Project Title: Exploring the Feasibility of a Group Prenatal Program, Kōmmour Prenatal, to Reduce Maternal and Infant Health Challenges 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 challenges 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 groups 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 challenges.
Current health care interventions focus primarily on individual-level motivations that are not effective within highly collectivistic Pacific Islander communities. Pacific Islander communities’ concept of health and wellbeing are largely shaped by collectivistic values and practices. This concept of health would suggest the need for community adapted group-based interventions. Recent data with other 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 adapted and tested with the Marshallese or other Pacific Islanders in the mainland US. The purpose of the proposed study is to 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.
Ayers joined the College of Medicine as a new faculty member in 2018. She received her doctorate from the University of Arkansas. 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
 

Development of a Falls Prevention Self-Management Plan to Improve Older Adults Adherence to Prevention Strategies after Community-Based Falls Risk Screenings
Jennifer Vincenzo, Ph.D., M.P.H., PT, is an assistant professor in the Lewis E. Epley Jr. Department of Physical Therapy in the College of Health Professions on the Northwest Campus. The KL2 Mentored Research Career Development Award will support her project to develop and pilot a falls prevention self-management plan to facilitate adherence to prevention strategies among older adults.
Falls are the leading cause of fatal and nonfatal injuries among older adults, costing upwards of $50 billion every year. Despite national efforts towards prevention, fall rates remain high. One in four older adults falls each year nationally and Arkansas ranks 48/50 with fall rates of 35.2%. The CDC provides falls prevention screening, assessment, and recommendation resources; however, there are no resources in place to assist providers and older adults in developing and implementing a falls prevention self-management plan.
Developing strategies to improve adherence to fall prevention recommendations is imperative to addressing this public health crisis. Results from Dr. Vincenzo’s preliminary studies indicate only ~50% of older adults adhere to recommendations following a one-time community-based falls prevention screening. Moreover, she found that those who were not adherent reported higher rates of falls compared to those who were. Thus, implementing a falls prevention self-management plan could prevent up to 45,000 medically treated falls, save $442 million in direct medical costs associated with those falls, and decrease the risk of falls by up to 67%.
Barriers and facilitators to adhering to falls prevention recommendations have been identified; however, implementation strategies to address older adults’ lack of adherence have not been explored. Therefore, the aims of this project are to develop and pilot a falls prevention self-management plan to improve older adults’ adherence to falls prevention recommendations after attending a community-based screening.
Vincenzo joined the Department of Physical Therapy in 2015. She completed her Ph.D. in Kinesiology with a graduate certificate in Educational Statistics and Research Design at the University of Arkansas. She also has a Master of Public Health from Southern Connecticut State University and a Bachelor of Physical Therapy degree from Quinnipiac College in Hamden, Connecticut. Vincenzo was an inaugural recipient of the UAMS Geriatric Junior Faculty Development Award through the Arkansas Geriatric Education Collaborative. She holds board certifications in Geriatric Physical Therapy, Health Education, Brain Injury Rehabilitation, and Dementia Management.
Mentors:
Jeanne Wei, Ph.D, M.D., Executive Director, Reynolds Institute on Again, UAMS; Chair, Geriatrics, UAMS College of Medicine.
Leanne Lefler, Ph.D, R.N, A.P.R.N., Associate Professor, UAMS College of Nursing
Pearl McElfish, Ph.D., Vice Chancellor Northwest Arkansas region, UAMS; Assistant Professor, Office of Community Health and Research, UAMS College of Medicine
Geoffrey Curran, Ph.D., Director, Center for Implementation Research; Professor, Department of Pharmacy Practice, UAMS College of Pharmacy

