Type 2 diabetes has become a well-known part of daily life for the Marshallese community. In Northwest Arkansas, health screenings found 38.4 percent of Marshallese people with hemoglobin A1c (HbA1c) levels indicating diabetes. Read about a PCORI-funded study, which found that Marshallese adults in a culturally adapted diabetes education program experienced significantly greater reductions in hemoglobin A1c after one year in the program, compared with adults in a standard program.

Native Americans have the highest rate of diabetes of all US racial and ethnic groups. In response, this Massachusetts-based study trained laypeople known as community health representatives to coach and help coordinate care for people in their own Navajo communities. As reported in International Journal for Equity in Health, compared to those not in the program, people in it lowered blood sugar and cholesterol levels at a greater level, and they also were more likely to make and keep appointments with doctors and other health providers.

A PCORI-funded project led by David Kent, MD, MS, of Tufts Medical Center, shows that data from large clinical studies can provide not just the average effect of a treatment, as most studies now do, but indicate which patients are likely to benefit—or not. Kent’s team is now working with the American Medical Group Association to spread the risk model to 50 clinics in two major health systems.

Native Americans have disproportionately high rates of diabetes. Two PCORI-funded studies are searching for answers in the Navajo Nation and its health data. Challenges abound—including far-flung geography, low health resources, and language barriers—but together, Navajo researchers and community health workers are meeting them.

This project evaluates whether utilizing a system of text message reminders alone, support from a community health worker alone, or a strategy that employs both, is most successful in improving healthy behaviors among Medicaid recipients with diabetes.