Background

Stephanie Alexander Kitchen Garden (SAKG) Program was established with a vision to promote positive food habits among children. It is powered by small dedicated team of professionals who promote food education among school children. It is implemented in Victorian Schools in order to bring change in the attitude of the child, skills, knowledge and overall confidence in relation to cooking and gardening. In the domain of food, the SAKG program helps to increase the willingness of the children to try new foods and increase the innovation among the children to cook different nutritional food. In the domain of gardening, the SAKG program mainly promotes proper gardening activity and thereby helping to increase plantation of green leafy vegetables and plants in school lawn (Stephanie’s Alexander Kitchen Garden Foundation, 2018).

The main target group of Stephanie Alexander Garden Project (SAGP) are the school children. However, the main inequities of the SAKG program, though not inadvertent is mainly target the school children. According to De Leo et al. (2013), there is an increase in the tendency of suicide rates among the older adults residing in Australia. The psychological autopsy method that was used by De Leo et al. (2013) to investigate the underlying reasons behind high suicidal rates among older adults highlighted social isolation as the principal factors. Social isolation leads to mental health complications leading to the development and depression and overall decline in the health related quality of life. This in turn increases the suicidal rates of the older adults (De Leo et al., 2013). According to the Aged and Community Services Australia (2015) there is increase in the rate of social isolation among the older adults in Australia irrespective of their age and this social isolation cause loneliness which give rise of depression. The outcome of depression is lack of proper food intake (malnutrition) and impending chances of committing suicides.

Thus, the innovation of SAKG program will be to broaden the focus group and inclusion of the elderly population. The implementation of the program in the elderly population will be done is community level practice.

Figure: Gardening Area Availability in Victoria

From the image it can be seen that there are adequate gardening area in Victoria Australia.

Figure: The community based gardening in Victoria

The analysis of the images highlight that in spite of having adequate for gardening in the local or community based area in Victoria, mainly the young adults are middle aged adults participate in group gardening process.

Needs assessment description: SHOWeD technique

Thus it can be concluded that majority of the older adults do not take part in the socialization in the form of gardening in Victoria.

Thus the main problem is older adults are not engaged in community level activities and thus suffer from social isolation. This social isolation leads to depression and lack of proper intake of food.

Figure: A healthy family with children and gardening parents enjoying quality time outdoors in the garden

The main thing that can be done in order to increase the social isolation and poor mental and physical health condition of the older adults in Australia is increase in the community activity like gardening and cooking classes with groups. This will help to increase their social participation and at the same time will increase their intake of quality food. In cooking classes, they will come across healthy and easy to make recopies’ and this will help to increase the nutritional status and social interaction while cooking in groups. Doing community level gardening will help to increase their physical fitness and the same time will help to reduce social isolation (Wang & MacMillan, 2013).

The main aim of the new project is to increase the social participation of the older adults

• Increase in the social participation among older adults via devising community level gardening and cooking classes
• Increase the social participation of the older adults from the Aboriginal community via structure culturally competent community care plan like recruitment of Aboriginal professional as an instructor in the cooking or the gardening class

The success of the project will be ascertained post 6 months of the implementation of the program. The evaluation will mainly be based on open-ended questionnaire directed towards the participation (older adults) in community level activities (cooking and gardening). Apart from personal opinion the assessment of the nutritional level and mental health state will be done to get an overview of the quantitative output of the study.

Later photovoice approach will be used in order to assess the level of participation of the older adults in community programs.

According to Adams, Savahl and Fattore (2017) participatory techniques, photovoice and community mapping are used extensively in empirical studies. It is a process by which people identifies, represents and increases their community level understanding through the application of specific photographic technique. This approach mainly entrusts cameras over to the hands of people and thus helping them to act as records and potential catalysts for effective social action and change in their own communities. In this assignment, SHOWeD approach of photovoice was used to collect the data and while proposing plan for the health promotion. The same technique will also be used after the implementation of the plan in order to access its success.

