Kellams: Research into maternal health for Arkansas is getting an $11.7 million boost. The grant comes from the National Institutes of Health and will be administered through the University of Arkansas for Medical Sciences’ Institute for Community Health Innovation. All right. Some acronyms here. The grant allows for the establishment of MARCH, the Maternal and Reproductive Community Health Excellence Research Center, and the money is coming from the NIH’s Center for Biomedical Research Excellence, or COBRE. Pearl McElfish, the director of the UAMS Institute for Community Health Innovation, says the institute was developed to bring and find the best health innovations to rural Arkansans.
McElfish: Often we think of innovations coming from California or New York or places outside Arkansas, but I am convinced that the best innovations, the solutions to Arkansas and other rural states’ problems, can be developed in Arkansas, in rural states. And so this grant really is an opportunity to advance research specifically around maternal and reproductive health, with a focus on rural Arkansans and developing the innovations that will improve maternal health right here in Arkansas.
Kellams: You used the word innovation. So the idea here is to get some new research developed and results from that.
McElfish: Absolutely. I see the solutions kind of on a continuum. On one end, we need to implement evidence-based practices, and we need to do that better. So in some ways there’s innovation in that. How do we take what’s known but is not reaching rural populations or populations that may feel disenfranchised? And there can be innovations in implementation sciences, which is what we call it in academia. And then there are brand-new innovations, and these are often digital health technologies. How can we have better wearable technologies, better remote monitoring so that a pregnant woman who might have gestational diabetes or gestational hypertension can get the monitoring that she needs, even if she lives in Searcy County or in Phillips County in south Arkansas? And so both of those innovations are critical and will be funding research and generating research, both in implementation sciences as well as digital health technology.
Kellams: The fictional mom we’re talking about here in Phillips County or Searcy County — the idea here, if you have some wearable device that actually works, you may not have to schedule an entire day to get to a doctor in West Memphis or Little Rock or Conway.
McElfish: Absolutely. We want women to see the doctor, but we also know that many women, if they have to see a doctor weekly for something like gestational hypertension and they have to take off work, drive two hours, have child care, have the gas costs, they’re just not going to do it. And that’s one of the biggest reasons that we have the maternal mortality and maternal morbidities that we do. We just don’t have the right access to health care, and being able to have the remote monitoring, particularly for rural areas, is critical.
Kellams: Rural areas that would be considered maternal health deserts.
McElfish: Absolutely. We know that more than half of our counties do not have obstetrical care, which means women are driving not just more than 30 minutes to their doctor, but often more than an hour, an hour and a half. And it’s not just that hour, hour and a half each way. It really is all day by the time they coordinate their lives. And we often think, well, women should just care more about their health. They care about their health, but they’re living real lives — trying to raise other children, having jobs, managing a budget. That means taking off work or paying for the gas to go there and back really can be prohibitive.
Kellams: There’s also going to be a conference that stems out of this in spring of 2026.
McElfish: Yes, absolutely. The dates are actually set for April 2 and 3. We want to make sure that we do it before the session starts on April 8. And so we’ll have two days, and the first day will be our typical health summit. It will be around collaboration and community partnership to reach rural communities. The second day, we are going to bring in probably 20 of the top researchers in the U.S. around maternal and reproductive health and have panel discussions around what are some of the top innovations, what are some of the research topics that Arkansas should be considering. And so it will be a wonderful, dynamic two days. We’ll get the save-the-date out soon. Certainly, anyone can reach out to our office for more information.
Kellams: And you said before the session starts — by session, you mean when the grant period—
McElfish: No, the state legislation. So I always know that many of the people, including the governor, the governor’s office, legislators, Department of Health — that we want to have there at the conference — they will get really busy as session starts. And so we want to be considerate of that. We also think the timing is important to bring in some of the best researchers and innovative ideas before session starts, to maybe inform some of the discussion.
Kellams: This is a question that’s not entirely fair, but as you start to use some of this grant money to do research, there’s obviously some lag time. But do you think some of the innovations can be realized in real life before the end of this five-year period?
McElfish: Absolutely. The research that I’m most interested in doing personally, and that this grant will focus on funding other researchers to do, is translational research. And so it really is testing which intervention might be best, where the women and children are getting interventions in real time. And then also implementation sciences, which is what is the most effective way to do evidence-based practice and reach people who are not otherwise reached. And so we really are interested in policy-relevant and intervention-relevant research. The term we often use in academia is translational research. How can we do translational research? We don’t need people to tell us that Arkansas has maternal health issues — we know that. We need to really be investing in what are the best solutions.
Kellams: The health of expecting mothers and their newborns and their families is obviously paramount, at the top. Is there an idea that this can have a benefit for Arkansas as a whole moving forward?
McElfish: Absolutely. I think if we can support moms and babies in that first thousand days, our population as a whole — there will be less cost, a healthier population as a whole. We also added reproductive health because we want women to have babies when they’re ready to have babies. We also want to support women in their timing and ability to have contraception access. And so being able to really look at that whole picture — a woman being healthy before she gets pregnant, a woman being able to choose when she gets pregnant, and then have a healthy pregnancy and that early part of a child’s life. We know that investment during that time will have monetary benefits in addition to health benefits.
Kellams: I think some folks might hear this and think, oh, this is the launch of the institute because of this more than $11 million grant. But there has been research and study coming out already, obviously.
McElfish: Absolutely. I just celebrated my 17th year at UAMS, which is astounding to me. It makes me feel a little old. But we’ve been doing this work for several years, and then the institute was codified about three years ago. We have more than 40 ongoing translational research, rural health projects and research in Arkansas right now. I think the wonderful thing about this new grant is that it will allow us to fund other researchers to do similar work. And so in many ways, this is less about Pearl McElfish doing wonderful research and more about how can we help influence other researchers across the state. The other wonderful thing is it is a five-year grant, but it’s renewable for up to 15 years. And so it should help advance rural research across Arkansas in maternal and reproductive health for the next 15 years and beyond.
Kellams: COBRE grants have not traditionally gone toward maternal health research, right?
McElfish: No, they really have been more basic science. So when you think about a researcher in a lab looking at cells, there have been few translational research COBREs at all. Arkansas has one other in childhood obesity, which has been very successful. But to the best of our knowledge, this is the first one in maternal health, and we know how critically important that is. It also will allow us to have influence on research that’s done across the nation, because it is the first.
Kellams: Yeah, we’re not the only state with rural populations.
McElfish: We’re not, or maternal health crisis.
Kellams: Right. Pearl, thanks so much.
McElfish: Thank you.
Kellams: Pearl McElfish is the director of the University of Arkansas for Medical Sciences’ Institute for Community Health Innovation. The $11.7 million grant from NIH will be distributed during a five-year period and, according to UAMS, will support at least three new maternal and reproductive health researchers each year. Our conversation took place last week at the Carver Center for Public Radio.
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