Half an Ocean Away: Health in the US-Affiliated Pacific Islands

Carlin, Margaret F.; Mendoza-Walters, Alison; Ensign, Karl

doi:10.1097/phh.0000000000000467

Cited by 8 publications

(11 citation statements)

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“…Overall, the reaction to the F-DSMES intervention was positive; participants felt the classes and resources were helpful and informative for themselves and their family members. However, a lack of transportation to and from the intervention site may have constrained participants’ ability to attend multiple class sessions and data collection events [ 50 , 51 ]. In addition, the intervention was held in the RMI during an important and controversial election and an outbreak of Dengue Fever, which may have limited attendance and participation in classes and post-intervention data collection [ [51] , [52] , [53] ].…”

Section: Discussionmentioning

confidence: 99%

“…However, a lack of transportation to and from the intervention site may have constrained participants’ ability to attend multiple class sessions and data collection events [ 50 , 51 ]. In addition, the intervention was held in the RMI during an important and controversial election and an outbreak of Dengue Fever, which may have limited attendance and participation in classes and post-intervention data collection [ [51] , [52] , [53] ]. Future research should attempt qualitative interviews with those who do not attend classes or post-intervention data collection and work to address the availability of transportation that may limit full participation in the F-DSMES intervention.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility and efficacy of a pilot family model of diabetes self-management intervention in the Republic of the Marshall Islands

Andersen

Felix

Selig

et al. 2021

Contemporary Clinical Trials Communications

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Background The Republic of the Marshall Islands (RMI) faces numerous health disparities, including one of the highest prevalence of type 2 diabetes mellitus (T2DM) in the world. Diabetes self-management education and support (DSMES) has shown efficacy in improving glycemic control and through increases in knowledge and self-management activities; however, there is limited research on DSMES in the RMI. This study evaluated the feasibility and efficacy of a culturally adapted family model of DSMES (F-DSMES) in the RMI. The F-DSME included 8 h of group educational classes delivered in churches by a community health worker. Methods This pilot study assessed retention and dosage rates (e.g., class attendance) among the participants with T2DM (n = 41). Efficacy was evaluated by examining pre- and post-intervention differences in HbA1c, knowledge, family support, and self-management activities among those who completed the post-intervention data collection (n = 23). Results The results indicate completion of post-intervention data collection and attendance were associated; 70% of participants who completed the post-intervention data collection received at least 6 h of intervention compared to 3 h for those who did not. Although the reduction in HbA1c was not statistically significant, participants demonstrated statically significant increases in knowledge, family support, and an increase in self-management including in checking of blood glucose and feet. Conclusions This study provides important information to help address T2DM disparities in the RMI, including the feasibility and efficacy of F-DSMES. Additional research will help in understanding how to translate improvements in knowledge, family support, and self-management activities into improvements in HbA1c. This may include addressing social ecological factors that affect glycemic control.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Feasibility and efficacy of a pilot family model of diabetes self-management intervention in the Republic of the Marshall Islands

Andersen

Felix

Selig

et al. 2021

Contemporary Clinical Trials Communications

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“…They are also at greater risk of end-stage renal disease and myocardial infarction as a result of uncontrolled diabetes [ 4 , 5 ]. In the US territory of American Samoa, the most recently available national survey data reports a diabetes prevalence of 47.3% [95% CI: 44.0–50.7] among adults [ 6 ], far exceeding the prevalence in any other US state or territory 1 and placing a catastrophic burden on a poorly resourced health system [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Protocol: Implementation and evaluation of an adolescent-mediated intervention to improve glycemic control and diabetes self-management among Samoan adults

et al. 2023

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Background Diagnoses of Type 2 Diabetes in the United States have more than doubled in the last two decades. One minority group at disproportionate risk are Pacific Islanders who face numerous barriers to prevention and self-care. To address the need for prevention and treatment in this group, and building on the family-centered culture, we will pilot test an adolescent-mediated intervention designed to improve the glycemic control and self-care practices of a paired adult family member with diagnosed diabetes. Methods We will conduct a randomized controlled trial in American Samoa among n = 160 dyads (adolescent without diabetes, adult with diabetes). Adolescents will receive either a six-month diabetes intervention or a leadership and life skills-focused control curriculum. Aside from research assessments we will have no contact with the adults in the dyad who will proceed with their usual care. To test our hypothesis that adolescents will be effective conduits of diabetes knowledge and will support their paired adult in the adoption of self-care strategies, our primary efficacy outcomes will be adult glycemic control and cardiovascular risk factors (BMI, blood pressure, waist circumference). Secondarily, since we believe exposure to the intervention may encourage positive behavior change in the adolescent themselves, we will measure the same outcomes in adolescents. Outcomes will be measured at baseline, after active intervention (six months post-randomization) and at 12-months post-randomization to examine maintenance effects. To determine potential for sustainability and scale up, we will examine intervention acceptability, feasibility, fidelity, reach, and cost. Discussion This study will explore Samoan adolescents’ ability to act as agents of familial health behavior change. Intervention success would produce a scalable program with potential for replication in other family-centered ethnic minority groups across the US who are the ideal beneficiaries of innovations to reduce chronic disease risk and eliminate health disparities.

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“…These are the Republic of the Marshall Islands (RMI), the Federated States of Micronesia (FSM), and the Republic of Palau, collectively known as Compact nations or the FAS. 3…”

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confidence: 99%

Strategies to Operationalize Health Equity in Island Area Health Departments

Ensign

Wheatley²,

Alexander³

et al. 2023

Journal of Public Health Management and Practice

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A previous column presented the Association of State and Territorial Health Officials' (ASTHO's) overarching health equity technical package, which is a resource describing priority interventions for implementation within state health departments and by extension territorial, rural, and local health departments. 1 This column furthers the specification of a technical package developed for ASTHO's engagement with island jurisdictions, necessitated by important cultural and contextual nuances and differences, including both strengths and challenges. This technical package, along with other frameworks and logic models ASTHO is developing, will help ensure our engagement with island jurisdictions is of the highest quality and relevance, aimed at successfully impacting health outcomes. Island Representation Within ASTHO's MembershipASTHO is the only national nonprofit organization representing the nation's 59 chief health officials, the agencies they lead, and the more than 100 000 public health professionals these agencies employ. 2 ASTHO members formulate and influence sound public health policy and ensure excellence in state-and island-based public health practice. ASTHO's mission is to support, equip, and advocate for state and territorial health officials in their work of advancing the public's

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Half an Ocean Away: Health in the US-Affiliated Pacific Islands

Cited by 8 publications

References 0 publications

Feasibility and efficacy of a pilot family model of diabetes self-management intervention in the Republic of the Marshall Islands

Feasibility and efficacy of a pilot family model of diabetes self-management intervention in the Republic of the Marshall Islands

Protocol: Implementation and evaluation of an adolescent-mediated intervention to improve glycemic control and diabetes self-management among Samoan adults

Strategies to Operationalize Health Equity in Island Area Health Departments

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