Aim of the new project

Socio-ecological model (SEM) is a theory-based framework that is used to understanding the multifaceted and interactive effects of environmental and personal factors those determination specific behaviours. It also helps in the identification of the behavioural and organizational leverage points and intermediaries for effective health promotions. There are five nested hierarchical levels of SEM and these encompass individual, interpersonal, community, organizational and policy or enabling environment (Centers for Disease Control and Prevention, 2018).  

At the individual level, biological and the personal history factors are recorded of the target group in order to gain the knowledge about the increase in the likelihood of becoming the victim of the social isolation. The main factors which are taken into consideration include age, education, substance use, income and any relation to the past history of abuse. In the second level of the model, there is relationship. An unhealthy relationship increases the risk of experiencing violence either as perpetrator or as a victim. The closet circle of an individual like family members, peers and friends influence their behaviours and contributes of their experience (Centers for Disease Control and Prevention, 2018). Thus while selecting the focus group, effective inputs from the closed peers and the dimensions of the personal relationships will be taken into consideration. The third level is community. Community is an important consideration of this health promotional plan proposal. This is because, the proposal health promotion plan aims to explore the community level participation in influence the mental and physical health of the older adults. Information regarding neighborhoods and workplace settings will be taken into consideration (Centers for Disease Control and Prevention, 2018).

The main data collection methods is guided by the photovoice qualitative methodology and health behavioral model of SEM.

The main inputs that are required for the project how the older adults who are suffering from the social isolation will be encourage to take part in community programs like gardening and cooking classes. Additional inputs that are required to be undertaken include how the Aboriginal population will be encourage to take part in said health promotion program via overcoming the social stigma. Moreover, professional inputs are required to taken from the healthcare professionals in order to understand that whether taking part in gardening will increase their chances of accidental falls or gait performance. According to the occupational therapist, use of slip resistant floor, high traction shoes and walker/walking stick along with raised taps prevent the chances of accidental falls among the older adults while gardening (Bird et al., 2013). In cooking classes, the inputs will be taken from professional chefs and occupational therapists regarding whether the use of sharp instruments like knives can invite in threats (Tucker & Turner, 2013).

Methodology: Photovoice

The main target group is the older adults, both men and women who are aged above 65 years. The target group will also encompass the Aboriginal population. Apart from age, other factors that will be taken into consideration include the older adults who lives alone or is estranged from their life partners or whose children are settled out of the city due to professional reasons. This is because Steptoe et al. (2013) highlighted that older adults who live alone have higher chances of developing social isolation followed by depression.

Other stakeholders of this health promotion plan are listed below

Stakeholder	Rationale
The land community member	He or she will provide the land over which the community based gardening activity will be undertaken
Community health leaders like nurses	They will help encourage the older adults to take part in the health promotion program
Professional chefs	In order to guide the participants in the cooking class
Occupational therapists	For the risk assessment in the community level participation program
Professional gardening expert	Assisting the older adults in gardening
Activity-coordinators	To evaluate the overall process and its operation

Community based gardening program: outdoor program

Community based cooking classes: Indoor program

• Increase in the overall community level performance
• Decrease in social isolation
• Improvement of the quality health

The short terms effects of the increase in the community level participation of the older adults in the cooking class will be increase in the willingness to try new foods. This increase in the willingness will help to promote overall reduction of malnutrition among the older adults who live alone. This can be regarded as the long-term goals (Volkert, 2013). Other long-term effects will increase in the overall food choices along with overall increase the level of food literacy. Food literary holds prime importance for the Aboriginals and the Torres Strait Islanders. Increase in the overall food literacy will help to promote decrease in the health-related inequalities (Velardo, 2015). In gardening class, the short term goal is community engagement. In the long the term, there will be increase in the rate of physical activity which will help to increase the health-related quality of life and reducing the chances of accidental fall due to gait imbalance (Wang & MacMillan, 2013). Other long-term goal of the overall health promotion plan will be increase in the enjoyment and confidence in life and this will help to promote proper mental health and well-being.

