Above all else, Mary Nies knows what it’s like to work and live in a rural community. The professor and director of nursing research at ISU grew up on a farm and has spent the majority of her professional career promoting health in vulnerable populations, including her current position as co-project director of the Idaho Senior Refugee Interprofessional Holistic Health Project.
“My whole research trajectory and research career has been working in the community using a community-based participatory approach,” Nies said.
This is part of what prompted Nies to send a project proposal to the Patient-Centered Outcomes Research Institute in the spring of 2015. In it, she outlined her intent to study prediabetes in Idaho’s Latino population, and emphasized the great risk diabetes poses to Americans and those of Latino heritage especially.
In September of this year, Nies received confirmation that she was granted PCORI’s Pipeline-to-Proposal Award, a $50,000 one-year award that will be used to establish a committee made up of prediabetic Latinos, their families and caregivers and members of Ventanilla de Salud, a program within the Mexican consulate that works to provide healthcare access and information to Mexicans in the U.S.
the director of the Spanish for the Health Professions program and the co-principal investigator for the grant, said one of the big reasons why they were awarded the funds was that PCORI is mainly interested in, as the name suggests, patient-centered care and looks for proposals in which patients are key to the process.
“This grant fits right into that,” Nies said. “But what’s unique about this grant is that it’s a pipeline-to-proposal grant, so the whole idea is for us to plan and work to get the ideas from the community we’re interested in to move to do the next grant, wherever that might be.”
Nies will use the funding from this award to help pay salaries of some involved, as well as pay for transportation costs, incentives for participants and equipment needed for collecting onsite information.
After Nies and her team have found participants, they will establish a focus group to generate research questions. Those will then be used to move toward the next stage of research: trying out the questions and solutions offered by the participants and discovering which ones actually work.
“The community participates actively in trying to figure out what to do,” Tarp said. “When we discuss the issue of prediabetes, they have recommendations, but it’s not always that easy. There’s issues of money, transportation and access to resources.”
For many people living in the rural areas of Idaho, it can be difficult to follow the actions and steps usually recommended for those who are prediabetic. Walking every day becomes difficult when it is far too cold to go outside for many months out of the year, and for many people the notion of a gym membership is laughable: even if there’s a gym in their town, they may not be able to afford a membership. Additionally, it can be expensive and difficult to buy healthy food when people are inexperienced in that area.
“It’s bad enough to be diagnosed with prediabetes,” Tarp said, “but if we can help people on that process of discussing it with each other and help them come up with a way to deal with that themselves, that empowers them.”
Nies said she was inspired to study prediabetes specifically when considering research topics that would be important and helpful to the community.
“We were trying to think about what would be important, so my idea was, why not prediabetes?” she said. “Everyone focuses on diabetes, but really, once you’ve got it, it’s kind of too late.”
Nies and Tarp also said they hope the project will help communities become more aware of prediabetes in addition to assisting those already diagnosed. Many people with prediabetes may not even realize they have it, and Nies said she hopes this research will encourage people to consider the possibility of the disease and get tested frequently.
“We also hope that by taking on this project, we’re reminding people who are prediabetic, that they can stop this now,” Tarp said. “We really want to help these people and support them by having them help us.”