Racial and Ethnic Approaches to Community Health (REACH)

The Racial and Ethnic Approaches to Community Health (REACH) grant from the United States Centers for Disease Control and Prevention (CDC) focuses on reducing non-communicable diseases among racial and ethnic groups in various communities. REACH project strives to make healthy choices easier by promoting healthy behaviors and chronic disease management.

In September 2020, the Department of Family Medicine and Community Health (DFMCH) at the University of Hawai’i John A. Burns School of Medicine was awarded REACH funds to work with the United States Affiliated Pacific Islands (USAPI) on tobacco, physical activity, and community-clinical linkages policy, system, and environmental interventions. This 3-year REACH grant uses tailored community-based participatory approaches to identify and develop culturally appropriate strategies for addressing health disparities. This project strengthens the existing collaboration of the local coalitions, health departments, clinics, government agencies, community organizations, and other partners from various settings and disciplines to take action to address risk factors contributing to their chronic diseases.

The USAPI REACH project goals are to:

  1. Reduce tobacco use and exposure by implementing tobacco-free policies within worksites and traditional houses.
  2. Create activity-friendly routes to make it safe and convenient to increase access for walking, running, hiking, biking, etc.
  3. Promote and increase referral of individuals to available community health and preventive care programs through community health workers, health educators, pharmacists, and other health professionals.
Voluntary smoke-free policies from 20ft to 25ft from entrances/exits, including awnings at Micronesia Mall, and signage to include e-cigarettes and smokeless tobaccoAdd markings, directional signage and maps to improve pathways at Mangilao villageBetween Northern Region Community Health Center and the Tobacco Free Guam Quitline and Community Nutrition Education Program
Republic of the Marshalls Islands
Expand smoke-free policies at Majuro Hospital/Ministry of Health and Human Services (MOHHS), the Majuro Airport, Assumption Catholic School basketball court, the Wellness Center, and FlameTree RestaurantAdd traffic safety signs, repaint crosswalks, add speed humps and solar lights outside Marshall Islands High School, K&K Store, and Delap Elementary SchoolBetween MOHHS clinic and the Wellness Center’s 2 Weto community programs (Tur, Ioonmaaj), and KIJLE to provide tobacco cessation, exercise classes, and cooking demonstration
Republic of Palau
Strengthen and enhance Ministry of Health and Human Services (MHHS) betel nut and tobacco-free policyRerouting of traffic and adding traffic safety signs and paint markings for a Go Slow Zone at Koror Elementary School, Meketii and Airai Roads-Refer MHHS employees through the Operation Strong Wellness Program
-Between Koror Community Health Center and gardening, exercise program, and tobacco cessation
FSM Kosrae State
Increase smoke-free policy from 20ft to 50ft and ban betel nut use at the Kosrae Hospital/Department of Health Services and Department of Administration and FinanceAdd painted crosswalks and delineators, add traffic signs in Utwe Municipality and Tafunsak MunicipalityBetween Tafunsak and Utwe Community Health Centers and Tobacco Program and Behavioral Health and Wellness for tobacco cessation and Utwe Women's Organization for exercise programs
FSM Pohnpei State
Develop new or strengthen existing tobacco-free policies at municipal “nahs” (traditional houses) through resolutions-Repaint crosswalks and install traffic signs at 10 schools
-Add distance markers and pedestrian safety measures at Dekehtik Causeway
Establish referral between Lukop and Pohnlangas Health Dispensaries, and the following community programs: Island Food Community of Pohnpei, Lien Alem (substance abuse counseling, exercise, walking groups, nutrition counseling, and farming/planting), Rainbow Zumba, Madol Trekkers, and Lien Ononleng

Major intervention activities to reach goals include:

  • Conducting community assessments pre- and post-intervention.
  • Securing and continuing partnerships with local coalition groups, government agencies, health programs, and other stakeholders to develop and carry out action plans and sustain the project.
  • Conducting workshops and educational training for department staff, coalitions, and other stakeholders.
  • Disseminating monthly messages through the media (newspaper, radio, bulletins) and social media (Facebook) to increase knowledge and awareness and for the promotion of REACH interventions.
  • Creating linguistically and culturally appropriate signage.
  • Monitoring and evaluating the progress of the intervention activities and the effectiveness of the program at achieving its outcomes

Current USAPI REACH staff:

  • Guam: Mr. Kin Guerrero
  • RMI: Ms. Lise Johnson
  • Palau: Ms. Carla Ngirailemesang
  • Kosrae State, FSM: Ms. Jacoline Esau
  • Pohnpei State, FSM: Ms. Bernolina Hedson
REACH Group Photo 2023
REACH Group Photo 2023


Digital Stories:

Guam’s tobacco-free video

Palau’s tobacco-free video

Pohnpei’s physical activity video

List of publications:

