Deborah Taira Juarez is an associate professor of pharmacy practice at the Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo. Her research focuses on medication adherence, cost-effectiveness of cardiovascular interventions, and health disparities, particularly involving Asian and Pacific Americans. She has worked at the Health Institute at the New England Medical Center examining outcomes from the patient perspective and spent ten years working at Hawai‘i Medical Service Association analyzing large administrative datasets, including cost and lab data.
“Much of my work over the past decade has focused on understanding factors related to ethnic disparities in medication adherence,” she says. “We have found that Native Hawaiians, Filipinos, and other Pacific islanders all have worse medication adherence than Caucasians.” Her work has included the development of interventions that improve medication adherence in these groups.
Juarez is working with faculty from the Center for Native and Pacific Health Disparities Research to develop an online training course entitled Community 101 that would instruct researchers on how best to interact with community members to facilitate community-based research.
Part of her salary is funded by grants from the National Institutes of Health, including an NIH National Institute on Minority Health and Health Disparities grant, for which Marjorie Mau of the UH Mānoa Department of Native Hawaiian Health serves as principal investigator. “I am the director of the Research Training and Education Core and a mentor for a junior investigator for her pilot project involving reduction in racial and ethnic disparities in preventable hospitalizations for patients with chronic disease,” says Juarez.
She also serves as a research coordinator for a second NIH grant where her time is spent forming research collaborations between investigators from different minority institutions.
She recently has completed several other research projects. A collaboration with the UH Mānoa John A. Burns School of Medicine involved adding laboratory data to Hawai‘i Health Information Corporation hospital data to explore factors that affect hospitalizations and the quality of care of hospitalists relative to community physicians. Another involved a collaboration with UH Mānoa School of Nursing and Dental Hygiene, which examined the cost-effectiveness of simulation training for nurses in combat and was funded by the Department of Defense.
In terms of future goals, Juarez recently submitted a grant proposal in collaboration with faculty from anthropology and nursing that would use m-health (short for mobile health, the use of mobile phones and other wireless technology in medical care) interventions to improve physical activity and medication adherence among Pacific Islanders. The specific aims are to:
- Enlist Pacific Islander key informants from the community to aid in the development of effective, widely-understandable messaging using mobile health technology to improve medication adherence, physical activity, and blood pressure levels;
- Pilot test a cost-effective, culturally, clinically, and environmentally appropriate intervention to promote medication adherence and exercise among Pacific Islanders in Hawai‘i using mobile health technologies;
- Examine the association between behavior change in medication adherence and physical activity and blood pressure levels in Pacific Islanders with uncontrolled hypertension.
“Achievement of the specific aims will help meet long-term goals by fostering a collaborative partnership between our multidisciplinary academic team and the Pacific Islander community,” Juarez says. The project also will lay the foundation for a larger, more in-depth randomized controlled trial examining effectiveness of mobile health interventions.
“Pacific Islanders in Hawai‘i provide an opportunity to test an intervention that, if effective among the people in this highly diverse community, is likely to be of wide applicability to other diverse high risk groups, which are becoming increasingly common across the U.S.,” she says.
Juarez received her master in public affairs (domestic policy) from the Woodrow Wilson School of Public and International Affairs at Princeton University and her doctor of science in health economics from the Harvard School of Public Health.