Abstract
BackgroundMarshallese face significant health disparities, with particularly high rates of type 2 diabetes. Engaging stakeholders in the research process is essential to reduce health inequities.MethodsA community- and patient-engaged research approach was used to involve community Marshallese stakeholders in a randomized comparative effectiveness trial testing two Diabetes Prevention Program interventions.ResultsThe article outlines the engagement process and the specific influence that stakeholders had on the research planning and implementation, discussing the areas of agreement and disagreement between community and patient stakeholders and academic investigators and documenting changes to the research protocol.ConclusionThe article provides an example of methods that can be used to design and conduct a randomized controlled trial testing with a population who has been underrepresented in research and suffered significant historical trauma.
Highlights
Marshallese face significant health disparities, with high rates of type 2 diabetes
Between June 2015 and December 2017, the community-academic research team engaged in discussions with Marshallese stakeholder advisory boards regarding all aspects of the research design
Academic researchers often find it challenging to balance the need for rigorous research design with the desires of community and patient stakeholders
Summary
Marshallese face significant health disparities, with high rates of type 2 diabetes. Pacific Islanders are one of the fastest growing populations in the United States (US), with a 40% increase from 2000 to 2010 [1]. Southern and Midwestern states, such as Arkansas, Kansas, Missouri, and Oklahoma, had rapid growth in Pacific Islander communities [1]. Most of the Pacific Islander population growth in these states are Micronesian populations from the Compact of Free Association (COFA) nations, including Marshallese from the Republic of the Marshall Islands (RMI). Between 1946 and 1958 the US military tested nuclear weapons on the RMI, which were equivalent to more than 7000 Hiroshima-sized bombs [10, 11].
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