# Addressing Marshallese Immigrant Barriers to Diabetes Self-Management through Family DSMES

> **NIH NIH R01** · UNIV OF ARKANSAS FOR MED SCIS · 2022 · $570,000

## Abstract

Abstract
 The racial/ethnic disparities in Northwest Arkansas (Benton and Washington Counties) were so stark that
the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health sent investigators.
The CDC's report documented that 45% of all adult cases in Northwest Arkansas were among Hispanic/Latinx
patients and 19% were Native Hawaiian/Pacific Islander (NHPI) patients.1 Hispanic/Latinxs and NHPIs only
account for 17% and 2.4% of the two-county population, respectively. COVID-19 deaths in Northwest Arkansas
were also disparate across race and ethnicity. NHPI deaths were estimated to be more than 200 per 100K —
much higher than the overall death ratio for the county of 5.10 per 100K, as well as the death ratio for Whites
of 4.03 per 100K.1 Among racial/ethnic minorities, the Northwest Arkansas NHPI population stands out as
having much higher odds of death from COVID-19.1 Even with the increased availability of COVID-19 testing
and vaccination, barriers remain for racial and ethnic minority populations. While the availability of COVID-19
testing has improved, disparities in testing across race, ethnicity, and socioeconomic status continue to stymie
efforts to reduce COVID-19 morbidity and mortality. Hispanic/Latinx and NHPIs have also experienced
increased discrimination related to COVID-19. Our preliminary research documents that these experiences
with discrimination may reduce Hispanic/Latinx and NHPI willingness to get tested. Minority populations are
more likely to distrust traditional approaches to health care. In addition to concerns with trust and
discrimination, Hispanic/Latinx and NHPI community members face access barriers including long-working
shifts, inability to take off work for health care, and lack of insurance. Self-testing for COVID-19 holds promise
in overcoming the barriers of trust, discrimination, and health care access. Yet no studies have tested the best
distribution methods for self-testing among Hispanic/Latinx and NHPI. This study fills that gap and holds
promise for increasing sustained access for Hispanic/Latinx and NHPI communities and reducing significant
COVID-19 disparities in incidence, hospitalization, and death. Our specific aims are: Aim 1. Leverage and fully
engage our long-standing community-based partnerships to overcome barriers of trust, discrimination, and
health care access to increase the use of COVID-19 self-testing. Aim 2. Implement and evaluate access and
uptake strategies of two self-testing distribution approaches (local community clinics and community-based
non-profit organizations) to understand effectiveness and impact for vulnerable populations. Aim 3. Fully
collaborate with the RADx-UP Coordination and Data Collection Center (CDCC) and other RADx sites.

## Key facts

- **NIH application ID:** 10469701
- **Project number:** 3R01MD013852-04S2
- **Recipient organization:** UNIV OF ARKANSAS FOR MED SCIS
- **Principal Investigator:** Pearl McElfish
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $570,000
- **Award type:** 3
- **Project period:** 2019-07-29 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10469701

## Citation

> US National Institutes of Health, RePORTER application 10469701, Addressing Marshallese Immigrant Barriers to Diabetes Self-Management through Family DSMES (3R01MD013852-04S2). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10469701. Licensed CC0.

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