The multicultural population of Hawai'i provides a unique window into the future of health in the United States, and RMATRIX is the engine driving the research to make that future healthier for everyone.
Imagine a brilliant scientific discovery in a laboratory—a new potential treatment for diabetes. Now, imagine that discovery traveling from a researcher's bench, to a patient's bedside in a Honolulu hospital, and finally into a community health program helping a Native Hawaiian family. This journey is the heart of clinical and translational research, and in Hawai'i, a powerful program called RMATRIX is the engine making it all possible.
Established to tackle the significant health disparities affecting Native Hawaiian, Pacific Islander, and Asian communities, RMATRIX, which stands for RCMI Multidisciplinary And Translational Research Infrastructure EXpansion, has become a cornerstone of health equity efforts in the islands 2 . It represents a bold vision: to create a seamless "home" for research that quickly turns scientific breakthroughs into real-world health solutions for the people who need them most 3 .
To understand RMATRIX's mission, it helps to think of medical research as a journey across multiple stages. This journey is what scientists call translational research.
This first step moves a discovery from basic laboratory science into a potential application for human health, like testing a new drug in a clinical trial.
Here, researchers determine how well these new interventions work in controlled settings to establish evidence-based guidelines for doctors.
This crucial phase focuses on implementing proven treatments and guidelines into "real-world" community clinics, hospitals, and neighborhoods 5 .
The final step involves studying the broader factors and interventions that influence the long-term health of entire populations 5 .
RMATRIX is designed to support researchers and communities across all of these stages, with a special focus on T3 and T4 to ensure that innovations actually reach the diverse communities of Hawai'i.
Born from a grant awarded to the University of Hawai'i at Mānoa's John A. Burns School of Medicine in 2010, RMATRIX was built on the understanding that solving complex health issues requires a team effort 2 . Its structure is designed to break down traditional silos between scientific disciplines and between the university and the community.
The program is organized around several core "Key Functions" that act as a comprehensive toolkit for researchers 2 3 :
Fostering synergy between university researchers, hospital systems, and community organizations.
Actively working with community partners to ensure research addresses their most pressing health concerns.
Providing expert help to design robust studies and analyze complex data.
Developing advanced data storage and electronic health record systems to support research.
The program initially focused its efforts on six key health areas, known as the HEALTH Initiatives (Health Equity & Lifestyle Transformation in Hawai'i): Cardiovascular Health, Respiratory Health, Cancer Prevention, Nutrition & Metabolic Health (including obesity and diabetes), Perinatal and Growth/Developmental Health, and Aging & Neurocognitive Health 2 . Based on community needs, this was later refined to three core initiatives: Nutrition & Metabolic Health; Reproductive, Growth & Developmental Health; and Aging & Chronic Disease Prevention/Management 3 .
One of the most impactful elements of RMATRIX is its Pilot Project Program. This program provides crucial seed funding and support to emerging investigators, allowing them to explore innovative ideas and gather preliminary data needed to secure larger, national grants 3 .
From 2010 to 2012, RMATRIX received 55 applications and funded 18 promising pilot projects 3 . These studies were not just small academic exercises; they were the starting point for research that would have a lasting impact. The process is highly competitive, with each application undergoing a rigorous external review similar to the National Institutes of Health (NIH) process 3 .
The Pilot Project Program followed a meticulous, multi-step process to ensure its success:
The investment in these pilot projects yielded an extraordinary return. A follow-up analysis tracked the success of these investigators in the 3-5 years after their pilot awards. The data below showcases how this seed funding catalyzed major research careers and projects.
| Pilot Project Investigator's Discipline | Pilot Project Title | Subsequent Grants Secured |
|---|---|---|
| Native Hawaiian Health | PILI 'Aina Project: Partnerships to Overcome Obesity Disparities in Hawaii | 4 NIH grants, including an R01 (the NIH's most competitive research grant) 3 |
| Neurology | Neuroimaging Correlates in HIV-infected Individuals | NIH R21 grant 3 |
| Cell & Molecular Biology | Protection from Cardiac Hypertrophy via Pharmacological Inhibition of the Ion Channel TRPV1 | Department of Defense grant 3 |
| Anatomy, Biochemistry & Physiology | Correlation of Genetic Risk Factors with Gestational Diabetes and Preeclampsia in Women from Hawaii | NIH grant 3 |
| Cancer | Discrimination and Substance Abuse Among Adolescents in Hawaii | Multi-institute NIH grant 3 |
The table above demonstrates that the pilot funding was not an end, but a beginning. It provided the proof-of-concept needed to convince major national funders of the research's value. This success translated into tangible benefits for the community. The PILI 'Aina Project, for instance, directly addressed obesity disparities in Native Hawaiian communities, a clear example of research translating into community action 3 .
Beyond just funding, RMATRIX also invested in building the human capital required to sustain this work. A needs assessment survey of academic and community researchers revealed a strong desire for training in collaborative mentoring, community-engaged research, and specific skills like data monitoring and statistics 5 . In response, RMATRIX developed workshops, seminars, and webinars to meet these needs, fostering a robust research culture 5 .
| Topic Category | Specific Topic | Percentage Interested in Attending |
|---|---|---|
| Research Processes | Data monitoring | 39% |
| Community/Academic Interaction | Networking with different cultural groups | 39% |
| Research Processes | Research design and methods | 37% |
| Research Processes | Community-based intervention development | 37% |
| Community/Academic Interaction | Understanding community infrastructure/leadership | 34% |
The work supported by RMATRIX requires more than just test tubes and microscopes. It relies on a diverse set of tools and resources to bridge the gap between academia and the community.
| Tool Category | Specific Function | Example in RMATRIX |
|---|---|---|
| Community Advisory Boards (CABs) | Ensures research is culturally respectful, relevant, and aligned with community priorities 5 . | The RMATRIX CAB with 12 members from community health centers, hospitals, and academia guided all community-based efforts 5 . |
| Research Design & Biostatistics Core | Provides expert assistance in crafting rigorous study methodologies and analyzing complex data. | A Key Function that helped investigators design robust studies and interpret their results accurately 2 3 . |
| Biomedical Informatics Platform | Manages, stores, and links complex data, including electronic health records, for research purposes. | A dedicated Key Function that developed data storage and Internet-based applications for researchers 2 . |
| Regulatory Knowledge & Support | Guides researchers through the complex ethical and regulatory landscape of human subjects research. | A Key Function that helped researchers navigate ethics and regulatory challenges, particularly in community settings 2 . |
| Pilot Project Funding | Provides seed money for high-risk, high-reward ideas to generate preliminary data for larger grants. | The program that funded 18 emerging investigators, leading to numerous federal grants 3 . |
The story of RMATRIX is more than a local success; it is a model for the nation.
As one researcher noted, the multicultural and multiethnic nature of Hawai'i today may reflect what the entire U.S. mainland will look like in 20 to 30 years 2 .
By building a research infrastructure that is inherently collaborative, multidisciplinary, and deeply connected to the community, RMATRIX is not only addressing immediate health disparities in the islands but also paving the way for a more effective and equitable healthcare future for all.
Its legacy is visible in the thriving careers of the researchers it launched, the robust community-academic partnerships it sustains, and the powerful idea that the path to better health is a journey we take together, from the lab bench all the way to the family home.