Current Role at Stanford
Community-Based Research Coordinator
Honors & Awards
Outstanding Community Partner Award, Stanford University Office of Community Engagement (2014)
Regional Impact Award, National Indian Health Board (2013)
Archstone Foundation Award-Excellence in Innovation, American Public Health Association (2011)
Leadership in Data Use Award, Urban Indian Health Institute (2011)
Frank Vinicor Award of Excellence, Centers for Disease Control and Prevention (2010)
Local Impact Award, National Indian Health Board (2009)
SDPI Voices for Change Award, American Diabetes Association (2009)
Education & Certifications
MPH, NDSU, American Indian Public Health (2015)
Wipe Out Melanoma-California, Stanford University
Palo Alto, CA
(SPHERE) Stanford Precision Health for Ethnic and Racial Equity
1070 Arastradero Rd, Palo Alto CA
Comparing enhanced versus standard Diabetes Prevention Program among indigenous adults in an urban setting: a randomized controlled trial.
BMC public health
2020; 20 (1): 139
Indigenous people in the United States are at high risk for diabetes. Psychosocial stressors like historical trauma may impede success in diabetes prevention programs.A comparative effectiveness trial compared a culturally tailored diabetes prevention program (standard group) with an enhanced one that addressed psychosocial stressors (enhanced group) in 2015 to 2017. Participants were 207 Indigenous adults with a body mass index (BMI) of ≥30 and one additional criterion of metabolic syndrome, and were randomized to the standard or enhanced group. Both groups received a culturally tailored behavioral diabetes prevention program. Strategies to address psychosocial stressors were provided to the enhanced group only. Change in BMI over 12 months was the primary outcome. Secondary outcomes included change in quality of life, and clinical, behavioral, and psychosocial measures at 6 and 12 months.The two groups did not significantly differ in BMI change at 12 months. The two groups also did not differ in any secondary outcomes at 6 or 12 months, with the exception of unhealthy food consumption; the standard group reported a larger mean decrease (95% CI) in consumption of unhealthy food compared with the enhanced group (- 4.6 [- 6.8, - 2.5] vs. -0.7 [- 2.9, 1.4], p = 0.01). At 6 months, significant improvements in weight and the physical component of the quality of life measure were observed for both groups compared with their baseline level. Compared with baseline, at 12 months, the standard group showed significant improvement in BMI (mean [95% CI], - 0.5 [- 1.0, - 0.1]) and the enhanced group showed significant improvement in the physical component of the quality of life (2.9 [0.7, 5.2]).Adding strategies to address psychosocial barriers to a culturally tailored diabetes prevention program was not successful for improving weight loss among urban Indigenous adults.(if applicable): NCT02266576. Registered October 17, 2014 on clinicaltrials.gov. The trial was prospectively registered.
View details for DOI 10.1186/s12889-020-8250-7
View details for PubMedID 32000738
- Community Engagement in an Urban AIAN Community to Address Diabetes Prevention Researching Health Together: Engaging Patients and Stakeholders from Topic Identification to Policy Change 1st Edition Sage Publishing. 2020; 1
- Perspectives on precision health among racial/ethnic minority communities and the physicians that serve them Journal of Ethnicity and Disease 2020
UNDERSTANDING HISTORICAL TRAUMA AMONG INDIGENOUS ADULTS AT RISK FOR DIABETES TO INFORM BEHAVIORAL INTERVENTIONS
OXFORD UNIV PRESS INC. 2018: S219
View details for Web of Science ID 000431185200516
Development and evaluation of an enhanced diabetes prevention program with psychosocial support for urban American Indians and Alaska natives: A randomized controlled trial
CONTEMPORARY CLINICAL TRIALS
2016; 50: 28-36
Diabetes is highly prevalent, affecting over 25 million adults in the US, yet it can be effectively prevented through lifestyle interventions, including the well-tested Diabetes Prevention Program (DPP). American Indian/Alaska Native (AIAN) adults, the majority of whom live in urban settings, are more than twice as likely to develop diabetes as non-Hispanic whites. Additionally, prevalent mental health issues and psychosocial stressors may facilitate progression to diabetes and hinder successful implementation of lifestyle interventions for AIAN adults. This 2-phased study first engaged community stakeholders to develop culturally-tailored strategies to address mental health concerns and psychosocial stressors. Pilot testing (completed) refined those strategies that increase engagement in an enhanced DPP for urban AIAN adults. Second, the enhanced DPP will be compared to a standard DPP in a randomized controlled trial (ongoing) with a primary outcome of body mass index (BMI) and a secondary outcome of quality of life (QoL) over 12months. Obese self-identified AIAN adults residing in an urban setting with one or more components of the metabolic syndrome (excluding waist circumference) will be randomized to the enhanced or standard DPP (n=204). We hypothesize that addressing psychosocial barriers within a culturally-tailored DPP will result in clinical (BMI) and superior patient-centered (QoL) outcomes as compared to a standard DPP. Exploratory outcomes will include cardiometabolic risk factors (e.g., waist circumference, blood pressure, fasting glucose) and health behaviors (e.g., diet, physical activity). Results of this trial may be applicable to other urban AIAN or minority communities or even diabetes prevention in general.
View details for DOI 10.1016/j.cct.2016.06.015
View details for Web of Science ID 000385321600005
View details for PubMedID 27381232
- In the circle American Indians and Stanford researchers come together to prevent diabetes Stanford Medicine -SUMMER 2016, STRIVE, THRIVE AND TAKE FIVE. Stanford, CA. 2016
International Diabetes Federation.
American Indians lived healthy, balanced lifestyles for thousands of years before they were displaced to reservations. Reservation lands were typically not suitable for sustaining their traditional healthy lifestyles, which involved hunting, gathering, fishing and farming. Many diseases including diabetes were unknown until the 1950s. Nowadays, however, diabetes and its complications are major contributors to death and disability in every Tribal community. The growing epidemic of diabetes threatens populations around the world, and the American Indian and Alaska Native population has been hit particularly hard. The authors report on a successful initiative that blends a conventional medical approach to diabetes prevention with centuries-old traditional practices.