Environmental and Toxicology Studies Journal

HOPE Works was an innovative, community-based participatory research (CBPR) intervention aimed at addressing health promotion and obesity in the context of social determinants for obese, low-income and minority rural North Carolina women. This study incorporated multiple social health determinants, including hope, which assesses participants’ abilities to set and achieve goals to reach desired health and life changes.Community Coordinators identified women to serve as HOPE Circle Leaders who received training and recruited women from their social networks. Thirty-four Circles met bi-weekly for 6 months following a manual-based curriculum and received tailored newsletters addressing health and economic literacy. Comparison women were drawn from the same communities. The primary outcome was weight loss. Secondary outcomes were moderate and vigorous physical activity (MVPA), fruit and vegetable (F&V) consumption, and hope. Outcomes were analyzed using the completer cohort and intent-to-treat (ITT), controlling for baseline weight, socioeconomic variables, and Circle cluster effects. Results: A total of 485 women (73% of baseline sample) completed both baseline and follow-up surveys (208 intervention; 277 comparison)