Abstract
BACKGROUND: Gardening initiatives may help address modifiable risk factors for cancer and chronic disease among children and youth by fostering more supportive and equitable environments for health. However, the extent to which these initiatives have been intentionally designed to address the social determinants of health and promote health equity remains unclear. The purpose of this review is to identify whether equity-related factors have been considered in gardening initiatives for children and youth, and to explore any reported equity-related effects. METHODS: A rapid review was conducted in March 2024 across multiple electronic databases. Peer-reviewed studies from the past ten years focusing on gardening initiatives in schools, daycares, or community settings within high-income countries were included. Articles underwent dual screening, and one reviewer independently conducted quality appraisal. Equity-related data were extracted using the PROGRESS-Plus framework and synthesized narratively. RESULTS: Studies most frequently incorporated social capital, age/grade level, and socioeconomic status in gardening initiatives. Social capital was commonly associated with improved social connections and relationships among children and their parents, peers, and teachers. It was also linked to the transfer of food-related knowledge and skills to the home environment and contributed to the perceived success and sustainability of initiatives. These outcomes are relevant to reducing modifiable risk factors for cancer and chronic disease. However, barriers such as transportation and time constraints limited parent involvement. Few studies systematically evaluated outcomes or impacts in relation to equity-related factors. CONCLUSIONS: Gardening initiatives that foster social capital - through engagement with parents, peers, and family members, and school-community partnerships - may support positive health-related outcomes for children and youth, including those relevant to cancer and chronic disease prevention. However, to enhance their potential to reduce inequities in health outcomes, these initiatives should be developed, implemented, and evaluated with explicit attention to equity-related factors. Rigorous, equity-focused evaluation is needed to assess the extent and nature of equity-related effects and to strengthen the evidence base for gardening as a strategy to reduce disparities in cancer and chronic disease risk among children and youth. TRIAL REGISTRATION: N/A.