# Marshallese: Alternate Surveillance for COVID-19 in a Unique Population

> **NIH NIH R01** · WASHINGTON STATE UNIVERSITY · 2021 · $722,487

## Abstract

ABSTRACT
 Marshallese Pacific Islanders bear a disproportionate burden of COVID-19 infection, hospitalization, and
death, with rates 4 to 25 times higher than those of other US racial and ethnic groups in the Continental US.2,3
For example, in Northwest Arkansas Marshallese people represent less than 3% of the total population, but
they account for 1 out of 5 COVID-19 cases in this area.2 Similarly, Marshallese represent just 1% of the
population in Spokane County, Washington, but were nearly 30% of COVID-19 cases between March and
May, 2020.4 Social determinants of health have powerful influences on community and individual risks for
COVID-19.18 Culturally, the Marshallese community is extremely tight-knit, self-contained, and highly clustered;
they often live in multi-generational households; and they traditionally value close contact and large social
events, all of which increase vulnerability to the COVID-19 pandemic.19,20Marshallese are important recipients
of effective surveillance efforts given the disproportionate impact of COVID-19 on this population and the long-
standing disparities in health and health care.
 The MASC-UP study will generate novel data that reflect variation in risk of COVID-19 infection based on
one’s place in the highly clustered Marshallese community. For Specific Aim 1, bilingual Marshallese
Community Health Workers will recruit and train a longitudinal cohort of 800 Marshallese adults, ages 18 and
older, in participatory disease surveillance methods that include using a wireless thermometer to continuously
track body temperature; social media and text messaging in which participants (aka citizen scientists) can
report symptoms; and a CHW helpline to report symptoms and request COVID-19 information. Participatory
disease surveillance complements traditional surveillance systems by engaging communities in reporting
COVID-19 symptoms and events. Its strengths lie in the speed at which data can be made available, the ability
to scale the technology to obtain data at low cost, and the ability to cover populations that might not otherwise
be tracked. For Specific Aim 2 participants will complete an ego-centric contact survey to characterize the
social contact networks of members in the disease surveillance cohort from Aim 1. The networks will allow
identification of people at highest risk of COVID-19 infection and elucidate targets for high-impact preventive
intervention. For Specific Aim 3 we will integrate findings from Aims 1 and 2 into the existing test-based
disease surveillance currently being performed at the state and local levels. This Aim will augment existing
surveillance systems that have proved insufficient to stem the pandemic in Marshallese people. The proposed
study will be generalizable to other high risk, clustered underserved populations.

## Key facts

- **NIH application ID:** 10273577
- **Project number:** 1R01MD016526-01
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** KA'IMI ALOHILANI SINCLAIR
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $722,487
- **Award type:** 1
- **Project period:** 2020-12-21 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10273577

## Citation

> US National Institutes of Health, RePORTER application 10273577, Marshallese: Alternate Surveillance for COVID-19 in a Unique Population (1R01MD016526-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10273577. Licensed CC0.

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