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Review
. 2017 Feb;43(1):54-77.
doi: 10.1177/0145721716683811.

Culturally Targeted Strategies for Diabetes Prevention in Minority Population

Pooja A Lagisetty  1   2 , Shubadra Priyadarshini  1 , Stephanie Terrell  1 , Mary Hamati  1 , Jessica Landgraf  1 , Vineet Chopra  1 , Michele Heisler  1   2
Affiliations
Review

Culturally Targeted Strategies for Diabetes Prevention in Minority Population

Pooja A Lagisetty et al. Diabetes Educ. 2017 Feb.

Abstract

Purpose The purpose of this study is to (a) assess the effectiveness of culturally tailored diabetes prevention interventions in minority populations and (b) develop a novel framework to characterize 4 key domains of culturally tailored interventions. Prevention strategies specifically tailored to the culture of ethnic minority patients may help reduce the incidence of diabetes. Methods We searched PubMed, EMBASE, and CINAHL for English-language, randomized controlled trials (RCTs) or quasi-experimental (QE) trials testing culturally tailored interventions to prevent diabetes in minority populations. Two reviewers independently extracted data and assessed risk of bias. Inductive thematic analysis was used to develop a framework with 4 domains (FiLLM: Facilitating [ie, delivering] Interventions Through Language, Location, and Message). The framework was used to assess the overall effectiveness of culturally tailored interventions. Results Thirty-four trials met eligibility criteria. Twelve studies were RCTs, and 22 were QE trials. Twenty-five out of 34 studies (74%) that used cultural tailoring demonstrated significantly improved A1C, fasting glucose, and/or weight loss. Of the 25 successful interventions, 21 (84%) incorporated at least 3 culturally targeted domains. Seven studies used all 4 domains and were all successful. The least utilized domain was delivery (4/34) of the intervention's key educational message. Conclusions Culturally tailoring interventions across the 4 domains of facilitators, language, location, and messaging can be effective in improving risk factors for progression to diabetes among ethnic minority groups. Future studies should evaluate how specific tailoring approaches work compared to usual care as well as comparative effectiveness of each tailoring domain.

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Conflict of interest statement

CONFLICTS OF INTEREST: none

Figures

Figure 1
Figure 1
FiLLM Conceptual Framework FiLLM (Facilitating interventions through Language, Location, and Messaging) Conceptual Framework. Depicts how facilitators (i.e. program deliverers) affect participant outcomes through language, location, and message.
Figure 2
Figure 2
PRISMA Flow Diagram
See this image and copyright information in PMC

References

    1. Oldroyd J, Banerjee M, Heald A, Cruickshank K. Diabetes and ethnic minorities. Postgrad Medical J. 2005;81(958):486–490. - PMC - PubMed
    1. Prevention CfDCa. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2011.
    1. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403. - PMC - PubMed
    1. Pan XR, Yang WY, Li GW, Liu J. Prevalence of diabetes and its risk factors in China, 1994. National Diabetes Prevention and Control Cooperative Group. Diabetes Care. 1997;20(11):1664–1669. - PubMed
    1. Ramachandran A, Snehalatha C, Mary S, et al. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1) Diabetologia. 2006;49(2):289–297. - PubMed