of the intervention. Ethics and dissemination Findings will be published and inform development of a natural experiment and will be disseminated to probation services, care farms and academics. University of Leeds Ethical Review Board approved: SoMREC/13/014. National Offender Management Service (NOMS) approved: 2013-257.

Assessing the impact of care farms on quality of life and offending: a pilot study among probation service users in England

Objectives To assess the feasibility of conducting a cost-effectiveness study of using care farms (CFs) to improve quality of life and reduce reoffending among offenders undertaking community orders (COs). To pilot questionnaires to assess quality of life, connection to nature, lifestyle behaviours, health and social-care use. To assess recruitment and retention at 6 months and feasibility of data linkage to Police National Computer (PNC) reconvictions data and data held by probation services. Design Pilot study using questionnaires to assess quality of life, individually linked to police and probation data. Setting The pilot study was conducted in three probation service regions in England. Each site included a CF and at least one comparator CO project. CFs are working farms used with a range of clients, including offenders, for therapeutic purposes. The three CFs included one aquaponics and horticulture social enterprise, a religious charity focusing on horticulture and a family-run cattle farm. Comparator projects included sorting secondhand clothes and activities to address alcohol misuse and anger management. Participants We recruited 134 adults (over 18) serving COs in England, 29% female. Results 52% of participants completed follow-up questionnaires. Privatisation of UK probation trusts in 2014 negatively impacted on recruitment and retention. Linkage to PNC data was a more successful means of follow-up, with 90% consenting to access their probation and PNC data. Collection of health and social-care costs and quality-adjusted life year derivation were feasible. Propensity score adjustment provided a viable comparison method despite differences between comparators. We found worse health and higher reoffending risk among CF participants due to allocation of challenging offenders to CFs, making risk of reoffending a confounder. Conclusions Recruitment would be feasible in a more stable probation environment. Follow-up was challenging; however, assessing reconvictions from PNC data is feasible and a potential primary outcome for future studies.

Exploring the Role of Farm Animals in Providing Care at Care Farms

Simple Summary This paper provides insight into the role of farm animals in farm-based programs and their importance to different types of participants. Farm animals provide real work, close relationships, challenging tasks and opportunities for reflection. They also contribute to a welcoming atmosphere for various types of participants. Abstract We explore the role of farm animals in providing care to different types of participants at care farms (e.g., youngsters with behavioural problems, people with severe mental problems and people with dementia). Care farms provide alternative and promising settings where people can interact with animals compared to a therapeutic healthcare setting. We performed a literature review, conducted focus group meetings and carried out secondary data-analysis of qualitative studies involving care farmers and different types of participants. We found that farm animals are important to many participants and have a large number of potential benefits. They can (i) provide meaningful day occupation; (ii) generate valued relationships; (iii) help people master tasks; (iv) provide opportunities for reciprocity; (v) can distract people from them problems; (vi) provide relaxation; (vii) facilitate customized care; (viii) facilitate relationships with other people; (ix) stimulate healthy behavior; (x) contribute to a welcoming environment; (xi) make it possible to experience basic elements of life; and (xii) provide opportunities for reflection and feedback. This shows the multi-facetted importance of interacting with animals on care farms. In this study the types of activities with animals and their value to different types of participants varied. Farm animals are an important element of the care farm environment that can address the care needs of different types of participants.