A University of Arkansas for Medical Sciences (UAMS) research team in Northwest Arkansas will study a potential way to improve health outcomes of pregnant Marshallese women using group-based care and health care navigators.
Led by UAMS researcher Britni Ayers, Ph.D., the study of maternal health care involving small groups of women, known as CenteringPregnancy, is funded by a two-year, $420,750 grant from the National Institute of Nursing Research at the National Institutes of Health (NIH).
Pacific Islanders/Marshallese living in the United States have almost twice the infant mortality rate as non-Hispanic whites. Arkansas is home to the country’s largest population of Marshallese, about 14,000 residents.
Ayers’ preliminary research has found that 15% of Marshallese women in Arkansas received no prenatal care (compared to 1.6% women nationally); more than 50% do not attend the recommended number of prenatal care visits; 19% of Marshallese infants were born preterm (compared to 9.6% nationally); and 15% of Marshallese infants were low birthweight (compared to 8.3% nationally).
Marshallese women face a number of barriers to medical care, including language, transportation and lack of information to help navigate the medical system and access resources.
“They are fearful of the medical system,” said Ayers, an assistant professor at UAMS Office of Community Health & Research in Springdale. “It’s ubiquitous — Marshallese women have expressed fear of the prenatal care process in all of our focus group interviews.”
Ayers hopes her CenteringPregnancy research will show that it is effective and can be used on a larger scale.
“Pregnant Marshallese women in Arkansas are experiencing urgent health needs, and we have the potential to move the needle tremendously with this type of concept,” she said.
CenteringPregnancy programs have proved effective in other areas of the United States, but it has not been tried with Pacific Islanders/Marshallese women. It should be a good fit for the population, Ayers said.
“The Marshallese culture is collectivist. They value the group more than the individual, so I think any sort of group health care will be a better way to reach this population,” she said.
Ayers will recruit 40 Marshallese women to take part in 90-minute small-group sessions. The sessions will include a bilingual CenteringPregnancy-trained Marshallese registered nurse and other prenatal health professionals providing brief one-on-one examinations and leading discussion of pregnancy topics at each of the 10 prenatal sessions. Additionally, all participants will be provided a bilingual Marshallese care navigator to aid in assessment and enrollment in social support services.
Over the last two years, Ayers used research pilot funding and training from a UAMS Translational Research Institute KL2 Mentored Research Career Development Award to help secure the NIH grant.