  1. Sy A, Tareg A, Nitta M, et al. Feasibility of Healthy Beverages Policies in American Samoa and Federated States of Micronesia: Water and Coconut Water Only Community Interventions. Health Promotion Practice. 2023;24(1)doi:https://doi.org/10.1177/1524839923115942
  2. Hyatt A, Chan B, Moodie R, et al. Strengthening cancer control in the South Pacific through coalition-building: a co-design framework. The Lancet Regional Health-Western Pacific. 2023:100681. doi:https://doi.org/10.1016/j.lanwpc.2022.100681
  3. Hadley J, Jr., Sablan E. Lessons from the Field: The Traditional Monarch of Kitti in Pohnpei Addresses the High Rates of Non-Communicable Diseases through Local Policy. Hawai’i journal of health & social welfare. Jun 1 2020;79(6 Suppl 2):6-9.  PMC7311939
  4. Tareg AC, Reichhardt MLE. Lessons from the Field: Going Local-Everybody Wins. Hawai’i journal of health & social welfare. Jun 1 2020;79(6 Suppl 2):13-18.  PMC7311945
  5. Gonzales R, Alam L, Silverio A, Navasca D. Lessons from the Field: Guam Salt Reduction Campaign. Hawai’i journal of health & social welfare. Jun 1 2020;79(6 Suppl 2):30-32.  PMC7311934
  6. Sy A, Tannis C, McIntosh S, et al. An Assessment of E-health Resources and Readiness in the Republic of the Marshall Islands: Implications for Non-communicable Disease Intervention Development. Hawai’i journal of health & social welfare. Jun 1 2020;79(6 Suppl 2):52-57.  PMC7311931
  7. Sy A, Marriott J, Tannis C, et al. A Rapid Assessment Procedure to Develop A Non-Communicable Disease Prevention Pilot Health Communications Project Using E- and M-Health Communications in Pohnpei State, Federated States of Micronesia. Hawai’i journal of health & social welfare. Jun 1 2020;79(6 Suppl 2):58-63.  PMC7311940
  8. Sarfati D, Dyer R, Sam FA, et al. Cancer control in the Pacific: big challenges facing small island states. Lancet Oncol. Aug 5 2019;doi:10.1016/S1470-2045(19)30400-0
  9. Sarfati D, Dyer R, Vivili P, et al. Cancer control in small island nations: from local challenges to global action. Lancet Oncol. Aug 5 2019;doi:10.1016/S1470-2045(19)30511-X
  10. Palafox NA, Given L, Hohman K, et al. Comprehensive cancer control planning in the Pacific: the Cancer Council of the Pacific Islands a multi-national regional coalition. Cancer Causes Control. Dec 2018;29(12):1287-1295. doi:10.1007/s10552-018-1115-z  PMC6311141
  11. Palafox NA, Reichhardt M, Taitano JR, et al. A Socio-ecological Framework for Cancer Control in the Pacific: A Community Case Study of the US Affiliated Pacific Island Jurisdictions 1997-2017. Frontiers in Public Health. 2018;6:313. doi:10.3389/fpubh.2018.00313
  12. Nitta M, Navasca D, Tareg A, Palafox NA. Cancer risk reduction in the US Affiliated Pacific Islands: Utilizing a novel policy, systems, and environmental (PSE) approach. Cancer Epidemiol. 2017;50:278-282.
  13. Nitta M, Tanner C, Narvarte K, et al. Policy, System, and Environment Strategies to Promote Physical Activity and Healthy Food Sources to Address Guam’s Disparate Non-Communicable Disease Burden. J Health Care Poor Underserved. May 2015;26(2 Suppl):96-103. doi:10.1353/hpu.2015.0057
  14. Sy AU, Heckert KA, Jamison C, Maskarinec GG, Lim A, Buenconsejo-Lum LE. Pacific CEED legacy projects and local projects: Culturally tailored promising practices to prevent breast and cervical cancer in the US affiliated Pacific Island jurisdictions. In: Joav Merrick M, MMedSci, DMSc (Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services, Jerusalem, Israel), ed. Public Health Yearbook 2013. Nova Science Pub Inc; 2014:99-114:chap 9. Health and Human Development (Joav Merrick – Series Editor – Medical Director, Ministry of Social Affairs, Jerusalem, Israel.
  15. Sy AU, Heckert KA, Buenconsejo-Lum L, Hedson J, Tamang S, Palafox N. An assessment of the Pacific Regional Cancer Coalition: outcomes and implications of a regional coalition internal and external assessment. Hawaii Med J. Nov 2011;70(11 Suppl 2):47-53.  3254227
  16. Palafox NA, Gunawardane K, Demei Y. Pacific island partnership: the Pacific Cancer Initiative. J Cancer Educ. Spring 2006;21(1 Suppl):S87-90. doi:10.1207/s15430154jce2101s_15