Family model diabetes self-management education and support in faith-based organizations in the republic of the Marshall Islands study protocol

McElfish, Pearl A.; Boyers, Janine; Purvis, Rachel S.; O'Connor, Betsy; Carleton, Ayoola; Bing, Williamina Ioanna; Rowland, Brett; Molgaard, Craig A.; George, Ainrik; Tibon, Lydia R.; Hoose, Dalton; Riklon, Sheldon

doi:10.1016/j.conctc.2021.100710

Cited by 6 publications

(8 citation statements)

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“…This paper explored external relationships (organizational and individual) as barriers and facilitators for equitable community-based implementation of a COVID-19 vaccination intervention leveraging FBOs to reach underserved and hard-to-reach Hispanic and Marshallese communities. Engagement with FBOs to promote health equity and mitigate health disparities among Hispanic and/or Marshallese communities is described in detail in prior publications ( 41 , 49 , 57 – 60 ). Importantly, vaccination events held in partnership with FBOs reached a higher proportion of Hispanic and Marshallese persons compared to vaccination events in secular, community contexts, and individuals vaccinated at these events were more likely to report completely trusting the COVID-19 vaccine ( 49 ).…”

Section: Discussionmentioning

confidence: 99%

External relationships as implementation determinants in community-engaged, equity-focused COVID-19 vaccination events

Moore,

Callaghan-Koru,

Vincenzo

et al. 2024

Front. Health Serv.

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BackgroundWhile relationships and connectedness among organizations have been included in implementation theories, models, and frameworks, the increased attention to health equity in implementation science raises the urgency of understanding the role of relationships external to the implementing organization. This paper addresses this gap through an exploration of the role of external relationships in community-based, equity-focused interventions.MethodsThis study focuses on an equity-focused, community-based COVID-19 vaccination intervention in Arkansas, drawing upon long-term community-engaged relationships among University of Arkansas for Medical Sciences and the Hispanic and Marshallese Islander communities. We used an exploratory qualitative descriptive design to examine barriers and facilitators to implementation of COVID-19 vaccination events analyzing in-depth qualitative interviews with implementation team members (n = 17).ResultsAll participants described pre-existing relationships among the implementing organization, partner organizations, and communities as a key implementation determinant for this equity-focused program. At the inter-organizational level, external relationships included formal connections and informal relationships among staff (e.g., communication channels from prior partnerships). At the individual level, strong external relationships with the community were facilitators leveraging long-term engagement, community familiarity, and staff from the communities of focus. Strong external relationships facilitated program reach in underserved communities through three mechanisms: (1) reduced time required to establish functional working relationships among partners; (2) accessibility and cultural congruence of health services; and (3) increased trust among community members. Barriers to implementation also existed in external relationships, but had less influence than facilitators.ConclusionsAchieving health equity in implementation science requires greater understanding of external relationships as implementation determinants. This exploratory study makes a significant contribution to the literature by describing the types of external relationships that facilitate equitable implementation and identifying the mechanisms through which they may work. We argue that approaches to community engagement drawn from community-engaged research approaches may be useful, as these processes require investment in building/maintaining formal and informal organizational and interpersonal relationships. Further research is needed to understand connections among external relationships and other implementation determinants.

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Section: Discussionmentioning

confidence: 99%

External relationships as implementation determinants in community-engaged, equity-focused COVID-19 vaccination events

Moore,

Callaghan-Koru,

Vincenzo

et al. 2024

Front. Health Serv.

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“…All materials and the study protocol were adapted from the materials developed as part of the Arkansas F-DSMES randomized controlled trial (RCT) (University of Arkansas for Medical Sciences [UAMS] Institutional Review Board [IRB] #203482) (Clinical Trial #NCT02407132) [ 24 ]. The pilot study was reviewed and approved by the UAMS IRB (#239272) and by the RMI Ministry of Health & Human Services [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

“…Of a total sample of 97, 41 participants had T2DM, and 56 family members agreed to participate. Further details on the study, including study design, recruitment, consent, inclusion and exclusion criteria, and intervention dosage, are available in prior publications [ 13 , 27 , 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…Research staff collected biometric data, including HbA1c, blood pressure, weight, and height measurements. HbA1c was collected via finger stick blood collection and point-of-care analyzer (Siemens DCA Vantage Analyzer) [ 27 ]. While the participant was seated, a research assistant used an OMRON digital blood pressure monitor to measure systolic and diastolic blood pressure.…”

Section: Methodsmentioning

confidence: 99%

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Lessons learned from the pilot family model of diabetes self-management intervention in the Republic of the Marshall Islands

Andersen¹,

Purvis²,

Scott³

et al. 2023

Contemporary Clinical Trials Communications

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“…12 At the request of the Marshallese Consulate General and the Marshallese Ministry of Health and Human Services, the community-based partnerships in Arkansas have been extended to the RMI. 13 Most of the research that has informed interventions to prevent and treat T2DM among Pacific Islanders and Marshallese has taken place in the US, and little is known about the health of Marshallese in the RMI. Given the disparate rates of T2DM in the RMI, it is important to gather information on the health profiles of both Marshallese diagnosed with T2DM and those who have not been diagnosed with T2DM.…”

Section: Introductionmentioning

confidence: 99%

Health Profiles of Marshallese With and Without a Type 2 Diabetes Diagnosis in the Republic of the Marshall Islands

Andersen,

Felix,

Malhis

et al. 2023

Clin Med Insights Endocrinol Diabetes

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Background: The Republic of the Marshall Islands (RMI) faces a high prevalence of type 2 diabetes (T2DM). Objectives: The aim of the study is to document the health of Marshallese with and without a T2DM diagnosis to inform future interventions. Design: Data are from screenings collected in preparation for a diabetes education intervention. Data, including HbA1c, random glucose, cholesterol, weight, and self-rated health, were collected. Methods: Kruskal-Wallis and Fisher’s exact tests were used to identify differences in participants with and without T2DM diagnosis. Results: There were significant differences in both HbA1c level ( P ⩽ .0001) and glucose level ( P ⩽ .0001) between the diagnosed T2DM and non-diagnosed T2DM groups, as well as diastolic blood pressure ( P = .0179), systolic blood pressure ( P = .0003), and pulse pressure ( P = .0023). There were no differences in weight, body mass index (BMI), high density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol, or self-rated health. Marshallese without a T2DM diagnosis have signs of insulin resistance, including elevated glucose and triglyceride levels. Conclusion: The results indicate a need for a socioecological approach to T2DM interventions, and interventions in the RMI should consider inclusion of blood pressure and cholesterol management. There is a need for interventions to prevent prediabetes and its progression to T2DM.

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Family model diabetes self-management education and support in faith-based organizations in the republic of the Marshall Islands study protocol

Cited by 6 publications

References 51 publications

External relationships as implementation determinants in community-engaged, equity-focused COVID-19 vaccination events

External relationships as implementation determinants in community-engaged, equity-focused COVID-19 vaccination events

Lessons learned from the pilot family model of diabetes self-management intervention in the Republic of the Marshall Islands

Health Profiles of Marshallese With and Without a Type 2 Diabetes Diagnosis in the Republic of the Marshall Islands

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