HJAR Jul/Aug 2019

Healthcare Journal of ARKANSAS I  JUL / AUG 2019 33 For weekly eNews updates and to read the journal online, visit HealthcareJournalAR.com stipend for their work. “It’s very important to NYITCOM that we fos- ter interests in science in young people,” said Rajendram Rajnarayanan, PhD., assistant dean of Research at NYITCOM at A-State. “We cre- ated the SHARE program to give students very practical, hands-on learning opportunities that will be extremely beneficial and enjoyable for the participants.” To participate in SHARE, the student must be an Arkansas high school junior or senior during the 2019-20 school year and must be recognized as economically disadvantaged. Preference will be given to students whose maximum family income does not exceed 200 percent of the current fed- eral poverty guidelines based on family size.  To receive an application, please email Dr. Rajnarayanan at  rrajnara@nyit.edu .  The SHARE program is funded by American Chemical Soci- ety #ProjectSEED, NYITCOM at A-State, Arkan- sas Biosciences Institute and Community Health Centers of Arkansas, Inc. (CHCA). At the end of the summer, some of the SHARE program participants will be eligible to apply for a college scholarship from the American Chemical Society, and some of them will enter the INTEL/ Regeneron Science Competitions facilitated by a grant funded by Society for Science & the Public. For more information, contact Casey Pearce of NYITCOM at A-State at (870) 882-9954 or  cpearce@nyit.edu .  UAMS Uses Culturally UniqueMethods to Improve Diabetes Management Researchers at the University of Arkansas for Medical Sciences (UAMS) have demonstrated that a culturally adapted family model of diabe- tes self-management is an effective approach for Marshallese community members in Northwest Arkansas to manage diabetes. A recently published study by researchers at the UAMS Northwest Regional Campus showed that by using cultural concepts familiar to Marshal- lese people with diabetes, researchers recorded significant improvements in their levels of blood sugar. Multiple studies have found diabetes self- management education (DSME) to be generally effective at improving patients’ diabetes-related health outcomes. However, previous DSME inter- ventions with Marshallese community members have been unsuccessful. The researchers hypothesized that emphasiz- ing family and community as a part of diabetes self-management would be more effective with members of the Marshallese population, who come from a Pacific Islander culture that empha- sizes the importance of family and community in day-to-day life. To test this hypothesis, the researchers recruited 221 Marshallese people with diabetes and com- pared a standard DSME with a culturally adapted DSME. Changes to the curriculum included pre- senting the material in Marshallese rather than using an interpreter; using culturally appropriate nature analogies, such as tidal changes, to explain changes in glucose concentrations; integrating culturally relevant food preferences, such as fish and fruit; and emphasizing engagement of par- ticipants’ family members. As a result, participants in the adapted DSME group showed significantly greater reductions (-0.77 percent units) in mean glycated hemoglo- bin 12 months after the intervention compared with those in the standard DSME group. Gly- cated hemoglobin tests reflect a person’s aver- age blood sugar level over the past two to three months. The higher your HbA1c level, the poorer your blood sugar control and the higher your risk of diabetes complications. “This study adds to the body of research that shows the effectiveness of including partici- pants’ family and community members as part of a diabetes self-management plan,” said Pearl McElfish, PhD, vice chancellor of the UAMS Northwest Regional Campus and co-director of the Center for Pacific Islander Health at UAMS. “This study also fills several important gaps in the literature. Pacific Islanders are a rapidly growing population that experiences significant health dis- parities, but they have been underrepresented in research. We plan to change that.” Health care providers have worked for years to help control the extremely high rates of type 2 diabetes found in the Marshallese population. Estimates of type 2 diabetes among Marshallese adults range from 20–40 percent, compared with 12 percent among the U.S. adult population and 9 percent among the worldwide adult population. In Northwest Arkansas, type 2 diabetes among Marshallese adults is at 38.4 percent and predia- betes is at 32.6 percent. Arkansas has the largest population of Marshallese in the continental U.S. (10,000 residents as of 2016). “These research results are likely to have pos- itive clinical implications for diabetes self-man- agement, including reduced risks of heart attack, microvascular complications and death from dia- betes,” said Peter O. Kohler, MD, former vice chancellor for the UAMS Northwest Regional Campus and a distinguished professor in the UAMS College of Medicine’s Department of Inter- nal Medicine. “We are excited about the prom- ising implications this study has for patient deci- sion-making and clinical practice.” The study was conducted from May of 2015 to May of 2018 in Washington and Benton Counties in Northwest Arkansas. Both DSME interventions covered eight core topics: healthy eating, being active, glucose monitoring, understanding blood glucose and taking medications, problem solv- ing, reducing risks and healthy coping, mitigat- ing complications of diabetes, and goal setting. “Marshallese culture centers around family and community,” said Sheldon Riklon, MD, an associ- ate professor in the UAMS College of Medicine’s Department of Family and Preventive Medicine and one of only two Marshallese physicians in the world who were trained at a U.S.-accredited pro- gram. “So it is extremely important to engage the entire family and community in behavioral changes. The family approach is particularly important for the family-centered, collectivist nature of the Pacific Islander culture.” Financial support for the study was provided by the Patient-Centered Outcomes Research Insti- tute (grant no. AD-1310-07159). Initial funding for a pilot project of the study was provided by a Uni- versity of Arkansas for Medical Sciences College of Medicine Intramural Sturgis Grant for Diabetes Research from the Sturgis Foundation. Additional support for the community-based participatory research team was provided by the Translational Research Institute grant 1U54TR001629-01A1 through the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH). The content is solely the respon- sibility of the authors and does not necessarily represent the official views of the NIH.