HOPE Works

The University of North Carolina

at Chapel Hill Center for Health Promotion and Disease Prevention

Funded by the Centers for

Disease Control and Prevention

HOPE Works Team (UNC)

• Marci K. Campbell, PhD, MPH, RD (PI)• Salli Benedict, MPH, Project

Coordinator• Margaret Bentley, PhD• Brenda DeVellis, PhD• Kristine Kelsey, PhD• Chantelle Fisher-Borne, MPH

Community Advisory Committee and Community Staff (*)

• Priscilla Allen• David Barnes• *Katie Barnes, Chair• Annie Blue• *Tabatha Brewer• Sharon Brown• Consuela Combs• Darlene Leysath Dixon• *Anne Doolen• Pamela Gonzalez

• Addie Hall• *Barbara Harris• Katherine Hernandez• Judy Johnson-Truitt• Donna Kelly• Elizabeth Maynor• *Pastor Patricia Peterson,

Co-Chair• *Lily Pool• *Imani Rivera• Delphine Smith

The evolution of the Health Works projects: from participation to empowerment

Health Works for Women (HWW) 1993-1998

• Work-site health promotion project focusing on individual risk factors such as diet and exercise as well as strengthening of social support networks

• Works sites included nine textile, apparel, and light manufacturing companies in Eastern North Carolina

• Project employed traditional research methods, as well as formative research methods

The evolution of the Health Works projects: from participation to empowerment

Health Works for Women/Health Works in the Community (HWW/HWC) 1998-2003

• Scope of the project expanded to address organizational and community factors that impact health and well-being

• Community Advisory Committee (CAC), consisting of workplace representatives, local agencies, advocacy groups, established to provide guidance and feedback

• Plant closings and lay-offs occurred in the course of project implementation

The evolution of the Health Works projects: from participation to empowerment

Health Works After the Flood (HWATF)2000-2003

• In the wake of devastation wrought by Hurricane Floyd in 1999, CAC members and UNC initiated a project with CDC support to address stress and IPV in the months following the flooding

• Composition of the CAC changes to include more community members, domestic violence and mental health agencies, more leadership rather than advice

The evolution of the Health Works: from participation to empowerment

Women’s Empowerment Days (2002)• Events planned and implemented by CAC members

in response to community concerns about the economic downturn and the need for grassroots development and empowerment efforts

• First formal linkage between health and economic issues

• Process evaluation: women want education and jobs

HOPE Works 2004-2009

Health: obesity prevention, healthy eating, physical activity, stress management; mental health

Opportunities: education, work, economic improvement

Partnerships: community resources, community colleges, support from other women

Empowerment: to make healthy life choices

“Poverty is hazardous to women’s health”The link between health and poverty

• Considerable micro-level research suggests a strong relationship between individual health and income (i.e. poverty leads to lower health status)

• Important findings include:– Income level is a more important predictor of health

status than income change– Income level has a greater impact on the health status

of poor than high-income individuals– Extended periods of time in poverty have a greater

and more negative impact on health than occasional episodes of poverty

Phipps, S.

Loss of traditional industries in eastern NC

• The manufacturing industry in the United States has experienced extensive economic restructuring in the past 30 years, primarily affecting rural areas in the Southeast.

• Between 1997 and 2002, North Carolina lost 100,000 jobs in the textile industry and 70,000 jobs in the apparel industry.

Hossfeld L, Legerton M, Keuster G. Kalishman J, Stogner S, Ramey J.

HOPE Works

• Builds on previous 10 years of experience and community relationships

• CBPR project, active participation of CAC in all phases of planning

• Addresses high prevalence of obesity and community concern about this issue

• …and addresses social determinants of health, including education, employment, and income

HOPE Works

• Expands to larger community, not just workplaces

• Retain women’s health focus

• Address link between health and hope

• Goal setting and empowerment focus

• Uses principles and models from developing countries: micro-enterprise and loan circles

HOPE Works Intervention

HOPE Circles:• Low income, overweight women, multi-ethnic:

African American, Latina, American Indian (Coharie) and Anglo

• Circles led by trained facilitators from the community

• Provide social support, information, strategies for health behavior change

• Goal-setting in health and hope domains (e.g. getting education, jobs, housing, etc)

HOPE Works Intervention

• Tailored newsletters (6) that address both health and hope-related issues and goals

• Planning and participating in community-wide events (kickoffs, health fairs, advocacy)

Evaluation

--Randomized trial of 250 women in HOPE circles vs. 250 comparison women• Individual change in weight, diet, PA, hope, self-

efficacy, social support, community involvement, social capital, psychological and economic well-being

--Comparison of HOPE Works counties with neighboring counties via RDD surveys• Health behaviors, awareness, community

involvement, social capital, hope

--Cortisol sub-study on stress and weight

Seeds of HOPE

• Spin-off of HOPE Works

• Specifically addresses economic development/empowerment

• CDC provided funds for developing a strategic plan

• 2-day Seeds of HOPE Conference in Sampson and Duplin Counties July 2005

Seeds of HOPE Goal: to create a sustainable model

• Born of growing interest in the importance of economic empowerment to women’s health and community development

• Opportunities, training, education, resources for enhancing economic empowerment and community wealth

• Community-led partnership w/UNC, CDC, business and entrepreneurial organizations: one-year participatory strategic planning process

Seeds of HOPE Partners

• UNC (Jim Johnson, Anita Brown Graham, Jesse White)

• Community (community colleges, economic development agencies)

• Good Work

• NC Rural Center

Seeds of HOPE Strategic Plan Goals

• Start a business that will serve as an example of an exemplary worker-owned business

• Increase financial education across all HOPE Works activities

• Increase networking with organizations that support entrepreneurial activities

Threads of HOPE: Creation of a

Woman-owned Business

The Seeds of HOPE strategic plan: to create Threads of HOPE

Build on skills of unemployed textile/apparel workers

Unique design or product to reflect HOPE Works values, place and culture

Collaboration with NCSU College of Design and Penelope Bags

Threads of HOPE Goals

• Training for low income women in every aspect of running a business

• Worker owned• Living wage• Health benefits• Health promoting business/HOPE Circles• Leadership development• Opportunity to pursue educational goals

                                                                                                                   

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Threads of HOPE Activities

• Consultant: Lori Eichel

• Site visits to NCSU School of Textile and College of Design

• Student fashion show

• “Secret Shopper” marketing trip

• Meeting with Duplin County sewing business owner

                                                                                                                   

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Next steps

• Develop a business plan (Good Work)

• School of Design student competition

• Community meetings with design student

Mohamed Yunus,Grameen Bank Founcer

2006 Nobel Peace Prize Lecture“A human being is born into this world fully equipped not only to take care of him or herself, but also to contribute to enlarging the well being of the world as a whole. Some get the chance to explore their potential to some degree, but many others never get any opportunity, during their lifetime, to unwrap the wonderful gift they were born with.” Threads of HOPE may provide that opportunity.