Project Title: Decreasing methionine intake to improve survival in patients with metastatic melanoma
Isabelle Racine Miousse, Ph.D., is an Assistant Professor in the Department of Biochemistry and Molecular Biology in the UAMS College of Medicine. The KL2 Mentored Research Career Development Award will support her research in improving survival in patients with metastatic melanoma by exploiting a metabolic vulnerability in cancer cells.
In healthy animals, a reduction in methionine dietary intake leads to significant gains in metabolic health and an increase in lifespan. In contrast, most cancer cells are strictly dependent on the supply of exogenous methionine for survival, a phenomenon called “methionine dependence”. Based on this dichotomy, her project explores a window of methionine intake where we observe health benefits and preservation of body weight for the host, while at the same time impairing proliferation and metastasis in tumor. The three axes of the project are to link common genetic variations in methionine metabolism with the outcome of cancer therapy, to identify the molecular mechanism behind methionine dependence in cancer cells, and finally, to combine dietary methionine restriction with immunotherapy in metastatic melanoma. The long term objectives of this research is to increase the response rate to therapy with immune checkpoint inhibitors in metastatic melanoma, which currently stands at 50%, while at the same time improving quality of life in patients during the course of treatment.
Miousse joined the College of Medicine faculty in 2018 after completing her postdoctoral fellowship at UAMS. She received her doctorate in Human Genetics from McGill University in Montreal, Canada.
Mentors:
Alan Tackett, Ph.D., Scharlau Family Endowed Chair for Cancer Research; Associate Director for Basic Research, Winthrop P. Rockefeller Cancer Institute; Professor, Biochemistry and Molecular Biology, UAMS College of Medicine
Issam Makhoul, M.D., Director, Division of Hematology Oncology; Professor, Internal Medicine, UAMS College of Medicine

Project Title:An Exploration of the Mental Health Needs of Young Women with Breast Cancer and Implications for Developing Patient Educational Materials
Pearman Parker, Ph.D., M.P.H., RN, is a clinical instructor in the College of Nursing. The KL2 Mentored Research Career Development Award will support her project examining perceived mental health needs of young women with breast cancer. This project will also explore the mental health content within breast cancer educational materials.
Young women (18 – 45 years of age) with breast cancer are especially vulnerable to overwhelming daily stressors of cancer and face unique mental health challenges. However, due to the urgency of undergoing treatment and managing physiological side effects, mental health needs such as depression and anxiety are often not a priority. Younger women with breast cancer often have to learn about their disease and ways to cope with mental health at convenient times amidst the competing demands of treatment, family, and work responsibilities. They frequently rely on easily accessible cancer education materials to accommodate daily life schedules. However, we do not know the extent to which cancer education materials address mental health needs of this population, nor if the mental health content that does exist is readable and understandable for patients with a variety of health literacy skill levels. The purpose of this study is to explore the perceived mental health needs and the mental health content within cancer educational materials for young women with breast cancer. This study will provide the foundation for this program of research, which is dedicated to developing tailored educational interventions to improve the breast cancer treatment experience.
Dr. Parker joined the College of Nursing as a new faculty member in 2019. She received her doctorate from the University of South Carolina where her dissertation was funded through the Susan G. Komen Foundation. Dr. Parker draws upon her years as a psychiatric nurse and journalist to inform her evolving research.
Mentors:
Jean McSweeney, Ph.D., RN, FAAN, FAHA, Associate Dean for Research; Professor, UAMS College of Nursing
Kristin Zorn, MD, Professor, Department of Obstetrics and Gynecology; Associate Professor, Genetics, UAMS College of Medicine
Joseph Su, PhD, Co-Director, Cancer Prevention and Population Sciences, UAMS Winthrop P. Rockefeller Cancer Center; Professor, Department of Epidemiology, UAMS College of Public Health
Kristie Hadden, PhD, Executive Director, UAMS Center for Health Literacy; Associate Professor, Department of Medical Humanities and Bioethics, UAMS College of Medicine.
Carolyn Greene, PhD, National Program Manager, Office of Mental Health and Suicide Prevention, Washington DC; Associate Professor, Health Services Research Division, UAMS Department of Psychiatry

