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FAYETTEVILLE -- Recent recognition for work with Northwest Arkansas' Marshall Islander community is fueling research at the University of Arkansas for Medical Sciences Northwest campus.

The medical school's leaders said at an awards show that the university's done a good job of melding its research, education and health care missions. And their attention quickly turned to what's coming next and what still needs to be done.

The Association of American Medical Colleges in May awarded the university's North Street Clinic its Star of Community Achievement, which honors campuses improving community health in collaborative and innovative ways. The clinic has offered care to more than 600 uninsured Marshallese residents with diabetes since opening in 2014, according to the university.

The Southern Society for Clinical Investigation early this year inducted Drs. Sheldon Riklon and Thomas Schulz, both UAMS associate professors, as members. The society says its aim is to give a leg up to medical research throughout the South, especially involving students and young researchers. It includes about a dozen UAMS members in Arkansas counting the two recent additions, according to its website.

"A lot's going on that's really going to be a benefit to the community," said Schulz, who co-directs the North Street Clinic with Dr. Jonell Hudson.

More than 12,000 Marshallese live in Northwest Arkansas, according to university researchers, coming for jobs and schools or joining family members.

Poverty and dozens of American nuclear weapons tests decades ago in the Marshall Islands, which sit in the middle of the Pacific Ocean, have left many of its people with diets heavy in fat and salt and persistently high rates of diabetes, obesity and other health issues.

The North Street Clinic is a hub of the university's work to chip away at those problems. Riklon, himself Marshallese, supervises students from a variety of health fields and Marshallese community health workers who meet with patients. Schulz oversees the internal medicine residents who sometimes help too. And all of these researchers work with Marshallese leaders and residents at the clinic to find the best ways of improving their health.

"The North Street Clinic allows that to happen in a rapid cycle," said Pearl McElfish, associate vice chancellor for the campus and director of its Office of Community Health and Research.

For instance, the group recently finished a study looking at whether involving a patient's entire household, rather than just the patient, could make diet and behavioral interventions more effective against diabetes. The study is waiting for peer review and publication, but it found the family approach brings durable control to patients' blood-sugar levels, McElfish said. Those findings can then inform care at the clinic.

Research projects such as this one are all done in collaboration with the Marshallese community, taking their culture, priorities and needs into account, Schulz said. Riklon, who also works at the low-cost Community Clinic in Springdale, joined UAMS in 2016 specifically to bring a Marshallese perspective along with the white lab coat.

"It's been going well, and I'm enjoying every minute of it," Riklon said.

Lucy Capelle with the Arkansas Coalition of Marshallese said many community members in years past would go without care of any kind until their health deteriorated to the point of needing the emergency room. Now they know there are Marshallese health care workers at every level of training ready for them.

"At least someone is there to guide them and explain things for them," she said. "I think there is a lot of difference now."

Schulz said he hopes to start researching eye health among the Marshallese, which can be tied to diabetes but hasn't gotten the same attention. Being a member of the Southern Society for Clinical Investigation brings a network of researchers and ideas and also brings more awareness to what UAMS is doing, he added.

"It really bodes well for the future," Schulz said of his and Riklon's inductions.

McElfish said she also has more work in mind, such as expanding to Marshallese communities in Huntsville and Berryville as well as in other states and sharing successful health care approaches with other providers throughout the region.

The Marshallese community especially needs better health care, but McElfish has said her office's work can also help the region's population at large by finding ways to care for isolated or diverse groups wherever they are. A five-year project, sustained with a $2 million federal grant won last year, aims to make the food served at Springdale Public Schools, the Samaritan Community Center and other groups less salty and more healthful.

The project so far has analyzed the menus and offered recipe suggestions replacing salt with other flavorful ingredients, officials at Samaritan and the School District said. The school's meals in one year cut more than 10 percent of the sodium, child nutrition director Gena Smith said. Samaritan market coordinator Courtney Wrinkle said its Springdale and Rogers kitchens have cut their salt in half.

"They're great to work with," Smith said of UAMS. "They're always willing to help with any projects that we have at the schools."

The project continues, and McElfish said she wants to expand its focus to look at the amounts of fat and sugar and get more fruits and vegetables on the menu.

"I think there'll be lots more to come," she said of the campus's work.

Metro on 07/02/2018

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