UAMS Presents Research Findings Involving Marshallese Community at Town Hall

By David Wise

Oct. 23, 2025 | Ongoing studies into health challenges faced by Marshallese populations continue to show the impact of innovative approaches to community health, researchers and staff at the University of Arkansas for Medical Sciences (UAMS) Institute for Community Health Innovation recently told community members.

The institute presented progress reports and findings from several key research studies involving the Marshallese community at an Oct. 14 town hall at its Springdale office. Research surrounding maternal health, diabetes and cardiometabolic diseases, and other efforts to bridge gaps between the community and care were presented.

“By bringing the community together, we were able to bwebwenato (talk story) to report back to the community the work we’ve accomplished together over the past several years, and what we’ll accomplish in the years to come,” said Sheldon Riklon, M.D., an associate professor at UAMS and an investigator with the institute. “Our community is a vital part of this work, and we wanted to recognize them and say Kommool tata (thank you) for their support and guidance.”

Diabetes and Cardiometabolic Diseases

Community health worker Kejjo Clarence shared the impact of the institute’s Family-Model Diabetes Self-Management Education and Support (FDSMES) program, which saw significantly better results in the Marshallese community than standard, individual-based interventions. Through FDSMES, the institute worked with Marshallese families and persons with diabetes who live in Northwest Arkansas to tailor dietary and lifestyle habits to reduce A1c levels and improve quality of life for the diabetic research participants. In that study, Marshallese individuals with diabetes saw lower A1c levels than those participating in standard DSMES.

“Not only did we see our participants’ numbers improve, but so did their daily lives,” Clarence said. “We saw changes in the healthy foods they chose for meals, and how they came together to be healthier among their own families or churches. The FDSME project did a lot of good for our community.”

Since that study, the institute has expanded its diabetes outreach to Marshallese communities across Arkansas, Oklahoma, Washington, Hawaii and the Republic of the Marshall Islands. As part of a church-based intervention in Arkansas and Oklahoma, 60% of participants saw stable A1c or a reduction in A1c, and 54% experienced stable weight or weight reduction.

As part of the UAMS’ efforts to combat diabetes in the Marshallese community, it opened the North Street Clinic in Fayetteville in 2014. The clinic is student-led and provides free medical care to uninsured populations with Type 2 diabetes and hypertension.

“The North Street Clinic opened during a time when COFA migrants weren’t eligible for Medicaid,” said community health worker Terry Takamaru, referring to the Compact of Free Association (COFA) between the U.S., the Marshall Islands, the Federated States of Micronesia and Palau. “I’m honored to work for the clinic and help Marshallese patients combat diabetes and hypertension, and I am proud to witness the passion and care the students and faculty put into each patient’s care plan.”

Clarence said on Tuesday that data analysis is ongoing for interventions the institute pioneered in Washington and Hawaii, and the final cycle of a study in the Marshall Islands is currently recruiting. Results from those studies will be shared with the community as they are available.

To learn more about the North Street Clinic, click here.

Maternal Health

Through Healthy Start, a program that connects pregnant women to essential support and care, Marshallese women experienced more than a 3% reduction in preterm birth over the first five years of the program.

Since 2019, the UAMS Institute for Community Health Innovation has offered the Healthy Start program — funded by the Health Resources and Services Administration — in Northwest Arkansas. During that time, the institute has served more than 1,700 clients. Through Healthy Start, community health workers deliver vital services including clinical navigation, education, home visiting services and comprehensive case management. The program is designed to support women who may face socioeconomic or other barriers to optimal health.

“Healthy Start helps mothers by improving their access to Medicaid, prenatal care and well-woman and well-child visits,” said Philmar Mendoza, RN, a nurse project manager with the institute. “With the support of community health workers and nurse educators who speak their language, mothers receive care that builds trust and comfort. The program has also strengthened health literacy around pregnancy, postpartum care, safe sleep practices, reproductive life planning and navigating the health care system.”

Mendoza also presented other key statistics from the first five years of the UAMS Healthy Start program, showing a significant increase in Northwest Arkansas women and children who received health insurance, a postpartum visit, had a usual source of medical care and more. The program continues to thrive in the region — and was recently launched in south Arkansas and east Arkansas — and is currently recruiting new clients, Mendoza said.

“As a result of Healthy Start, many Marshallese families are better connected to community resources and are experiencing improved birth and maternal health outcomes,” Mendoza said.

Healthy Start is offered in select counties in Northwest (Benton, Carroll, Madison and Washington), south (Ashley, Ouachita and Union) and east (Lee, Phillips and St. Francis) Arkansas.

To learn more about Healthy Start, visit uams.info/HealthyStart.

Current Projects

The institute presented two new projects that are actively recruiting: a study to learn how Marshallese COFA migrants have navigated the Medicaid enrollment process over the last year, and a study to enhance provider training, policy analysis and development of health care resources for Native Hawaiian, Pacific Islander and U-S.-Affiliated Pacific Islander (NHPI-USAPI) veterans.

To date, researchers have completed nine focus groups and interviewed 42 Marshallese individuals to explore barriers and facilitators to Medicaid enrollment. Findings from the interviews will be used to conduct a needs assessment to improve Medicaid enrollment and use of primary and preventative health services.

Researchers will conduct another round of surveys later this year and are seeking Marshallese adults who have applied or attempted to apply for Medicaid coverage for themselves or another person. To be considered for the study, email COFA_MedicaidStudy@uams.edu.

In collaboration with the University of Hawaii, the Institute for Community Health Innovation has completed 10 interviews so far for its study to improve access to VA benefits for Pacific Islander communities.

“This project provides a platform for veterans to share their experiences, stories and the barriers they’ve faced during and after their service,” UAMS project manager Romaldo Kabua said. “This initiative enables UAMS to better understand these challenges and address them where support is most effective.”