Background The Pacific Islander population in the United States is growing rapidly. However, research on Pacific Islanders in the US is limited, or sometimes misleading due to aggregation with Asian Americans. This project seeks to add to the dearth of health literature by conducting a health assessment of Marshallese in northwest Arkansas. Methods Using a community-based participatory research approach, nine health screening events were conducted at local Marshallese churches. Participants completed the Behavioral Risk Factors Surveillance Survey core questionnaire and diabetes module if applicable. Biometric data, including Hemoglobin A1c, blood pressure, and body mass index, was gathered by an interprofessional team. Results 401 participants completed health screenings. High proportions of diabetes, obesity, and hypertension were found. A high percentage of participants were uninsured, and multiple barriers to health care were found within the sample. Discussion This project represents one of the first broad health assessments of Pacific Islanders in the US. Proportions of diabetes, hypertension, obesity, and uninsured found in the sample are much higher than national proportions.

The program had to be flexible enough to meet the educational requirements and class schedules of the different health professions' education programs. The target community spoke limited English, so providing interpretation services using bilingual Marshallese community health workers was integral to the program's success.

Marshallese adults experience high rates of type 2 diabetes. Previous diabetes selfmanagement education (DSME) interventions among Marshallese were unsuccessful. This study compared the extent to which two DSME interventions improved glycemic control, measured on the basis of change in glycated hemoglobin (HbA 1c). RESEARCH DESIGN AND METHODS A two-arm randomized controlled trial compared a standard-model DSME (standard DSME) with a culturally adapted family-model DSME (adapted DSME). Marshallese adults with type 2 diabetes (n = 221) received either standard DSME in a community setting (n = 111) or adapted DSME in a home setting (n = 110). Outcome measures were assessed at baseline, immediately after the intervention, and at 6 and 12 months after the intervention and were examined with adjusted linear mixed-effects regression models. RESULTS Participants in the adapted DSME arm showed significantly greater declines in mean HbA 1c immediately (20.61% [95% CI 21.19, 20.03]; P = 0.038) and 12 months (20.77% [95% CI 21.38, 20.17]; P = 0.013) after the intervention than those in the standard DSME arm. Within the adapted DSME arm, participants had significant reductions in mean HbA 1c from baseline to immediately after the intervention (21.18% [95% CI 21.55, 20.81]), to 6 months (20.67% [95% CI 21.06, 20.28]), and to 12 months (20.87% [95% CI 21.28, 20.46]) (P < 0.001 for all). Participants in the standard DSME arm had significant reductions in mean HbA 1c from baseline to immediately after the intervention (20.55% [95% CI 20.93, 20.17]; P = 0.005). CONCLUSIONS Participants receiving the adapted DSME showed significantly greater reductions in mean HbA 1c immediately after and 12 months after the intervention than the reductions among those receiving standard DSME. This study adds to the body of research that shows the potential effectiveness of culturally adapted DSME that includes participants' family members.

Food pantries serve millions of Americans, yet the nutritional quality of foods distributed has been poor. Policy, systems, and environmental (PSE) changes were implemented in 3 food pantries in northwest Arkansas with the aims of improving the nutritional quality of foods distributed and increasing distribution of fresh fruits and vegetables (FFVs). Between pre-intervention and 1 year follow-up, food pantry bag audits showed increases from 20,256.38 to 25,108.46 calories distributed per household (P = .009) and 0.22 to 3.33 servings of FFVs distributed per person per household (P < .001). Findings highlight the promise of pantry-level PSE interventions.

Purpose and ObjectivesThe Centers for Disease Control and Prevention’s Sodium Reduction in Communities Program (SRCP) aims to reduce dietary sodium intake through policy, systems, and environmental approaches. The objective of this study was to evaluate and document the progress of the first year of a 5-year SRCP project in northwest Arkansas.Intervention ApproachIn collaboration with 30 partner schools and 5 partner community meals programs, we sought to reduce dietary sodium intake through increased implementation of 1) food service guidelines, 2) procurement practices, 3) food preparation practices, and 4) environmental strategies.Evaluation MethodsWe collected daily menus, information on nutritional content of meals, and procurement records and counted the number of people served in partnering schools and community meals programs. We used a pretest–posttest quantitative evaluation design to analyze changes in the sodium content of meals from baseline to Year 1 follow-up.ResultsFrom baseline to Year 1 follow-up, participating schools lowered the mean sodium content served per lunch diner from 1,103 mg to 980 mg (−11.2%). The schools also reduced the mean sodium content of entrées offered (ie, entrées listed on the menu) from 674 mg to 625 mg (−7.3%) and entrées served from 615 mg to 589 mg (−4.2%). From baseline to follow-up, participating community meals programs reduced the mean sodium content of meals offered (ie, meals listed on the menu) from 1,710 mg to 1,053 mg (−38.4%). The community meals programs reduced the mean sodium content of meals served from 1,509 mg to 1,258 mg (−16.6%).Implications for Public HealthIn both venues, our evaluation findings showed reductions in sodium served during the 1-year evaluation period. These results highlight the potential effectiveness of sodium reduction interventions focused on food service guidelines, procurement practices, food preparation practices, and environmental strategies for schools and community meals programs.