Obesity and other health risks are often influenced by social and economic factors. In parts of rural North Carolina, the loss of manufacturing plants and tobacco farming has contributed to a growing unemployment rate, poverty, stress, and a lack of hope among many residents. Addressing these environmental factors can help advance health promotion efforts.
Researchers are implementing and evaluating the dissemination of HOPE Works, a stress management, obesity prevention, and economic development program designed for women in rural eastern North Carolina (Sampson, Duplin, Robeson, and Lenoir counties). The dissemination project, Seeds of HOPE, addresses the need to reduce obesity and recognizes the context of economic and social factors that may affect weight control. An expanded model addresses health-related goals (healthy eating, physical activity, and weight management) as well as hope-related goals (such as education, job skills training, financial literacy, and business development). Seeds of HOPE’s emphasis on grassroots economic improvement responds to the community’s expressed need for economic stability as a basis for health.
Participants are recruited from local community organizations in each of the program’s four participating counties. Each organization completes surveys about its leadership, membership, and readiness to adopt the program; is matched, based on these characteristics, to a similar organization; and is assigned to an early intervention or delayed intervention (six months later) group. The intervention consists of meetings, or Talking Circles, led by women trained as Circle Leaders. The Talking Circles are based on an American Indian tradition that encourages “speaking and listening from the heart.” Together, the circle members set goals and build skills. Topics include resume preparation and salary negotiation; banking services and checking accounts; and loans and how they work.
Researchers assess whether participants’ increases in weight loss, healthy eating, physical activity, education, and income in the early intervention group are greater than for women who have not yet received the intervention. Measures of program impact, such as sustainability, are also being monitored. If Seeds of HOPE is successful, the researchers plan to disseminate the program’s most effective components to other areas.