Project Title: Changes in epigenetic mechanisms and symptom clusters associated with the resolution of persistent pain following spinal cord stimulation
Kimberly Stephens, MPH, PhD is an assistant professor in the Department of Pediatrics/Division of Center for Applied Research and Evaluation in the UAMS College of Medicine. Dr. Stephens’s research is focused on understanding how epigenetic mechanisms contribute to the development, maintenance and resolution of chronic pain.
Chronic pain is a significant clinical and public health problem which is associated with adverse health outcomes such as decreased quality of life, altered mood and sleep patterns, and disability. Neuromodulation has emerged as a minimally invasive therapy effective for the treatment of refractory neuropathic pain conditions. The chronic pain patient population who seeks neuromodulation treatment is complex and constitutes a previously unstudied clinical model to study the resolution of chronic pain. We will be inviting patients seeking treatment at the UAMS Pain Treatment Center to participate.
We anticipate that our findings will provide a comprehensive assessment of how the epigenome changes following the resolution of persistent pain and how these changes impact gene expression upon resolution of pain. Therefore, we may improve our understanding of the molecular mechanisms that underlie analgesia in long-standing pain. Ultimately, our findings may facilitate reductions in opioid use in chronic pain by identifying patients who may benefit from opioid sparing treatments like neuromodulation thereby improving long-term outcomes for complex chronic pain patients.
Dr. Stephens joined the UAMS faculty in 2019 after completing her postdoctoral fellowship at the Johns Hopkins University.  She received her PhD at the University of California, San Francisco after working for several years as a Registered Nurse in critical care.
Mentors:
Johnathan Goree, MD, Director of Chronic Pain Division and Assistant Professor, Department of Anesthesiology, College of Medicine, UAMS
W. Brooks Gentry, MD, Professor, Department of  Anesthesiology and the Department of Pharmacology and Toxicology, College of Medicine, UAMS
Alan Tackett, PhD, Scharlau Family Endowed Chair for Cancer Research; Associate Director for Basic research, Winthrop P. Rockefeller Cancer Institute; Professor, Biochemistry and Molecular Biology, College of Medicine, UAMS
 

Project Title: Exploring the Feasibility of a Group Prenatal Program, Kōmmour Prenatal, to Reduce Maternal and Infant Health Disparities among Marshallese Pacific Islander Women
Britni Ayers, PhD, is an Assistant Professor in the College of Medicine. The KL2 Mentored Research Career Development Award will support her efforts to reduce maternal and infant health disparities among Marshallese Pacific Islander women and secure external funding as an independent investigator. Pacific Islanders residing in the United States (US) have disproportionally higher rates of preterm birth and lower birthweight infants and are also more likely to experience preeclampsia, primary cesarean delivery, excessive gestational weight gain, gestational diabetes mellitus, and low exclusive breastfeeding initiation and duration at six months compared to other racial/ethnic minorities and the US population in general. Preterm birth is one of the most pressing challenges to maternal, infant, and child health in the US. Preterm babies can face lifelong disabilities and are at higher risk of death during their first few days of life.  Early and consistent prenatal care is strongly associated with positive birth outcomes and is a global health priority. However, Pacific Islanders are less likely to receive prenatal care in the first trimester and are thus at a higher risk for maternal and infant health disparities.
Current health care interventions are not culturally relevant or focus primarily on individual-level motivations that are not effective within highly collectivistic Pacific Islander cultures. Pacific Islander communities’ concept of health and wellbeing are largely shaped by collectivistic cultural values and practices. This concept of health would suggest the need for culturally adapted group-based interventions. Recent data with other cultural groups report that pregnant women who received a group-based prenatal intervention (Centering) had a significantly lower risk of having a preterm birth, low birth weight infants, and improved outcomes with gestational diabetes mellitus compared to women receiving individualized care. However, group prenatal care has not been culturally adapted and tested with the Marshallese or other Pacific Islanders in the mainland US. The purpose of the proposed study is to culturally adapt and examine the feasibility and preliminary effectiveness of a group prenatal program (Kōmmour Prenatal) to reduce maternal and infant health disparities among Marshallese Pacific Islander women in the US.
Dr. Ayers joined the College of Medicine as a new faculty member in 2018. She received her doctorate from the University of Arkansas. Dr. Ayers draws upon her years as a Lactation Consultant and Midwifes Apprentice to inform her evolving research.
Mentors:
Hari Eswaran, Ph.D., Professor, Obstetrics and Gynecology, College of Medicine, UAMS; Professor, Biomedical Informatics, College of Medicine, UAMS; Director of Research in the Squid Array Reproductive Assessment Research Center
Pearl McElfish, Ph.D., Vice Chancellor Northwest Arkansas Region, UAMS;  Director of the Division of Office of Community Health and Research, UAMS;  Director of the Center for Pacific Islanders, UAMS
Keawe Kaholokula, Ph.D., Professor and Chair of Native Hawaiian Health, University of Hawaii.
Nicola Hawley, Ph.D., Associate Professor of Epidemiology, Yale University
Nirvana Manning, M.D., Service Line Director of Gynecology and Obstetrics, College of Medicine, UAMS
Wendy Nembhard, Ph.D., Associate Professor of Epidemiology and Pediatrics, College of Medicine, UAMS
 
 
 
 
 

Project Title: Adapting a Supervision Strategy for Sustaining Fidelity to Evidence-Based Practices in Substance Use Disorder Treatment Settings
Jure Baloh, PhD, is an Assistant Professor of Health Policy and Management at the UAMS College of Public Health. The KL2 Mentored Research Career Development Award will support his research in adapting a supervision strategy to help implement evidence-based practices and other innovations in substance use disorder treatment programs.
Several evidence-based practices have been developed for substance use disorder treatment, however they are often not implemented in routine care or are implemented with poor fidelity (e.g., non-adherence to core components). Substance use disorder counselors can be trained to deliver evidence-based practices, but their training typically consists of one- or two-day workshops and without ongoing organizational support, their knowledge and skills can wane. We have limited knowledge of what strategies would best support addiction counselors to implement and sustain delivery of evidence-based practices with fidelity.
The objective of this study is to adapt the R³ supervision strategy, an implementation strategy developed for child welfare services that improves supervision, organizational implementation context and, in turn, service delivery and outcomes. Since substance use disorder services are organized and delivered in a similar way as child welfare services, the R³ strategy has strong potential to reinforce implementation of evidence-based practices in substance use disorder settings and, in turn, improve quality and outcomes. The adapted R³ strategy will be tested in future studies.
Baloh joined the Department of Health Policy and Management in 2019 after completing his postdoctoral fellowship on a NIDA-funded T32 at the UAMS Psychiatric Research Institute. He received his PhD in Health Services and Policy from the University of Iowa, and MHA in Health Services Administration from the University of Missouri.
Mentors:
Geoffrey Curran, Ph.D., Director, Center for Implementation Research, UAMS; Professor, Department of Pharmacy Practice, College of Pharmacy, UAMS; Professor, Department of Psychiatry, College of Medicine, UAMS; Research Health Scientist, Central Arkansas Veterans Healthcare System
Michael Cucciare, Ph.D., Associate Professor, Department of Psychiatry and Behavioral Sciences, College of Medicine, UAMS
Lisa Saldana, Ph.D., Director, ODI Clinic- Oregon Social Learning Center, Eugene, Oregon
J. Mick Tilford, Ph.D.., Professor and Chair of Health Policy and Management, College of Public Health, UAMS