Will be done via photovoice via taking pictures to highlight the community participation

Increase in the participation of the older adults both from the indigenous and non-indigenous help to reduce the social stigma among the Aboriginals and at the same time will increase the health literacy among the Aboriginals. Overall this approach will help to reduce the socio-economic health inequality. Under the cultural context it can be said that exchange of the recipes of different culture from different group of participants will promote cultural awareness. Taking part with the Aboriginal participants in community health settings will further promote cultural competence among non-indigenous population. The inequity in the policy will be reduced as the target population is vast and is not solely restricted to children and school based programs (Walker, Schultz & Sonn, 2014).

Staffing	Employment Fraction	Rationale
Community health nurse	1 per 10 participants	To increase the community level participation and increase health literacy
Aboriginal nurses	1 per 10 participants	Design the cultural plan in a culturally competent manner
Occupational therapists	1 per 10 participants	To prevent accidental fall prevention
Professional Chefs	1 per 10 participants	To train the participants in cooking class
Professional gardening experts	1 per 10 participants	To train the participants in gardening and increasing knowing and participation in gardening
Healthcare professionals	1 per 10 participants	Period health condition check-up in order to avoid sudden emergency

Professionals or Items	Cost
Community health nurse	70$ per day
Aboriginal nurses	60$ per day
Occupational therapists	50$ per day
Professional Chefs	40$ per day
Professional gardening experts	40$ per day
Healthcare professionals	80$ per day
Land for gardening	30$ per day
Equipments for cooking	10$ per day
Equipments for gardening	10$ per day
Total cost per day	390$ per day

Task	Month 1	Month 2	Month3	Month4	Month5
Taking grant
Raising fund
Recruiting professionals
Collecting equipments and renting land
Enrolling participants
Implementation

References

Adams, S., Savahl, S., & Fattore, T. (2017). Children’s representations of nature using photovoice and community mapping: perspectives from South Africa. International journal of qualitative studies on health and well-being, 12(1), 1333900.

Aged and Community Services Australia. (2015). Social Isolation And Loneliness Among Older Australians. Access date: 27^th September 2018. Retrieved from: https://www.acsa.asn.au/getattachment/Publications-Submissions/Social-Isolation-and-Loneliness/1015-Social-Isolation-and-Loneliness-Paper.pdf.aspx?lang=en-AU 

Bird, M. L., Pittaway, J., Cuisick, I., Rattray, M., & Ahuja, K. (2013). Age-related changes in physical fall risk factors: results from a 3 year follow-up of community dwelling older adults in Tasmania, Australia. International journal of environmental research and public health, 10(11), 5989-5997.

Centers for Disease Control and Prevention. (2018). The Social-Ecological Model: A Framework for Prevention. Access date: 27^th September 2018. Retrieved from: https://www.cdc.gov/violenceprevention/overview/social-ecologicalmodel.html 

De Leo, D., Draper, B. M., Snowdon, J., & Kõlves, K. (2013). Suicides in older adults: A case–control psychological autopsy study in Australia. Journal of Psychiatric Research, 47(7), 980-988.

Stephanie’s Alexander Kitchen Garden Foundation. (2018). About Us. Access date: 27^th September 2018. Retrieved from: https://www.kitchengardenfoundation.org.au/content/about-us

Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences, 110(15), 5797-5801.

Tucker, S., & Turner, N. (2013). Waiting for safety: Responses by young Canadian workers to unsafe work. Journal of safety research, 45, 103-110.

Velardo, S. (2015). The nuances of health literacy, nutrition literacy, and food literacy. Journal of Nutrition Education and Behavior, 47(4), 385-389.

Volkert, D. (2013). Malnutrition in older adults-urgent need for action: a plea for improving the nutritional situation of older adults. Gerontology, 59(4), 328-333.

Walker, R., Schultz, C., & Sonn, C. (2014). Cultural competence–Transforming policy, services, programs and practice. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice, 195-220.

Wang, D., & MacMillan, T. (2013). The benefits of gardening for older adults: a systematic review of the literature. Activities, Adaptation & Aging, 37(2), 153-181.