Project Title: Fetal exposure to cannabinoids: exposure, methylation, and neurodevelopmental effects
Stefanie Kennon-McGill, Ph.D., is an instructor in the Department of Environmental and Occupational Health in the UAMS College of Public Health. The KL2 Mentored Research Career Development Award will support her efforts to evaluate the neurodevelopmental effects and epigenetic changes in children who were exposed to cannabinoids during the gestational period.
Cannabis and cannabis-derived phytochemicals known as cannabinoids, particularly the psychoactive component tetrahydrocannabinol (THC) and the non-psychoactive component cannabidiol (CBD), have become increasingly popular and widely available for use in the United States due to recent changes in state legislation. While there is a growing effort to evaluate the health effects of cannabinoids, especially during pregnancy, there is still relatively little known about the long term neurodevelopmental outcomes in children born to mothers who used any sort of cannabinoid during pregnancy.
Additionally, the mechanisms behind possible neurodevelopmental changes in children exposed to cannabis prenatally have not been thoroughly explored, particularly in humans. It has been suggested that epigenetic modifications may play an important role in “reprogramming” the developing fetal brain following prenatal exposure to cannabis. Yet, few studies have evaluated this quantitatively in humans. Dr. Kennon-McGill aims to fill these gaps in knowledge by using state-of-the-art analytical methods to quantify THC, CBD, and metabolites in mother/infant pairs where mother reports use of THC or CBD in the final trimester of pregnancy. Her study will also entail neurodevelopmental assessments in the infants at 6 and 12 months of age. The role of DNA methylation as a possible mechanism of importance in neural development will be examined as well.
Dr. Kennon-McGill joined the UAMS College of Public Health in 2017. Prior to her time at UAMS, she received her doctorate in Neuroscience from the University of Kansas Medical Center in 2014 and then completed a two year postdoctoral fellowship at Washington University in St. Louis.
Mentors:
Laura James, M.D., Associate Vice Chancellor, Clinical and Translational Research; Professor, Department of Pediatrics; Director, Translational Research Institute, UAMS College of Medicine
Shuk-Mei Ho, Ph.D., Vice Chancellor of Research; Professor, Department of Pharmacology and Toxicology, UAMS College of Medicine
John Constantino, M.D., Director of the Division of Child and Adolescent Psychiatry; Blanche F. Ittleson Professor of Psychiatry and Pediatrics Washington University, Saint Louis, MO
Ricky Leung, Ph.D., Associate Professor, Department of Pharmacology and Toxicology, UAMS College of Medicine
Jeff Moran, Ph.D., Assistant Professor, Department of Pharmacology and Toxicology, UAMS College of Medicine

Implementation and Quantification of the General Movement Assessment for Early Detection of Neurodevelopmental Disabilities in Infants

Tara Johnson, M.D., is an assistant professor in the Department of Pediatrics/Division of Pediatric Neurology in the UAMS College of Medicine. She is the Founding Director of the Arkansas Children’s Biomedical Innovations Program. Prior to joining the Arkansas Children’s Research Institute and UAMS faculty in 2018, Dr. Johnson was at Kennedy Krieger Institute and the Johns Hopkins Hospital in Baltimore, MD, where she completed her training in Neurodevelopmental Disabilities. Dr. Johnson’s research work is focused on the early identification of infants at high risk for the development of cerebral palsy and other neurodevelopmental disorders.
Her KL2 Mentored Research Career Development Award project will transform current clinical practice at Arkansas Children’s Hospital by implementing the General Movement Assessment, a low-cost diagnostic tool, to identify Neurodevelopmental Disabilities at an earlier age in high-risk infants. By further enhancing qualitative assessments with quantitative engineering methods, she will advance the technical capability of the General Movement Assessment on a larger scale. She will transform the General Movement Assessment into a quantitative algorithm through her novel artificial-intelligence based analysis of the general movements in healthy and high-risk infants. This work will promote the initiation of proven therapies at a younger age, leading to improved outcomes in children with Neurodevelopmental Disabilities.
Successful completion of her work will bring novel approaches to the “bedside” for early identification and treatment of children with Neurodevelopmental Disabilities. She is poised to further develop her knowledge in engineering and clinical research to further benefit individuals from her translational study. Through her translational research, she will transform the standard of care for high-risk infants by incorporating the General Movement Assessment into day-to-day clinical care for these infants at Arkansas Children’s Hospital. The translational impact of the concurrent quantification of the general movements will outperform qualitative analyses and ultimately reach beyond ACH and can be adopted worldwide.
Mentors:
Alan Tackett, Ph.D., Scharlau Family Endowed Chair for Cancer Research; Associate Director for Basic Research, Winthrop P. Rockefeller Cancer Institute; Professor, Biochemistry and Molecular Biology, UAMS College of Medicine
Kenneth Knecht, M.D., Associate Professor, Pediatrics, UAMS College of Medicine
Gresham Richter, M.D., President, Physician Hospital Organization, Children’s Health Care System Inc.; Vice Chairman and Professor, Otolaryngology-Head and Neck Surgery, UAMS College of Medicine