Adonica Ihilani Kauwe Tuitama arrives at the library a bit late, after having survived I-15 traffic all the way from Pleasant Grove. It’s the first time this dual doctorate degrees student has met librarian Lorelei face-to-face, although they’ve worked together for the past four years. They hug and you can see that they’ve become close friends through all the tedium of searching databases, citing references and clawing through assignment details. But it’s more complex than that; the two have grown to become a support system of each other.

A native of Hawaii and the mother of four children, Adonica is a registered nurse who is currently working at Huntsman Mental Health Institute (HMHI). However, she’ll soon be transitioning to the position of Senior Nurse Research Specialist within the College of Nursing. Before becoming a nurse, Adonica attained a MBA (emphasis in accounting). In addition to working and raising her one year-old, Adonica is working on a dual doctoral degree – a D.N.P. (Doctorate of Nursing Practice) and a Ph.D. focused on diabetes in Native Hawaiians and Pacific Islander populations. “There are both high incidence and prevalence rates of diabetes in Native Hawaiian and Pacific Islander (NHPI) populations and I want to be able to treat these patients but also learn more about why this population is so prone to this disease,” explains Adonica.

Having served a medical mission in Samoa, Adonica saw first-hand how terribly impacted by diabetes the Islander populations were. “We treated patients for everything under the sun, but we saw proportionately far more patients needing care for diabetes. The sad thing was there were so many people who were going untreated,” says Adonica.

When Adonica and Lorelei first meet virtually, it was in the middle of the pandemic. “I needed some guidance on citations and other help with my dissertation. But I also needed someone to listen when I was struggling. Lorelei was there for me, providing a lifeline during what was a very isolating moment in my life,” comments Adonica.

“I feel so privileged to know Adonica,” muses Lorelei, associate librarian. “She has taught me so much; she’s amazingly resilient and tough.” Lorelei goes on to explain that their connection took a more personal twist when Adonica was working on an assignment related to cerebral palsy, a condition that Lorelei knows well. “I went through a time when I was terribly sick. I lost my memory. Coming back to work was really tough. But Adonica was there for me all along the way. She believed in me.”

Adonica has plans to graduate in the spring of 2025. And where will she go from there? “I want to teach, I want to do research, and I want to help patients who are dealing with diabetes and other illnesses. I hope to change lives. But I know I would never be at this place today if it weren’t for many angels in my life, helping when things got tough and leading me to my ultimate goal.”

Native Hawaiians and Pacific Islanders (NHPIs) are 2.5 times more likely to be diagnosed with diabetes and die from associated complications when compared to non-Hispanic whites (OMH, 2021). Additionally, NHPI have the highest rate of end-stage kidney disease (ESKD), a known complication of diabetes, of any race group in the U.S. (Na’ai & Raphael, 2019). Despite being less than 1% of the U.S. population, NHPIs account for 19.8% of people diagnosed with diabetes (Office of Minority Health, [OMH], 2021). The landscape in Utah closely mirrors the national statistics where NHPIs make up a little over 1% of the population and account for 16.9% of diabetes cases (Utah Department of Health and Human Services, Indicator Based Information System for Publick Health, 2022). In part, this disparity is known to be because of the lack of access to culturally adapted and grounded health information that accounts for their interpersonal, sociocultural and socioeconomic realities (Kaholokula, J.K. et al., 2018). Diabetes requires early detection and treatment as well as engagement in healthy self-management behaviors such as diet, exercise, medication adherence, glucose monitoring and other activities (ADCES7; Adu, M. D. et al., 2019). Evidence validates the effectiveness of diabetes self-management education and support (DSMES) to empower persons with diabetes (PWD) to manage their diabetes with self-efficacy and reduce the risk of diabetes complications and improve quality of life (Sinclair, K.A. et al., 2020). Although the value of DSMES interventions is substantiated in the literature, few NHPIs have been included in these studies, and even fewer have interventions that are culturally adapted specifically for NHPIs (Kaholokula, J. K. et al., 2014; Sinclair, K. A. et al., 2020). No known DSMES intervention for the NHPI community in Utah exists.

Serving on Adonica’s Ph.D. Committee

Michelle Litchman, PhD, FNP-BC, FAANP, FADCES, FAAN (UofU)
Nancy Allen, PhD, ANP-BC, FADCES (UofU)
Paul Estabrooks, PhD (UofU)
Eli Iacob, PhD (UofU)
Joseph Keawe’aimoku Kaholokula, PhD (University of Hawaii – Manoa)