Project Objectives

• Aim 1: Assess community and organization characteristics among potential adopter groups including churches, faith-based networks, and community organizations, and identify stakeholder characteristics, institutional resources, and barriers and facilitators to dissemination and implementation.
• Aim 2: Use formative research to adapt the HOPE Works intervention strategies and materials for dissemination via organizational partners, including recruitment methods, data collection, Circle curricula/manuals, and tailored messages.
• Aim 3: Evaluate, in a randomized trial, the effect of Seeds of HOPE, when disseminated to a broader and more diverse group of participants, on primary outcome measures of weight loss and hope among participating women compared to a delayed intervention comparison condition;
• Aim 4: Evaluate secondary outcomes including health behaviors (fruit and vegetable consumption, physical activity), psychosocial factors (self-efficacy, positive affect, depressive symptoms, social support, social capital), and socioeconomic factors (education, income, employment, micro-business participation).
• Aim 5: Assess implementation and process factors associated with dissemination at the organization and community levels using the RE-AIM framework, evaluating intervention reach, adoption, implementation, and maintenance.
• Aim 6: Use the Center for Health Promotion and Disease Prevention’s Center of Excellence for Training and Research Translation (Center TRT) web-based dissemination tools and work with Lineberger Cancer Center Dissemination Core to disseminate Seeds of HOPE tested products and strategies to other NC counties, state health departments and Prevention Research Centers.

Project Description

Obesity and poor health exist in the context of social and economic determinants. Evidence-based strategies based on community participatory methods are urgently needed to combat this serious health issue. The purpose of this project is to implement and evaluate the dissemination of HOPE (Health, Opportunities, Partnerships, Empowerment) Works, an innovative weight management and economic development program designed for low-income women in rural eastern North Carolina. The conceptual framework for HOPE Works, based on the CDC’s Guide to Community Health, recognizes the complex and multi-factorial context of social, environmental, and economic factors that influence health issues such as obesity. The HOPE Works intervention is grounded in community based participatory research (CBPR) and uses an adaptation of a third world development model, the Grameen Bank Model of Muhammad Yunus. This model blends a system of mutually supportive microenterprise/financial literacy education with circle meetings of women to foster collaborative goal setting and support addressing both economic and health-related problems. In this case, the health goals of healthy eating, physical activity, and weight management are addressed in combination with the participants’ “hope” goals such as furthering education, job skills training, financial literacy, and starting businesses. The circle concept also builds on the American Indian tradition of Talking Circles, still used by many tribes to encourage “speaking and listening from the heart”. Women also receive monthly individually tailored newsletters to support their health behavior change and goal setting needs and priorities.

Funding

Source: Centers for Disease Control and Prevention

Dates of funding: September 2009-September 2014

Key Contacts

Lori Carter-Edwards, Project Investigator
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Phone: (919) 966-6034

Katie Barnes, Project Director
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Phone: (919) 843-6611

www.threadsofhopenc.org

Publications

Benedict S, Campbell M, Doolen A, Rivera I, Negussie T, Turner-McGrievy G. Seeds of HOPE: A Model for Addressing Social and Economic Determinants of Health in a Women's Obesity Prevention Project in Two Rural Communities. J Womens Health (Larchmt). Oct 2007;16(8):1117-1124.