OBJECTIVES: To determine the feasibility of a resident physician-based, culturally appropriate method of decreasing the disease burden of Type 2 Diabetes Mellitus (DM2) in a group of Pacific Islanders, Marshallese living in Hawai'i. METHODS: Thirty one Marshallese with diabetes who live on the island of Oahu, Hawaii were recruited. Baseline health status of the participants was characterized. Health parameters included HgbA1c, random blood sugar (RBS), lipid panels, body mass index (BMI), blood pressure, and medical history, along with qualitative information. A focus group was held with participants prior to beginning the curriculum to determine cultural views on diabetes, health, treatment, and to identify potential obstacles to health improvement. A DM2 educational curriculum culturally relevant to Marshallese populations was then started, including instruction in lifestyle modification, adherence to medication regimens, and planned quarterly assessment of health improvement. RESULTS: Baseline quantitative analysis revealed Marshallese with diabetes to be obese and hyperglycemic, with average BMI of 30 kg/m(2), RBS of 285, and HgbA1c of 9.3. Qualitative analysis revealed that nearly half the participants admitted to symptoms of severe hyperglycemia. The initial focus group had a substantial turnout. Attendance rapidly declined, becoming so low that classes were eventually terminated. However, in two participants who attended more than three classes there was evidence of major improvements in HgbA1c, cholesterol, and qualitative markers, which were sustained after one year. CONCLUSIONS: This pilot study of Marshallese with diabetes on Oahu showed that the majority had poor glycemic control with secondary co-morbid conditions. Although many barriers exist for successful implementation of a diabetes health improvement project in this group, the groundwork for translation of this project to the Republic of Marshall Islands (RMI) has been laid; curriculum translation and patient recruitment is currently underway to advance the project.
OBJECTIVES: To determine the feasibility of a resident physician-based, culturally appropriate method of decreasing the disease burden of Type 2 Diabetes Mellitus (DM2) in a group of Pacific Islanders, Marshallese living in Hawai'i. METHODS: Thirty one Marshallese with diabetes who live on the island of Oahu, Hawaii were recruited. Baseline health status of the participants was characterized. Health parameters included HgbA1c, random blood sugar (RBS), lipid panels, body mass index (BMI), blood pressure, and medical history, along with qualitative information. A focus group was held with participants prior to beginning the curriculum to determine cultural views on diabetes, health, treatment, and to identify potential obstacles to health improvement. A DM2 educational curriculum culturally relevant to Marshallese populations was then started, including instruction in lifestyle modification, adherence to medication regimens, and planned quarterly assessment of health improvement. RESULTS: Baseline quantitative analysis revealed Marshallese with diabetes to be obese and hyperglycemic, with average BMI of 30 kg/m(2), RBS of 285, and HgbA1c of 9.3. Qualitative analysis revealed that nearly half the participants admitted to symptoms of severe hyperglycemia. The initial focus group had a substantial turnout. Attendance rapidly declined, becoming so low that classes were eventually terminated. However, in two participants who attended more than three classes there was evidence of major improvements in HgbA1c, cholesterol, and qualitative markers, which were sustained after one year. CONCLUSIONS: This pilot study of Marshallese with diabetes on Oahu showed that the majority had poor glycemic control with secondary co-morbid conditions. Although many barriers exist for successful implementation of a diabetes health improvement project in this group, the groundwork for translation of this project to the Republic of Marshall Islands (RMI) has been laid; curriculum translation and patient recruitment is currently underway to advance the project.
Authors: S A Mazzuca; F Vinicor; S J Cohen; J A Norton; N S Fineberg; S E Fineberg; W C Duckworth; T W Kuebler; E E Gordon; C M Clark Journal: J Gen Intern Med Date: 1988 Jan-Feb Impact factor: 5.128
Authors: Pearl Anna McElfish; Peter A Goulden; Zoran Bursac; Jonell Hudson; Rachel S Purvis; Karen H Kim Yeary; Nia Aitaoto; Peter O Kohler Journal: Nurs Inq Date: 2016-06-20 Impact factor: 2.393
Authors: Pearl Anna McElfish; Brett Rowland; Christopher R Long; Jonell Hudson; Michelle Piel; Bill Buron; Sheldon Riklon; Williamina Ioanna Bing; T Scott Warmack Journal: J Racial Ethn Health Disparities Date: 2016-11-11
Authors: Pearl A McElfish; Christopher R Long; Peter O Kohler; Karen H K Yeary; Zoran Bursac; Marie-Rachelle Narcisse; Holly C Felix; Brett Rowland; Jonell S Hudson; Peter A Goulden Journal: Diabetes Care Date: 2019-03-12 Impact factor: 19.112
Authors: Pearl Anna McElfish; Melissa D Bridges; Jonell S Hudson; Rachel S Purvis; Zoran Bursac; Peter O Kohler; Peter A Goulden Journal: Diabetes Educ Date: 2015-09-11 Impact factor: 2.140
Authors: Holly Felix; Brett Rowland; Christopher R Long; Marie-Rachelle Narcisse; Michelle Piel; Peter A Goulden; Pearl A McElfish Journal: J Immigr Minor Health Date: 2018-12
Authors: Karen Hye Yeary; Nia Aitaoto; Karra Sparks; Mandy Ritok-Lakien; Jonell S Hudson; Peter Goulden; Williamina Bing; Sheldon Riklon; Jelleson Rubon-Chutaro; Pearl Anna Mcelfish Journal: Prog Community Health Partnersh Date: 2017